This
page
is
part
of
the
FHIR
Specification
(v3.0.2:
(v4.0.1:
R4
-
Mixed
Normative
and
STU
3).
)
in
it's
permanent
home
(it
will
always
be
available
at
this
URL).
The
current
version
which
supercedes
this
version
is
5.0.0
.
For
a
full
list
of
available
versions,
see
the
Directory
of
published
versions
.
Page
versions:
R4
R3
R4
R3
Vocabulary
Work
Group
|
Maturity
Level
:
|
|
Use Context : Any |
This
code
system
(http://hl7.org/fhir/v3/ActReason)
(http://terminology.hl7.org/CodeSystem/v3-ActReason)
is
defined
as
part
of
HL7
v3.
Summary
| Defining URL: |
|
| Version: | 2018-08-12 |
| Name: | v3.ActReason |
| Title: | v3 Code System ActReason |
| Definition: |
A
set
of
codes
specifying
the
motivation,
cause,
or
rationale
of
an
Act,
when
such
rationale
is
not
reasonably
represented
as
an
ActRelationship
of
type
|
| OID: | 2.16.840.1.113883.5.8 (for OID based terminology systems) |
| Source Resource | XML / JSON |
This Code system is used in the following value sets:
Release
Date:
2016-11-11
2018-08-12
| Level | Code | Display | Definition |
| 1 | (_ActAccommodationReason) Abstract |
Identifies
the
reason
the
patient
is
assigned
to
this
accommodation
type
|
|
| 2 | ACCREQNA | Accommodation Requested Not Available |
Accommodation
requested
is
not
available.
|
| 2 | FLRCNV | Floor Convenience |
Accommodation
is
assigned
for
floor
convenience.
|
| 2 | MEDNEC | Medical Necessity |
Required
for
medical
reasons(s).
|
| 2 | PAT | Patient request |
The
Patient
requested
the
action
|
| 1 | (_ActCoverageReason) Abstract |
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) Abstract |
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) Abstract |
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 | 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 | deceased |
Client
deceased.
|
| 4 | REGERR | registered in error |
Client
was
registered
in
error.
|
| 3 | (_CoverageEligibilityReason) Abstract |
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 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 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 | 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 | employment benefit |
A
person
becomes
eligible
for
insurance
provided
as
an
employment
benefit
based
on
employment
status.
|
| 4 | 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 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 | 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 | 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 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 | 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 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) Abstract |
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) Abstract |
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) Abstract |
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 | 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 | OVRINCOMP | incompetency override |
To
perform
one
or
more
operations
on
information
to
which
the
patient
has
not
consented
because
deemed
incompetent
to
provide
consent.
Usage Note: Maps to v2 CON-16 Subject Competence Indicator (ID) 01791 Definition: Identifies whether the subject was deemed competent to provide consent. Refer to table HL7 Table 0136 - Yes/No Indicator and CON-23 Non-Subject Consenter Reason User-defined Table 0502 - Non-Subject Consenter Reason code NC "Subject is not competent to consent". |
| 4 | 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 | 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 | 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 | 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 | healthcare marketing |
To
perform
one
or
more
operations
on
information
for
marketing
services
and
products
related
to
health
care.
|
| 4 | 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 | CAREMGT | care management |
To
perform
analytics,
evaluation
and
other
secondary
uses
of
treatment
and
healthcare
related
information
to
manage
the
quality,
efficacy,
patient
safety,
population
health,
and
cost
effectiveness
of
healthcare
delivery.
Explicitly
excludes
the
use
of
information
to
organize
the
delivery
of
health
care
for
care
coordination
and
case
management,
or
to
provide
healthcare
treatment.
Usage Note: The concept of care management is narrower than the list of activities related to more general organizational objectives such as provider profiling, education of healthcare and non-healthcare professionals; insurance underwriting, premium rating, reinsurance; organizational legal, medical review, auditing, compliance and fraud and abuse detection; business planning, development, and restructuring; fund-raising; and customer service. Map: Maps to ISO 14265 Classification Term "Health service management and quality assurance" described as "To inform persons or processes responsible for determining the availability, quality, safety, equity and cost-effectiveness of health care services." There is a semantic gap in concepts. This classification term is described as activities, i.e., "to inform persons" or "to inform processes" rather than the rationale for performing actions/operations on information related to the activity. |
| 5 | DONAT | donation |
To
perform
one
or
more
operations
on
information
used
for
cadaveric
organ,
eye
or
tissue
donation.
|
| 5 | FRAUD | fraud |
To
perform
one
or
more
operations
on
information
used
for
fraud
detection
and
prevention
processes.
|
| 5 | GOV | government |
To
perform
one
or
more
operations
on
information
used
within
government
processes.
|
| 5 | HACCRED | health accreditation |
To
perform
one
or
more
operations
on
information
for
conducting
activities
related
to
meeting
accreditation
criteria.
|
| 5 | HCOMPL | health compliance |
To
perform
one
or
more
operations
on
information
used
for
conducting
activities
required
to
meet
a
mandate.
|
| 5 | HDECD | decedent |
To
perform
one
or
more
operations
on
information
used
for
handling
deceased
patient
matters.
|
| 5 | 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 | HDM | healthcare delivery management |
To
perform
one
or
more
actions
on
information
used
for
conducting
administrative
and
contractual
activities
by
or
on
behalf
of
organizational
entities
responsible
for
delivery
of
an
individual's
benefits
in
a
healthcare
program,
health
plan
or
insurance.
Explicitly
excludes
the
use
of
information
to
organize
the
delivery
of
health
care
for
care
coordination
and
case
management,
or
to
provide
healthcare
treatment.
Usage Note: Examples of activities conducted under this purpose of use: provider profiling, risk adjustment, underwriting, fraud and abuse, quality improvement population health and care management. Aligns with HIPAA Operation POU minus coordination of care or other treatment related activities. Similar to the description in SAMHSA Confidentiality of Substance Use Disorder Patient Records Supplemental notice of proposed rulemaking. Map: Maps to ISO 14265 Classification Term "Administration of care for an individual subject of care" described as "To inform persons or processes responsible for enabling the availability of resources or funding or permissions for providing health care services to the subject of care." However, this classification term is described as activities, i.e., "to inform persons" or "to inform processes" rather than the rationale for performing actions/operations on information related to the activity. |
| 5 | HLEGAL | legal |
To
perform
one
or
more
operations
on
information
for
conducting
activities
required
by
legal
proceeding.
|
| 5 | 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 | health program reporting |
To
perform
one
or
more
operations
on
information
used
for
conducting
activities
to
meet
program
accounting
requirements.
|
| 5 | HQUALIMP | health quality improvement |
To
perform
one
or
more
operations
on
information
used
for
conducting
administrative
activities
to
improve
health
care
quality.
|
| 5 | HSYSADMIN | health system administration |
To
perform
one
or
more
operations
on
information
to
administer
the
electronic
systems
used
for
the
delivery
of
health
care.
|
| 6 | LABELING | labeling |
To
perform
one
or
more
operations
on
information
to
assign,
persist,
and
manage
labels
to
healthcare
data
to
characterize
various
aspects,
such
as
its
security
classification,
sensitivity,
compartment,
integrity,
and
provenance;
applicable
privacy,
consent,
security,
provenance,
and
trust
policies;
and
handling
caveats
such
as
purpose
of
use,
obligations,
and
refrain
policies.
Label management includes classification of target data by constructing and binding of a label set per applicable policies, security policy information file semantics, and classification guides. Label management also includes process and procedures for subsequent revision of a label for, e.g., reclassification, downgrading classification, and declassification. Label revisions may be triggered by, e.g., expiry of classification period; changes in applicable policy, e.g., revocation of a consent directive; or changes in the governing policy domain in which the data is relocated or a copy of the data is sent. If a label is revised, an audit log should be kept and the provenance of the label changes should be tracked. |
| 6 | METAMGT | metadata management |
To
perform
one
or
more
operations
on
information
to
assign,
persist,
and
manage
metadata
to
healthcare
data
to
characterize
various
aspects
used
for
its
indexing,
discovery,
retrieval,
and
processing
by
systems,
applications,
and
end
users.
For
example,
master
index
identifier,
media
type,
and
location.
|
| 5 | 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 | MILCDM | military command |
To
perform
one
or
more
operations
on
information
for
conducting
activities
required
by
military
processes,
procedures,
policies,
or
law.
|
| 5 | 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 | patient safety |
To
perform
one
or
more
operations
on
information
in
processes
related
to
ensuring
the
safety
of
health
care.
|
| 5 | PERFMSR | performance measure |
To
perform
one
or
more
operations
on
information
used
for
monitoring
performance
of
recommended
health
care
practices
and
interventions.
|
| 5 | RECORDMGT | records management |
To
perform
one
or
more
operations
on
information
used
within
the
health
records
management
process.
|
| 5 | SYSDEV | system development |
To
perform
one
or
more
operations
on
information
to
design,
develop,
implement,
test,
or
deploy
a
healthcare
system
or
application.
|
| 6 | HTEST | test health data |
To
perform
one
or
more
operations
on
information
that
is
simulated
or
synthetic
health
data
used
for
testing
system
capabilities
outside
of
a
production
or
operational
system
environment.
Usage Note: Data marked with a HTEST security label enables an access control system to permit interfacing systems or end users provisioned with a clearance, which includes a HTEST purpose of use attribute, to test, verify, or validate that a system or application will operate in production as intended based on design specifications. |
| 5 | TRAIN | training |
To
perform
one
or
more
operations
on
information
used
in
training
and
education.
|
| 4 | 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 | 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 | coverage authorization |
To
perform
one
or
more
operations
on
information
for
conducting
prior
authorization
or
predetermination
of
coverage
for
services.
|
| 5 | 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 | 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 | 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.,
government
health
program
such
as
workers
compensation
or
health
plan)
for
confirmation
of
enrollment,
eligibility
for
specific
services,
and
any
applicable
copays.
|
| 6 | 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.
|
| 6 | MILDCRG | military discharge |
To
perform
one
or
more
operations
on
information
for
the
process
of
releasing
military
personnel
from
their
service
obligations,
which
may
include
determining
service
merit,
discharge
benefits,
and
disability
assessment.
|
| 5 | REMITADV | remittance advice |
To
perform
one
or
more
operations
on
information
about
the
amount
remitted
for
a
health
care
claim.
|
| 4 | HRESCH | healthcare research |
To
perform
one
or
more
operations
on
information
for
conducting
scientific
investigations
to
obtain
health
care
knowledge.
Use
of
the
data
iincludes
basic
and
applied
research
such
as
biomedical,
population
origin
or
ancestry,
translational
research,
and
disease,
discipline,
specialty
specific
healthcare
research
and
clinical
trial
research.
|
| 5 | BIORCH | biomedical research |
To
perform
one
or
more
operations
on
information
for
conducting
scientific
investigations
to
obtain
health
care
knowledge.
Use
of
the
data
must
be
related
to
specified
biomedical
basic
or
applied
research.
For
example,
research
on
rare
plants
to
determine
whether
biologic
properties
may
be
useful
for
pharmaceutical
development.
May
be
used
in
combination
with
clinical
trial
and
other
healthcare
research
purposes
of
use.
|
| 5 | 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.
|
| 6 | CLINTRCHNPC | clinical trial research without patient care |
To
perform
one
or
more
operations
on
information
for
conducting
scientific
investigations
in
accordance
with
clinical
trial
protocols
to
obtain
health
care
knowledge
without
provision
of
patient
care.
May
be
post-coordinated
or
used
with
other
purposes
of
use
such
as
disease,
discipline,
specialty,
population
origins
or
ancestry,
translational
healthcare
research.
For
example,
a
clinical
trial
conducted
on
laboratory
specimens
collected
from
a
specified
patient
population.
|
| 6 | CLINTRCHPC | clinical trial research with patient care |
To
perform
one
or
more
operations
on
information
for
conducting
scientific
investigations
with
patient
care
in
accordance
with
clinical
trial
protocols
to
obtain
health
care
knowledge.
May
be
post-coordinated
or
used
with
other
purposes
of
use
such
as
disease,
discipline,
specialty,
population
origins
or
ancestry,
translational
healthcare
research.
For
example,
an
"off-label"
drug
used
for
cancer
therapy
administer
to
a
specified
patient
population.
|
| 6 | PRECLINTRCH | preclinical trial research |
To
perform
one
or
more
operations
on
information
in
preparation
for
conducting
scientific
investigation
to
obtain
health
care
knowledge,
such
as
research
on
animals
or
review
of
patient
health
records,
to
determine
the
feasibility
of
a
clinical
trial
study;
assist
with
protocol
design;
or
in
preparation
for
institutional
review
board
or
ethics
committee
approval
process.
May
be
post-coordinated
or
used
with
other
purposes
of
use
such
as
disease,
discipline,
specialty,
population
origins
or
ancestry,
translational
healthcare
research.
|
| 5 | DSRCH | disease specific healthcare research |
To
perform
one
or
more
operations
on
information
for
conducting
scientific
investigations
to
obtain
health
care
knowledge.
Use
of
the
data
must
be
related
to
specified
conditions,
diagnosis,
or
disease
healthcare
research.
For
example,
conducting
cancer
research
by
testing
reaction
of
tumor
cells
to
certain
biologics.
May
be
used
in
combination
with
clinical
trial
and
other
healthcare
research
purposes
of
use.
|
| 5 | POARCH | population origins or ancestry healthcare research |
To
perform
one
or
more
operations
on
information,
including
genealogical
pedigrees,
historical
records,
surveys,
family
health
data,
health
records,
and
genetic
information,
for
conducting
scientific
investigations
to
obtain
health
care
knowledge.
Use
of
the
data
must
be
related
to
population
origins
and/or
ancestry
healthcare
research.
For
example,
gathering
genetic
specimens
from
a
specific
population
in
order
to
determine
the
ancestry
and
population
origins
of
that
group.
May
be
used
in
combination
with
clinical
trial
and
other
healthcare
research
purposes
of
use.
|
| 5 | TRANSRCH | translational healthcare research |
To
perform
one
or
more
operations
on
information
for
conducting
scientific
investigations
to
obtain
health
care
knowledge
related
to
evidence
based
medicine
during
the
course
of
providing
healthcare
treatment.
Sometimes
referred
to
as
"bench
to
bedside",
which
is
the
iterative
feedback
loop
between
healthcare
research
and
clinical
trials
with
input
from
information
collected
in
the
course
of
routine
provision
of
healthcare.
For
example,
by
extending
a
patient
encounter
to
conduct
a
survey
related
to
a
research
topic
such
as
attitudes
about
use
of
a
wellness
device
that
a
patient
agreed
to
use.
May
be
used
in
combination
with
clinical
trial
and
other
healthcare
research
purposes
of
use.
|
| 4 | PATRQT | patient requested |
To
perform
one
or
more
operations
on
information
in
response
to
a
patient's
request.
|
| 5 | 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 | 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 | support network |
To
perform
one
or
more
operations
on
information
in
response
to
a
request
by
a
person
authorized
by
the
patient.
|
| 4 | 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 |
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 |
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 | treatment |
To
perform
one
or
more
operations
on
information
for
provision
of
health
care.
|
| 5 |
|
clinical trial |
To
perform
health
care
as
part
of
the
clinical
trial
protocol.
|
| 5 | COC | coordination of care |
To
perform
one
or
more
actions
on
information
in
order
to
organize
the
provision
and
case
management
of
an
individual’s
healthcare,
including:
Monitoring
a
person's
goals,
needs,
and
preferences;
acting
as
the
communication
link
between
two
or
more
participants
concerned
with
a
person's
health
and
wellness;
organizing
and
facilitating
care
activities
and
promoting
self-management
by
advocating
for,
empowering,
and
educating
a
person;
and
ensuring
safe,
appropriate,
non-duplicative,
and
effective
integrated
care.
Usage Note: Use when describing these functions: 1. Monitoring a person’s goals, needs, and preferences. 2. Acting as the communication link between two or more participants concerned with a person's health and wellness. 3. Organizing and facilitating care activities and promoting self-management by advocating for, empowering, and educating a person. 4. Ensuring safe, appropriate, non-duplicative, and effective integrated care. The goal is to clearly differentiate this type of coordination of care from HIPAA Operations by specifying that these actions on information are undertaken in the provision of healthcare treatment. For similar uses of this concept, see SAMHSA Confidentiality of Substance Use Disorder Patient Records Supplemental notice of proposed rulemaking, which differentiates concepts of care coordination and case management for the provision of treatment as specifically distinct from activities related to health care delivery management and the operations of organizational entities involved in the delivery of healthcare. Map: Maps to ISO 14265 Classification Terms: "Support of care activities within the provider organisation for an individual subject of care" described as "To inform persons or processes enabling others to provide health care services to the subject of care." "Subject of Care |
| 5 | ETREAT | Emergency Treatment |
To
perform
one
or
more
operations
on
information
for
provision
of
immediately
needed
health
care
|
|
|
|
|
To
perform
policy
override
operations
on
information
for
provision
of
immediately
needed
health
care
for
an
emergent
condition
affecting
potential
harm,
death
or
patient
safety
by
end
users
who
are
not
provisioned
for
this
purpose
of
use.
Includes
override
of
organizational
provisioning
policies
and
may
include
override
of
subject
of
care
consent
directive
restricting
access.
Map: Partially Maps to ISO 14265 Classification Term "Emergency care provision to an individual subject of care" described as "To inform persons needing to provide health care services to the subject of care urgently, possibly needing to over-ride the policies and consents pertaining to Purpose 1 above." Purpose 1 is equivalent to HL7 treatment purpose of use: "Clinical care provision to an individual subject of care" described as |
|
|
|
|
To
perform
one
or
more
operations
on
information
for
provision
of
immediately
needed
health
care
for
an
emergent
Map:Partially Maps to ISO 14265 Classification Term "Emergency care provision to an individual subject of care" described as "To inform persons needing to provide health care services to the subject of care urgently, possibly needing to over-ride the policies and consents pertaining to Purpose 1 above." Purpose 1 is equivalent to HL7 treatment purpose of use: "Clinical care provision to an individual subject of care" described as "To inform persons or processes responsible for providing health care services to the subject of care." The ISO description conflates both of the proposed specializations of HL7 ETREAT: break the glass and the typically broader access to health information normally available to providers who are provisioned for emergency workflows on a regular basis, e.g., Emergency Room providers. Examples of greater access than is normally accessible by providers based on the need to know are access to sensitive information for which access typically requires a patient's consent. This is not an override of a patient's dissent to disclose sensitive information in cases where the applicable policy waives the need for that consent to access this information. In US, Title 38 Section 7332 and 42 CFR Part 2 both permit emergency access without the need to override a patient's consent directive; rather, this access is a limitation to the patient's right to dissent from disclosure. There is a semantic gap in concepts. This classification term is described as activities “to inform persons� rather than the rationale for performing actions/operations on information related to the activity. |
| 5 | POPHLTH | population health |
To
perform
one
or
more
operations
on
information
for
provision
of
health
care
to
a
population
of
living
subjects,
e.g.,
needle
exchange
program.
|
| 2 | (_ActInformationPrivacyReason) Abstract |
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 | marketing |
Description:
|
| 3 | OPERAT | operations |
Description:Administrative
and
contractual
processes
required
to
support
an
activity,
product,
or
service
|
| 4 | LEGAL | subpoena |
Definition:To
provide
information
as
a
result
of
a
subpoena.
|
| 4 | 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 | compliance |
Description:Operational
activities
required
to
meet
a
mandate
related
to
an
activity,
product,
or
service
|
| 4 | ENADMIN | entity administration |
Description:Operational
activities
conducted
to
administer
information
relating
to
entities
involves
with
an
activity,
product,
or
service
|
| 4 | OUTCOMS | outcome measure |
Description:Operational
activities
conducted
for
the
purposes
of
assessing
the
results
of
an
activity,
product,
or
service
|
| 4 | PRGRPT | program reporting |
Description:Operational
activities
conducted
to
meet
program
accounting
requirements
related
to
an
activity,
product,
or
service
|
| 4 | QUALIMP | quality improvement |
Description:Operational
activities
conducted
for
the
purposes
of
improving
the
quality
of
an
activity,
product,
or
service
|
| 4 | SYSADMN | system administration |
Description:Operational
activities
conducted
to
administer
the
electronic
systems
used
for
an
activity,
product,
or
service
|
| 3 | PAYMT | payment |
Description:Administrative,
financial,
and
contractual
processes
related
to
payment
for
an
activity,
product,
or
service
|
| 3 | RESCH | research |
Description:Investigative
activities
conducted
for
the
purposes
of
obtaining
knowledge
|
| 3 | 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 | adverse storage condition |
Description:
Storage
conditions
caused
the
substance
to
be
ineffective.
|
| 3 | COLDCHNBRK | cold chain break |
Description:
Cold
chain
was
not
maintained
for
the
substance.
|
| 2 | EXPLOT | expired lot |
Description:
The
lot
from
which
the
substance
was
drawn
was
expired.
|
| 2 | OUTSIDESCHED | administered outside recommended schedule or practice |
The
substance
was
administered
outside
of
the
recommended
schedule
or
practice.
|
| 2 | PRODRECALL | product recall |
Description:
The
substance
was
recalled
by
the
manufacturer.
|
| 1 | (_ActInvoiceCancelReason) Abstract |
Domain
specifies
the
codes
used
to
describe
reasons
why
a
Provider
is
cancelling
an
Invoice
or
Invoice
Grouping.
|
|
| 2 | INCCOVPTY | incorrect covered party as patient |
The
covered
party
(patient)
specified
with
the
Invoice
is
not
correct.
|
| 2 | 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 | incorrect policy |
The
policy
specified
with
the
Invoice
is
not
correct.
For
example,
it
may
belong
to
another
Adjudicator
or
Covered
Party.
|
| 2 | INCPROV | incorrect provider |
The
provider
specified
with
the
Invoice
is
not
correct.
|
| 1 | (_ActNoImmunizationReason) Abstract |
A
coded
description
of
the
reason
for
why
a
patient
did
not
receive
a
scheduled
immunization.
(important for public health strategy |
|
| 2 | IMMUNE | immunity |
Definition:Testing
has
shown
that
the
patient
already
has
immunity
to
the
agent
targeted
by
the
immunization.
|
| 2 | 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 | product out of stock |
Definition:There
was
no
supply
of
the
product
on
hand
to
perform
the
service.
|
| 2 | PATOBJ | patient objection |
Definition:The
patient
or
their
guardian
objects
to
receiving
the
vaccine.
|
| 2 | PHILISOP | philosophical objection |
Definition:The
patient
or
their
guardian
objects
to
receiving
the
vaccine
because
of
philosophical
beliefs.
|
| 2 | RELIG | religious objection |
Definition:The
patient
or
their
guardian
objects
to
receiving
the
vaccine
on
religious
grounds.
|
| 2 | 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 | vaccine safety concerns |
Definition:The
patient
or
their
guardian
objects
to
receiving
the
vaccine
because
of
concerns
over
its
safety.
|
| 1 | (_ActSupplyFulfillmentRefusalReason) Abstract |
Indicates
why
a
fulfiller
refused
to
fulfill
a
supply
order,
and
considered
it
important
to
notify
other
providers
of
their
decision.
E.g.
(used when capturing 'refusal to fill' annotations) |
|
| 2 | 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 | stale-dated order |
Definition:Order
has
not
been
fulfilled
within
a
reasonable
amount
of
time,
and
may
not
be
current.
|
| 2 | 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 | product unavailable |
Definition:Product
not
available
or
manufactured.
Cannot
supply.
|
| 2 | FRR05 | ethical/religious |
Definition:The
dispenser
has
ethical,
religious
or
moral
objections
to
fulfilling
the
order/dispensing
the
product.
|
| 2 | 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) Abstract |
Definition:Specifies
the
reason
that
an
event
occurred
in
a
clinical
research
study.
|
|
| 2 | 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 | scheduled |
Definition:The
event
occurred
due
to
it
being
scheduled
in
the
research
protocol.
|
| 2 | TRM | termination |
Definition:The
event
occurred
in
order
to
terminate
the
subject's
participation
in
the
study.
|
| 2 | 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) Abstract |
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 | non-protocol |
Definition:The
observation
or
test
was
neither
defined
or
scheduled
in
the
study
protocol.
|
| 2 | 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 | per definition |
: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) Abstract |
Description:Indicates
why
the
prescription
should
be
suspended.
|
|
| 2 | 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 | prescription requires clarification |
Description:Clarification
is
required
before
the
order
can
be
acted
upon.
|
| 2 | 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 | admission to hospital |
Description:The
patient
has
been
admitted
to
a
care
facility
and
their
community
medications
are
suspended
until
hospital
discharge.
|
| 2 | 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 | 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 | 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 | 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 | 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 | 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 | 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 | 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 | 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 | 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 | entered in error |
Description:The
information
was
recorded
incorrectly
or
was
recorded
in
the
wrong
record.
|
| 2 | NORECMTCH | no record match |
Description:
There
is
no
match
for
the
record
in
the
database.
|
| 1 | (_ControlActNullificationRefusalReasonType) Abstract |
Description:
Reasons
to
refuse
a
transaction
to
be
undone.
|
|
| 2 | INRQSTATE | in requested state |
The
record
is
already
in
the
requested
state.
|
| 2 | NOMATCH | no match |
Description:
There
is
no
match.
|
| 3 | NORECMTCH | ||
| 3 | NOPRODMTCH | no product match |
Description:
There
is
no
match
for
the
product
in
the
master
file
repository.
|
| 3 | NOSERMTCH | no service match |
Description:
There
is
no
match
for
the
service
in
the
master
file
repository.
|
| 3 | NOVERMTCH | no version match |
Description:
There
is
no
match
for
the
record
and
version.
|
| 2 | NOPERM | no permission |
Description:
There
is
no
permission.
|
| 3 | NOUSERPERM | no user permission |
Definition:The
user
does
not
have
permission
|
| 3 | 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 | wrong version |
Description:
The
record
and
version
requested
to
update
is
not
the
current
version.
|
| 1 | (_ControlActReason) Abstract |
Identifies
why
a
specific
query,
request,
or
other
trigger
event
occurred.
|
|
| 2 | (_MedicationOrderAbortReasonCode) Abstract |
Description:Indicates
the
reason
the
medication
order
should
be
aborted.
|
|
| 3 | DISCONT | product discontinued |
Description:The
medication
is
no
longer
being
manufactured
or
is
otherwise
no
longer
available.
|
| 3 | INEFFECT | ineffective |
Description:The
therapy
has
been
found
to
not
have
the
desired
therapeutic
benefit
on
the
patient.
|
| 3 | 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 | 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 | not covered |
Description:The
product
does
not
have
(or
no
longer
has)
coverage
under
the
patientaTMs
insurance
policy.
|
| 3 | PREFUS | patient refuse |
Description:The
patient
refused
to
take
the
product.
|
| 3 | RECALL | product recalled |
Description:The
manufacturer
or
other
agency
has
requested
that
stocks
of
a
medication
be
removed
from
circulation.
|
| 3 | 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 | change in medication/dose |
Description:The
medication
is
being
re-prescribed
at
a
different
dosage.
|
| 3 | 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 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) Abstract |
Definition:A
collection
of
concepts
that
indicate
why
the
prescription
should
be
released
from
suspended
state.
|
|
| 3 | HOLDDONE | suspend reason no longer applies |
Definition:The
original
reason
for
suspending
the
medication
has
ended.
|
| 3 | HOLDINAP | suspend reason inappropriate |
Definition:
|
| 2 | (_ModifyPrescriptionReasonType) Abstract |
Types
of
reason
why
a
prescription
is
being
changed.
|
|
| 3 | ADMINERROR | administrative error in order |
Order
was
created
with
incorrect
data
and
is
changed
to
reflect
the
intended
accuracy
of
the
order.
|
| 3 | CLINMOD | clinical modification |
Order
is
changed
based
on
a
clinical
reason.
|
| 2 | _PharmacySupplyEventAbortReason | PharmacySupplyEventAbortReason |
Definition:Identifies
why
the
dispense
event
was
not
completed.
|
| 3 | CONTRA | contraindication |
Definition:Contraindication
identified
|
| 3 | FOABORT | order aborted |
Definition:Order
to
be
fulfilled
was
aborted
|
| 3 | FOSUSP | order suspended |
Definition:Order
to
be
fulfilled
was
suspended
|
| 3 | NOPICK | not picked up |
Definition:Patient
did
not
come
to
get
medication
|
| 3 | PATDEC | patient changed mind |
Definition:Patient
changed
their
mind
regarding
obtaining
medication
|
| 3 | QUANTCHG | change supply quantity |
Definition:Patient
requested
a
revised
quantity
of
medication
|
| 2 | (_PharmacySupplyEventStockReasonCode) Abstract |
Definition:A
collection
of
concepts
that
indicates
the
reason
for
a
|
|
| 3 | 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 | long term care use |
Definition:The
bulk
supply
will
be
administered
within
a
long
term
care
facility.
|
| 3 | OFFICE | office use |
Definition:The
bulk
supply
is
intended
for
general
clinician
office
use.
|
| 3 | PHARM | pharmacy transfer |
Definition:The
bulk
supply
is
being
transferred
to
another
dispensing
facility
to.
Example:Alleviate a temporary shortage. |
| 3 | PROG | program use |
Definition:The
bulk
supply
is
intended
for
dispensing
according
to
a
specific
program.
Example:Mass immunization. |
| 2 | (_PharmacySupplyRequestRenewalRefusalReasonCode) Abstract |
Definition:A
collection
of
concepts
that
identifies
why
a
renewal
prescription
has
been
refused.
|
|
| 3 | DISCONT | ||
| 3 | ALREADYRX | new prescription exists |
Definition:Patient
has
already
been
given
a
new
(renewal)
prescription.
|
| 3 | FAMPHYS | family physician must authorize further fills |
Definition:Request
for
further
authorization
must
be
done
through
patient's
family
physician.
|
| 3 | MODIFY | modified prescription exists |
Definition:Therapy
has
been
changed
and
new
prescription
issued
|
| 3 | NEEDAPMT | patient must make appointment |
Definition:Patient
must
see
prescriber
prior
to
further
fills.
|
| 3 | 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 | patient no longer in this practice |
Definition:Patient
no
longer
or
has
never
been
under
this
prescribers
care.
|
| 3 | ONHOLD | medication on hold |
Definition:This
medication
is
on
hold.
|
| 3 | PRNA | product not available |
Description:This
product
is
not
available
or
manufactured.
|
| 3 | STOPMED | prescriber stopped medication for patient |
Renewing
or
original
prescriber
informed
patient
to
stop
using
the
medication.
|
| 3 | TOOEARLY | too early |
Definition:The
patient
should
have
medication
remaining.
|
| 2 | (_SupplyOrderAbortReasonCode) Abstract |
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 | condition improved |
Definition:The
patient's
medical
condition
has
nearly
abated.
|
| 3 | INTOL | intolerance |
Description:The
patient
has
an
intolerance
to
the
medication.
|
| 3 | NEWSTR | new strength |
Definition:The
current
medication
will
be
replaced
by
a
new
strength
of
the
same
medication.
|
| 3 | NEWTHER | new therapy |
Definition:A
new
therapy
will
be
commenced
when
current
supply
exhausted.
|
| 1 | (_GenericUpdateReasonCode) Abstract |
Description:Identifies
why
a
change
is
being
made
to
a
record.
|
|
| 2 | CHGDATA | information change |
Description:Information
has
changed
since
the
record
was
created.
|
| 2 | FIXDATA | error correction |
Description:Previously
recorded
information
was
erroneous
and
is
being
corrected.
|
| 2 | MDATA | merge data |
Information
is
combined
into
the
record.
|
| 2 | NEWDATA | new information |
Description:New
information
has
become
available
to
supplement
the
record.
|
| 2 | UMDATA | unmerge data |
Information
is
separated
from
the
record.
|
| 1 | (_PatientProfileQueryReasonCode) Abstract |
Definition:A
collection
of
concepts
identifying
why
the
patient's
profile
is
being
queried.
|
|
| 2 | ADMREV | administrative review |
Definition:
To
evaluate
for
service
authorization,
payment,
reporting,
or
performance/outcome
measures.
|
| 2 | LEGAL | ||
| 2 | PATCAR | patient care |
Definition:To
obtain
records
as
part
of
patient
care.
|
| 2 | PATREQ | patient request query |
Definition:Patient
requests
information
from
their
profile.
|
| 2 | PRCREV | practice review |
Definition:To
evaluate
the
provider's
current
practice
for
professional-improvement
reasons.
|
| 2 | REGUL | regulatory review |
Description:Review
for
the
purpose
of
regulatory
compliance.
|
| 2 | RSRCH | research |
Definition:To
provide
research
data,
as
authorized
by
the
patient.
|
| 2 | 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 |
Definition:The
prescription
may
not
be
reassigned
from
the
original
pharmacy.
|
| 2 | NOUSERPERM | ||
| 2 | UNKWNTARGET | unknown target |
Definition:The
target
facility
does
not
recognize
the
dispensing
facility.
|
| 1 | (_RefusalReasonCode) Abstract |
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) Abstract |
Reasons
for
cancelling
or
rescheduling
an
Appointment
|
|
| 2 | PAT | ||
| 2 | BLK | Unexpected Block (of Schedule) |
The
time
slots
previously
allocated
are
now
blocked
and
no
longer
available
for
booking
Appointments
|
| 2 | DEC | Patient Deceased |
The
Patient
is
deceased
|
| 2 | FIN | No Financial Backing |
Patient
unable
to
pay
and
not
covered
by
insurance
|
| 2 | MED | Medical Status Altered |
The
medical
condition
of
the
Patient
has
changed
|
| 2 | 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 | 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 | 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 | patient not eligible |
Definition:Patient
not
eligible
for
drug
|
| 2 | PROTUNMET | protocol not met |
Definition:Patient
does
not
meet
required
protocol
|
| 2 | PROVUNAUTH | provider not authorized |
Definition:Provider
is
not
authorized
to
prescribe
or
dispense
|
| 1 | (_SubstanceAdminSubstitutionNotAllowedReason) Abstract |
Reasons
why
substitution
of
a
substance
administration
request
is
not
permitted.
|
|
| 2 | PAT | ||
| 2 | ALGINT | allergy intolerance |
Definition:
Patient
has
had
a
prior
allergic
intolerance
response
to
alternate
product
or
one
of
its
components.
|
| 2 | COMPCON | compliance concern |
Definition:
Patient
has
compliance
issues
with
medication
such
as
differing
appearance,
flavor,
size,
shape
or
consistency.
|
| 2 | THERCHAR | therapeutic characteristics |
The
prescribed
product
has
specific
clinical
release
or
other
therapeutic
characteristics
not
shared
by
other
substitutable
medications.
|
| 2 | TRIAL | clinical trial drug |
Definition:
The
specific
manufactured
drug
is
part
of
a
clinical
trial.
|
| 1 | (_SubstanceAdminSubstitutionReason) Abstract | ||
| 2 | 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 | formulary policy |
Indicates
that
the
decision
to
substitute
or
to
not
substitute
was
driven
by
a
policy
expressed
within
the
formulary.
|
| 2 | 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 | 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) Abstract |
The
explanation
for
why
a
patient
is
moved
from
one
location
to
another
within
the
organization
|
|
| 2 | ER | Error |
Moved
to
an
error
in
placing
the
patient
in
the
original
location.
|
| 2 | RQ | Request |
Moved
at
the
request
of
the
patient.
|
| 1 | (_ActBillableServiceReason) Abstract |
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) Abstract |
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 |
®©
HL7.org
2011+.
FHIR
Release
3
(STU;
v3.0.2-11200)
4
(Technical
Correction
#1)
(v4.0.1)
generated
on
Thurs,
Oct
24,
Fri,
Nov
1,
2019
11:53+1100.
09:38+1100.
QA
Page
Links:
Search
|
Version
History
|
Table
of
Contents
|
Credits
|
Compare
to
DSTU2
R3
|
|
Propose
a
change
Terminology