| ActCode [2.16.840.1.113883.5.4] Description: A code specifying the particular kind of Act that the Act-instance represents within its class. Constraints: The kind of Act (e.g. physical examination, serum potassium, inpatient encounter, charge financial transaction, etc.) is specified with a code from one of several, typically external, coding systems. The coding system will depend on the class of Act, such as LOINC for observations, etc. Conceptually, the Act.code must be a specialization of the Act.classCode. This is why the structure of ActClass domain should be reflected in the superstructure of the ActCode domain and then individual codes or externally referenced vocabularies subordinated under these domains that reflect the ActClass structure. Act.classCode and Act.code are not modifiers of each other but the Act.code concept should really imply the Act.classCode concept. For a negative example, it is not appropriate to use an Act.code "potassium" together with and Act.classCode for "laboratory observation" to somehow mean "potassium laboratory observation" and then use the same Act.code for "potassium" together with Act.classCode for "medication" to mean "substitution of potassium". This mutually modifying use of Act.code and Act.classCode is not permitted. |
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| Lvl- Typ | Concept Code Head Code-defined Value Set |
Print Name | Definition, Properties, Relationships |
|---|---|---|---|
| 0-L | C | corrected |
Definition: Description:Indicates that result data has been corrected. |
| 0-S | DIET v:ActDietCode |
Diet |
Definition: Code set to define specialized/allowed diets Concept Relationships: |
| 1-L | . BR | breikost (GE) |
Definition: A diet exclusively composed of oatmeal, semolina, or rice, to be extremely easy to eat and digest. Concept Relationships: |
| 1-L | . DM | diabetes mellitus diet |
Definition: A diet that uses carbohydrates sparingly. Typically with a restriction in daily energy content (e.g. 1600-2000 kcal). Concept Relationships: |
| 1-L | . FAST | fasting |
Definition: No enteral intake of foot or liquids whatsoever, no smoking. Typically 6 to 8 hours before anesthesia. Concept Relationships: |
| 1-L | . GF | gluten free |
Definition: Gluten free diet for celiac disease. Concept Relationships: |
| 1-L | . LF | low fat |
Definition: A diet low in fat, particularly to patients with hepatic diseases. Concept Relationships: |
| 1-L | . LP | low protein |
Definition: A low protein diet for patients with renal failure. Concept Relationships: |
| 1-L | . LQ | liquid |
Definition: A strictly liquid diet, that can be fully absorbed in the intestine, and therefore may not contain fiber. Used before enteral surgeries. Concept Relationships: |
| 1-L | . LS | low sodium |
Definition: A diet low in sodium for patients with congestive heart failure and/or renal failure. Concept Relationships: |
| 1-L | . N | normal diet |
Definition: A normal diet, i.e. no special preparations or restrictions for medical reasons. This is notwithstanding any preferences the patient might have regarding special foods, such as vegetarian, kosher, etc. Concept Relationships: |
| 1-L | . NF | no fat |
Definition: A no fat diet for acute hepatic diseases. Concept Relationships: |
| 1-L | . PAF | phenylalanine free |
Definition: Phenylketonuria diet. Concept Relationships: |
| 1-L | . PAR | parenteral |
Definition: Patient is supplied with parenteral nutrition, typically described in terms of i.v. medications. Concept Relationships: |
| 1-L | . RD | reduction diet |
Definition: A diet that seeks to reduce body fat, typically low energy content (800-1600 kcal). Concept Relationships: |
| 1-L | . SCH | schonkost (GE) |
Definition: A diet that avoids ingredients that might cause digestion problems, e.g., avoid excessive fat, avoid too much fiber (cabbage, peas, beans). Concept Relationships: |
| 1-L | . T | tea only |
Definition: This is not really a diet, since it contains little nutritional value, but is essentially just water. Used before coloscopy examinations. Concept Relationships: |
| 1-L | . VLI | low valin, leucin, isoleucin |
Definition: Diet with low content of the amino-acids valin, leucin, and isoleucin, for "maple syrup disease." Concept Relationships: |
| 0-L | DRUGPRG | drug program |
Definition: Definition: A public or government health program that administers and funds coverage for prescription drugs to assist program eligible who meet financial and health status criteria. |
| 0-L | F | final |
Definition: Description:Indicates that a result is complete. No further results are to come. This maps to the 'complete' state in the observation result status code. |
| 0-L | PRLMN | preliminary |
Definition: Description:Indicates that a result is incomplete. There are further results to come. This maps to the 'active' state in the observation result status code. |
| 0-L | STORE | Storage |
DEPRECATED from further use in HL7 designs, effective with Vocabulary release 637-20081220. Definition: The act of putting something away for safe keeping. The "something" may be physical object such as a specimen, or information, such as observations regarding a specimen. |
| 0-L | SUBSIDFFS | subsidized fee for service program |
Definition: Definition: A government health program that provides coverage on a fee for service basis for health services to persons meeting eligibility criteria such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds. Discussion: The structure and business processes for underwriting and administering a subsidized fee for service program is further specified by the Underwriter and Payer Role.class and Role.code. |
| 0-L | WRKCOMP | (workers compensation program |
Definition: Definition: Government mandated program providing coverage, disability income, and vocational rehabilitation for injuries sustained in the work place or in the course of employment. Employers may either self-fund the program, purchase commercial coverage, or pay a premium to a government entity that administers the program. Employees may be required to pay premiums toward the cost of coverage as well. |
| 0-A | _ActAccountCode v:ActAccountCode |
ActAccountCode |
Definition: An account represents a grouping of financial transactions that are tracked and reported together with a single balance. Examples of account codes (types) are Patient billing accounts (collection of charges), Cost centers; Cash. Concept Relationships: |
| 1-L | . ACCTRECEIVABLE | account receivable |
Definition: An account for collecting charges, reversals, adjustments and payments, including deductibles, copayments, coinsurance (financial transactions) credited or debited to the account receivable account for a patient's encounter. Concept Relationships: |
| 1-L | . CASH | Cash |
Concept Relationships: |
| 1-S | . CC . v:CreditCard |
credit card |
Definition: Description: Types of advance payment to be made on a plastic card usually issued by a financial institution used of purchasing services and/or products. Concept Relationships: |
| 2-L | . . AE | American Express |
Concept Relationships: |
| 2-L | . . DN | Diner's Club |
Concept Relationships: |
| 2-L | . . DV | Discover Card |
Concept Relationships: |
| 2-L | . . MC | Master Card |
Concept Relationships: |
| 2-L | . . V | Visa |
Concept Relationships: |
| 1-L | . PBILLACCT | patient billing account |
Definition: An account representing charges and credits (financial transactions) for a patient's encounter. Concept Relationships: |
| 0-A | _ActAdjudicationCode v:ActAdjudicationCode |
ActAdjudicationCode |
Definition: Includes coded responses that will occur as a result of the adjudication of an electronic invoice at a summary level and provides guidance on interpretation of the referenced adjudication results. Concept Relationships: |
| 1-S | . AA . v:AdjudicatedWithAdjustments |
adjudicated with adjustments |
Definition: The invoice element has been accepted for payment but one or more adjustment(s) have been made to one or more invoice element line items (component charges). Also includes the concept 'Adjudicate as zero' and items not covered under a particular Policy. Invoice element can be reversed (nullified). Recommend that the invoice element is saved for DUR (Drug Utilization Reporting). Concept Relationships: |
| 2-L | . . ANF | adjudicated with adjustments and no financial impact |
Definition: The invoice element has been accepted for payment but one or more adjustment(s) have been made to one or more invoice element line items (component charges) without changing the amount. Invoice element can be reversed (nullified). Recommend that the invoice element is saved for DUR (Drug Utilization Reporting). Concept Relationships: |
| 1-L | . AR | adjudicated as refused |
Definition: The invoice element has passed through the adjudication process but payment is refused due to one or more reasons. Includes items such as patient not covered, or invoice element is not constructed according to payer rules (e.g. 'invoice submitted too late'). If one invoice element line item in the invoice element structure is rejected, the remaining line items may not be adjudicated and the complete group is treated as rejected. A refused invoice element can be forwarded to the next payer (for Coordination of Benefits) or modified and resubmitted to refusing payer. Invoice element cannot be reversed (nullified) as there is nothing to reverse. Recommend that the invoice element is not saved for DUR (Drug Utilization Reporting). Concept Relationships: |
| 1-L | . AS | adjudicated as submitted |
Definition: The invoice element was/will be paid exactly as submitted, without financial adjustment(s). If the dollar amount stays the same, but the billing codes have been amended or financial adjustments have been applied through the adjudication process, the invoice element is treated as "Adjudicated with Adjustment". If information items are included in the adjudication results that do not affect the monetary amounts paid, then this is still Adjudicated as Submitted (e.g. 'reached Plan Maximum on this Claim'). Invoice element can be reversed (nullified). Recommend that the invoice element is saved for DUR (Drug Utilization Reporting). Concept Relationships: |
| 1-A | . _ActAdjudicationGroupCode . v:ActAdjudicationGroupCode |
ActAdjudicationGroupCode |
Definition: Catagorization of grouping criteria for the associated transactions and/or summary (totals, subtotals). Concept Relationships: |
| 2-L | . . CONT | contract |
Definition: Transaction counts and value totals by Contract Identifier. Concept Relationships: |
| 2-L | . . DAY | day |
Definition: Transaction counts and value totals for each calendar day within the date range specified. Concept Relationships: |
| 2-L | . . LOC | location |
Definition: Transaction counts and value totals by service location (e.g clinic). Concept Relationships: |
| 2-L | . . MONTH | month |
Definition: Transaction counts and value totals for each calendar month within the date range specified. Concept Relationships: |
| 2-L | . . PERIOD | period |
Definition: Transaction counts and value totals for the date range specified. Concept Relationships: |
| 2-L | . . PROV | provider |
Definition: Transaction counts and value totals by Provider Identifier. Concept Relationships: |
| 2-L | . . WEEK | week |
Definition: Transaction counts and value totals for each calendar week within the date range specified. Concept Relationships: |
| 2-L | . . YEAR | year |
Definition: Transaction counts and value totals for each calendar year within the date range specified. Concept Relationships: |
| 0-A | _ActAdjudicationResultActionCode v:ActAdjudicationResultActionCode |
ActAdjudicationResultActionCode |
Definition: Actions to be carried out by the recipient of the Adjudication Result information. Concept Relationships: |
| 1-L | . DISPLAY | Display |
Definition: The adjudication result associated is to be displayed to the receiver of the adjudication result. Concept Relationships: |
| 1-L | . FORM | Print on Form |
Definition: The adjudication result associated is to be printed on the specified form, which is then provided to the covered party. Concept Relationships: |
| 0-A | _ActBillableModifierCode v:ActBillableModifierCode |
ActBillableModifierCode |
Definition: Definition:An identifying modifier code for healthcare interventions or procedures. Concept Relationships: |
| 1-L | . CPTM | CPT modifier codes |
Definition: Description:CPT modifier codes are found in Appendix A of CPT 2000 Standard Edition. Concept Relationships: |
| 1-L | . HCPCSA | HCPCS Level II and Carrier-assigned |
Definition: Description:HCPCS Level II (HCFA-assigned) and Carrier-assigned (Level III) modifiers are reported in Appendix A of CPT 2000 Standard Edition and in the Medicare Bulletin. Concept Relationships: |
| 0-A | _ActBillingArrangementCode v:ActBillingArrangementCode |
ActBillingArrangementCode |
Definition: The type of provision(s) made for reimbursing for the deliver of healthcare services and/or goods provided by a Provider, over a specified period. Concept Relationships: |
| 1-L | . BLK | block funding |
Definition: A billing arrangement where a Provider charges a lump sum to provide a prescribed group (volume) of services to a single patient which occur over a period of time. Services included in the block may vary. This billing arrangement is also known as Program of Care for some specific Payors and Program Fees for other Payors. Concept Relationships: |
| 1-L | . CAP | capitation funding |
Definition: A billing arrangement where the payment made to a Provider is determined by analyzing one or more demographic attributes about the persons/patients who are enrolled with the Provider (in their practice). Concept Relationships: |
| 1-L | . CONTF | contract funding |
Definition: A billing arrangement where a Provider charges a lump sum to provide a particular volume of one or more interventions/procedures or groups of interventions/procedures. Concept Relationships: |
| 1-L | . FINBILL | financial |
Definition: A billing arrangement where a Provider charges for non-clinical items. This includes interest in arrears, mileage, etc. Clinical content is not included in Invoices submitted with this type of billing arrangement. Concept Relationships: |
| 1-L | . ROST | roster funding |
Definition: A billing arrangement where funding is based on a list of individuals registered as patients of the Provider. Concept Relationships: |
| 1-L | . SESS | sessional funding |
Definition: A billing arrangement where a Provider charges a sum to provide a group (volume) of interventions/procedures to one or more patients within a defined period of time, typically on the same date. Interventions/procedures included in the session may vary. Concept Relationships: |
| 0-A | _ActBoundedROICode v:ActBoundedROICode |
ActBoundedROICode |
Definition: Type of bounded ROI. Concept Relationships: |
| 1-L | . ROIFS | fully specified ROI |
Definition: A fully specified bounded Region of Interest (ROI) delineates a ROI in which only those dimensions participate that are specified by boundary criteria, whereas all other dimensions are excluded. For example a ROI to mark an episode of "ST elevation" in a subset of the EKG leads V2, V3, and V4 would include 4 boundaries, one each for time, V2, V3, and V4. Concept Relationships: |
| 1-L | . ROIPS | partially specified ROI |
Definition: A partially specified bounded Region of Interest (ROI) specifies a ROI in which at least all values in the dimensions specified by the boundary criteria participate. For example, if an episode of ventricular fibrillations (VFib) is observed, it usually doesn't make sense to exclude any EKG leads from the observation and the partially specified ROI would contain only one boundary for time indicating the time interval where VFib was observed. Concept Relationships: |
| 0-A | _ActCareProvisionCode v:ActCareProvisionCode |
act care provision |
Definition: Description:The type and scope of responsibility taken-on by the performer of the Act for a specific subject of care. Concept Relationships: |
| 1-A | . _ActCredentialedCareCode . v:ActCredentialedCareCode |
act credentialed care |
Definition: Description:The type and scope of legal and/or professional responsibility taken-on by the performer of the Act for a specific subject of care as described by a credentialing agency, i.e. government or non-government agency. Failure in executing this Act may result in loss of credential to the person or organization who participates as performer of the Act. Excludes employment agreements. Example:Hospital license; physician license; clinic accreditation. Concept Relationships: |
| 2-A | . . _ActCredentialedCareProvisionPersonCode . . v:ActCredentialedCareProvisionPersonCode |
act credentialed care provision peron |
Definition: Description:The type and scope of legal and/or professional responsibility taken-on by the performer of the Act for a specific subject of care as described by an agency for credentialing individuals. Concept Relationships: |
| 3-L | . . . CACC | certified anatomic pathology and clinical pathology care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CAIC | certified allergy and immunology care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CAMC | certified aerospace medicine care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CANC | certified anesthesiology care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CAPC | certified anatomic pathology care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CBGC | certified clinical biochemical genetics care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CCCC | certified clinical cytogenetics care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CCGC | certified clinical genetics (M.D.) care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CCPC | certified clinical pathology care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CCSC | certified colon and rectal surgery care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CDEC | certified dermatology care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CDRC | certified diagnostic radiology care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CEMC | certified emergency medicine care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CFPC | certified family practice care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CIMC | certified internal medicine care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CMGC | certified clinical molecular genetics care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CNEC | certified neurology care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board Concept Relationships: |
| 3-L | . . . CNMC | certified nuclear medicine care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CNQC | certified neurology with special qualifications in child neurology care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CNSC | certified neurological surgery care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . COGC | certified obstetrics and gynecology care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . COMC | certified occupational medicine care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . COPC | certified ophthalmology care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . COSC | certified orthopaedic surgery care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . COTC | certified otolaryngology care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CPEC | certified pediatrics care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CPGC | certified Ph.D. medical genetics care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CPHC | certified public health and general preventive medicine care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CPRC | certified physical medicine and rehabilitation care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CPSC | certified plastic surgery care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CPYC | certified psychiatry care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CROC | certified radiation oncology care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CRPC | certified radiological physics care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CSUC | certified surgery care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CTSC | certified thoracic surgery care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CURC | certified urology care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . CVSC | certified vascular surgery care |
Definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. Concept Relationships: |
| 3-L | . . . LGPC | licensed general physician care |
Definition: Description:Scope of responsibility taken-on for physician care of a patient as defined by a governmental licensing agency. Concept Relationships: |
| 2-A | . . _ActCredentialedCareProvisionProgramCode . . v:ActCredentialedCareProvisionProgramCode |
act credentialed care provision program |
Definition: Description:The type and scope of legal and/or professional responsibility taken-on by the performer of the Act for a specific subject of care as described by an agency for credentialing programs within organizations. Concept Relationships: |
| 3-L | . . . AALC | accredited assisted living care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency. Concept Relationships: |
| 3-L | . . . AAMC | accredited ambulatory care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency. Concept Relationships: |
| 3-L | . . . ABHC | accredited behavioral health care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency. Concept Relationships: |
| 3-L | . . . ACAC | accredited critical access hospital care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency. Concept Relationships: |
| 3-L | . . . ACHC | accredited hospital care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency. Concept Relationships: |
| 3-L | . . . AHOC | accredited home care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency. Concept Relationships: |
| 3-L | . . . ALTC | accredited long term care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency. Concept Relationships: |
| 3-L | . . . AOSC | accredited office-based surgery care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency. Concept Relationships: |
| 3-L | . . . CACS | certified acute coronary syndrome care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CAMI | certified acute myocardial infarction care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CAST | certified asthma care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CBAR | certified bariatric surgery care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CCAD | certified coronary artery disease care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CCAR | certified cardiac care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CDEP | certified depression care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CDGD | certified digestive/gastrointestinal disorders care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CDIA | certified diabetes care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CEPI | certified epilepsy care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CFEL | certified frail elderly care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CHFC | certified heart failure care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CHRO | certified high risk obstetrics care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CHYP | certified hyperlipidemia care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CMIH | certified migraine headache care |
Definition: Description:. Concept Relationships: |
| 3-L | . . . CMSC | certified multiple sclerosis care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . COJR | certified orthopedic joint replacement care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CONC | certified oncology care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . COPD | certified chronic obstructive pulmonary disease care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CORT | certified organ transplant care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CPAD | certified parkinsons disease care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CPND | certified pneumonia disease care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CPST | certified primary stroke center care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CSDM | certified stroke disease management care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CSIC | certified sickle cell care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CSLD | certified sleep disorders care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CSPT | certified spine treatment care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CTBU | certified trauma/burn center care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CVDC | certified vascular diseases care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CWMA | certified wound management care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 3-L | . . . CWOH | certified women's health care |
Definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. Concept Relationships: |
| 1-A | . _ActEncounterCode . v:ActEncounterCode |
ActEncounterCode |
Definition: Domain provides codes that qualify the ActEncounterClass (ENC) Concept Relationships: |
| 2-L | . . AMB | ambulatory |
Definition: A comprehensive term for health care provided in a healthcare facility (e.g. a practitioneraTMs office, clinic setting, or hospital) on a nonresident basis. The term ambulatory usually implies that the patient has come to the location and is not assigned to a bed. Sometimes referred to as an outpatient encounter. Concept Relationships: |
| 2-L | . . EMER | emergency |
Definition: A patient encounter that takes place at a dedicated healthcare service delivery location where the patient receives immediate evaluation and treatment, provided until the patient can be discharged or responsibility for the patient's care is transferred elsewhere (for example, the patient could be admitted as an inpatient or transferred to another facility.) Concept Relationships: |
| 2-L | . . FLD | field |
Definition: A patient encounter that takes place both outside a dedicated service delivery location and outside a patient's residence. Example locations might include an accident site and at a supermarket. Concept Relationships: |
| 2-L | . . HH | home health |
Definition: Healthcare encounter that takes place in the residence of the patient or a designee Concept Relationships: |
| 2-S | . . IMP . . v:ActInpatientEncounterCode |
inpatient encounter |
Definition: A patient encounter where a patient is admitted by a hospital or equivalent facility, assigned to a location where patients generally stay at least overnight and provided with room, board, and continuous nursing service. Concept Relationships: |
| 3-L | . . . ACUTE | inpatient acute |
Definition: An acute inpatient encounter. Concept Relationships: |
| 3-L | . . . NONAC | inpatient non-acute |
Definition: Any category of inpatient encounter except 'acute' Concept Relationships: |
| 2-L | . . SS | short stay |
Definition: An encounter where the patient is admitted to a health care facility for a predetermined length of time, usually less than 24 hours. Concept Relationships: |
| 2-L | . . VR | virtual |
Definition: A patient encounter where the patient and the practitioner(s) are not in the same physical location. Examples include telephone conference, email exchange, robotic surgery, and televideo conference. Concept Relationships: |
| 1-A | . _ActMedicalServiceCode . v:ActMedicalServiceCode |
ActMedicalServiceCode |
Definition: General category of medical service provided to the patient during their encounter. Concept Relationships: |
| 2-L | . . ALC | Alternative Level of Care |
Definition: Provision of Alternate Level of Care to a patient in an acute bed. Patient is waiting for placement in a long-term care facility and is unable to return home. Concept Relationships: |
| 2-L | . . CARD | Cardiology |
Definition: Provision of diagnosis and treatment of diseases and disorders affecting the heart Concept Relationships: |
| 2-L | . . CHR | Chronic |
Definition: Provision of recurring care for chronic illness. Concept Relationships: |
| 2-L | . . DNTL | Dental |
Definition: Provision of treatment for oral health and/or dental surgery. Concept Relationships: |
| 2-L | . . DRGRHB | Drug Rehab |
Definition: Provision of treatment for drug abuse. Concept Relationships: |
| 2-L | . . GENRL | General |
Definition: General care performed by a general practitioner or family doctor as a responsible provider for a patient. Concept Relationships: |
| 2-L | . . MED | Medical |
Definition: Provision of diagnostic and/or therapeutic treatment. Concept Relationships: |
| 2-L | . . OBS | Obstetrics |
Definition: Provision of care of women during pregnancy, childbirth and immediate postpartum period. Also known as Maternity. Concept Relationships: |
| 2-L | . . ONC | Oncology |
Definition: Provision of treatment and/or diagnosis related to tumors and/or cancer. Concept Relationships: |
| 2-L | . . PALL | Palliative |
Definition: Provision of care for patients who are living or dying from an advanced illness. Concept Relationships: |
| 2-L | . . PED | Pediatrics |
Definition: Provision of diagnosis and treatment of diseases and disorders affecting children. Concept Relationships: |
| 2-L | . . PHAR | Pharmaceutical |
Definition: Pharmaceutical care performed by a pharmacist. Concept Relationships: |
| 2-L | . . PHYRHB | Physical Rehab |
Definition: Provision of treatment for physical injury. Concept Relationships: |
| 2-L | . . PSYCH | Psychiatric |
Definition: Provision of treatment of psychiatric disorder relating to mental illness. Concept Relationships: |
| 2-L | . . SURG | Surgical |
Definition: Provision of surgical treatment. Concept Relationships: |
| 0-A | _ActClaimAttachmentCategoryCode v:ActClaimAttachmentCategoryCode |
ActClaimAttachmentCategoryCode |
Definition: Description: Coded types of attachments included to support a healthcare claim. Concept Relationships: |
| 1-L | . AUTOATTCH | auto attachment |
Definition: Description: Automobile Information Attachment Concept Relationships: |
| 1-L | . DOCUMENT | document |
Definition: Description: Document Attachment Concept Relationships: |
| 1-L | . HEALTHREC | health record |
Definition: Description: Health Record Attachment Concept Relationships: |
| 1-L | . IMG | image |
Definition: Description: Image Attachment Concept Relationships: |
| 1-L | . LABRESULTS | lab results |
Definition: Description: Lab Results Attachment Concept Relationships: |
| 1-L | . MODEL | model |
Definition: Description: Digital Model Attachment Concept Relationships: |
| 1-L | . WIATTCH | work injury report attachment |
Definition: Description: Work Injury related additional Information Attachment Concept Relationships: |
| 1-L | . XRAY | x-ray |
Definition: Description: Digital X-Ray Attachment Concept Relationships: |
| 0-A | _ActConsentType v:ActConsentType |
ActConsentType |
Definition: Definition: The type of consent directive, e.g., to consent or dissent to collect, access, or use in specific ways within an EHRS or for health information exchange; or to disclose health information for purposes such as research. Concept Relationships: |
| 1-L | . ICOL | information collection |
Definition: Definition: Consent to have healthcare information collected in an electronic health record. This entails that the information may be used in analysis, modified, updated. Concept Relationships: |
| 1-L | . IDSCL | information disclosure |
Definition: Definition: Consent to have collected healthcare information disclosed. Concept Relationships: |
| 1-S | . INFA . v:ActInformationAccess |
information access |
Definition: Definition: Consent to access healthcare information. Concept Relationships: |
| 2-L | . . INFAO | access only |
Definition: Definition: Consent to access or "read" only, which entails that the information is not to be copied, screen printed, saved, emailed, stored, re-disclosed or altered in any way. This level ensures that data which is masked or to which access is restricted will not be. Example: Opened and then emailed or screen printed for use outside of the consent directive purpose. Concept Relationships: |
| 2-L | . . INFASO | access and save only |
Definition: Definition: Consent to access and save only, which entails that access to the saved copy will remain locked. Concept Relationships: |
| 1-L | . IRDSCL | information redisclosure |
Definition: Definition: Information re-disclosed without the patient's consent. Concept Relationships: |
| 1-S | . RESEARCH . v:ActResearchInformationAccess |
research information access |
Definition: Definition: Consent to have healthcare information in an electronic health record accessed for research purposes. Concept Relationships: |
| 2-L | . . RSDID | de-identified information access |
Definition: Definition: Consent to have de-identified healthcare information in an electronic health record that is accessed for research purposes, but without consent to re-identify the information under any circumstance. Concept Relationships: |
| 2-L | . . RSREID | re-identifiable information access |
Definition: Definition: Consent to have de-identified healthcare information in an electronic health record that is accessed for research purposes re-identified under specific circumstances outlined in the consent. Example:: Where there is a need to inform the subject of potential health issues. Concept Relationships: |
| 0-A | _ActContainerRegistrationCode v:ActContainerRegistrationCode |
ActContainerRegistrationCode |
Definition: Constrains the ActCode to the domain of Container Registration Concept Relationships: |
| 1-L | . ID | Identified |
Definition: Used by one system to inform another that it has received a container. Concept Relationships: |
| 1-L | . IP | In Position |
Definition: Used by one system to inform another that the container is in position for specimen transfer (e.g., container removal from track, pipetting, etc.). Concept Relationships: |
| 1-L | . L | Left Equipment |
Definition: Used by one system to inform another that the container has been released from that system. Concept Relationships: |
| 1-L | . M | Missing |
Definition: Used by one system to inform another that the container did not arrive at its next expected location. Concept Relationships: |
| 1-L | . O | In Process |
Definition: Used by one system to inform another that the specific container is being processed by the equipment. It is useful as a response to a query about Container Status, when the specific step of the process is not relevant. Concept Relationships: |
| 1-L | . R | Process Completed |
Definition: Status is used by one system to inform another that the processing has been completed, but the container has not been released from that system. Concept Relationships: |
| 1-L | . X | Container Unavailable |
Definition: Used by one system to inform another that the container is no longer available within the scope of the system (e.g., tube broken or discarded). Concept Relationships: |
| 0-A | _ActControlVariable v:ActControlVariable |
ActControlVariable |
Definition: An observation form that determines parameters or attributes of an Act. Examples are the settings of a ventilator machine as parameters of a ventilator treatment act; the controls on dillution factors of a chemical analyzer as a parameter of a laboratory observation act; the settings of a physiologic measurement assembly (e.g., time skew) or the position of the body while measuring blood pressure. Control variables are forms of observations because just as with clinical observations, the Observation.code determines the parameter and the Observation.value assigns the value. While control variables sometimes can be observed (by noting the control settings or an actually measured feedback loop) they are not primary observations, in the sense that a control variable without a primary act is of no use (e.g., it makes no sense to record a blood pressure position without recording a blood pressure, whereas it does make sense to record a systolic blood pressure without a diastolic blood pressure). Concept Relationships: |
| 1-L | . AUTO | auto-repeat permission |
Definition: Specifies whether or not automatic repeat testing is to be initiated on specimens. Concept Relationships: |
| 1-L | . ENDC | endogenous content |
Definition: A baseline value for the measured test that is inherently contained in the diluent. In the calculation of the actual result for the measured test, this baseline value is normally considered. Concept Relationships: |
| 1-L | . REFLEX | reflex permission |
Definition: Specifies whether or not further testing may be automatically or manually initiated on specimens. Concept Relationships: |
| 0-A | _ActCoverageConfirmationCode v:ActCoverageConfirmationCode |
ActCoverageConfirmationCode |
Definition: Response to an insurance coverage eligibility query or authorization request. Concept Relationships: |
| 1-A | . _ActCoverageAuthorizationConfirmationCode . v:ActCoverageAuthorizationConfirmationCode |
ActCoverageAuthorizationConfirmationCode |
Definition: Indication of authorization for healthcare service(s) and/or product(s). If authorization is approved, funds are set aside. Concept Relationships: |
| 2-L | . . AUTH | Authorized |
Definition: Authorization approved and funds have been set aside to pay for specified healthcare service(s) and/or product(s) within defined criteria for the authorization. Concept Relationships: |
| 2-L | . . NAUTH | Not Authorized |
Definition: Authorization for specified healthcare service(s) and/or product(s) denied. Concept Relationships: |
| 0-A | _ActCoverageLimitCode v:ActCoverageLimitCode |
ActCoverageLimitCode |
Definition: Criteria that are applicable to the authorized coverage. Concept Relationships: |
| 1-S | . COVMX . v:ActCoverageMaximaCodes |
coverage maximum |
Definition: Definition: Codes representing the maximum coverate or financial participation requirements. Concept Relationships: |
| 2-L | . . LFEMX | life time maximum |
Definition: Definition: Maximum amount paid by payer or covered party; or maximum number of services or products covered under the policy or program during a covered party's lifetime. Concept Relationships: |
| 2-L | . . PRDMX | period maximum |
Definition: Definition: Maximum amount paid by payer or covered party; or maximum number of services/products covered under the policy or program by time period specified by the effective time on the act. Concept Relationships: |
| 1-A | . _ActCoverageQuantityLimitCode . v:ActCoverageQuantityLimitCode |
ActCoverageQuantityLimitCode |
Definition: Maximum amount paid or maximum number of services/products covered; or maximum amount or number covered during a specified time period under the policy or program. Concept Relationships: |
| 2-L | . . COVPRD | coverage period |
Definition: Codes representing the time period during which coverage is available; or financial participation requirements are in effect. Concept Relationships: |
| 2-L | . . LFEMX | life time maximum |
Definition: Definition: Maximum amount paid by payer or covered party; or maximum number of services or products covered under the policy or program during a covered party's lifetime. Concept Relationships: |
| 2-L | . . NETAMT | Net Amount |
Definition: Maximum net amount that will be covered for the product or service specified. Concept Relationships: |
| 2-L | . . PRDMX | period maximum |
Definition: Definition: Maximum amount paid by payer or covered party; or maximum number of services/products covered under the policy or program by time period specified by the effective time on the act. Concept Relationships: |
| 2-L | . . UNITPRICE | Unit Price |
Definition: Maximum unit price that will be covered for the authorized product or service. Concept Relationships: |
| 2-L | . . UNITQTY | Unit Quantity |
Definition: Maximum number of items that will be covered of the product or service specified. Concept Relationships: |
| 0-A | _ActCoverageTypeCode v:ActCoverageTypeCode |
ActCoverageTypeCode |
Definition: Definition: Set of codes indicating the type of insurance policy or program that pays for the cost of benefits provided to covered parties. Concept Relationships: |
| 1-A | . _ActInsurancePolicyCode . v:ActInsurancePolicyCode |
ActInsurancePolicyCode |
Definition: Set of codes indicating the type of insurance policy or other source of funds to cover healthcare costs. Concept Relationships: |
| 2-S | . . AUTOPOL . . v:AutomobileInsurancePolicy |
automobile |
Definition: Insurance policy for injuries sustained in an automobile accident. Will also typically covered non-named parties to the policy, such as pedestrians and passengers. Concept Relationships: |
| 3-L | . . . COL | collision coverage policy |
Definition: Definition: An automobile insurance policy under which the insurance company will cover the cost of damages to an automobile owned by the named insured that are caused by accident or intentionally by another party. Concept Relationships: |
| 3-L | . . . UNINSMOT | uninsured motorist policy |
Definition: Definition: An automobile insurance policy under which the insurance company will indemnify a loss for which another motorist is liable if that motorist is unable to pay because he or she is uninsured. Coverage under the policy applies to bodily injury damages only. Injuries to the covered party caused by a hit-and-run driver are also covered. Concept Relationships: |
| 2-L | . . EHCPOL | extended healthcare |
Definition: Private insurance policy that provides coverage in addition to other policies (e.g. in addition to a Public Healthcare insurance policy). Concept Relationships: |
| 2-L | . . HSAPOL | health spending account |
Definition: Insurance policy that provides for an allotment of funds replenished on a periodic (e.g. annual) basis. The use of the funds under this policy is at the discretion of the covered party. Concept Relationships: |
| 2-S | . . PUBLICPOL . . v:PublicHealthcareProgram |
public healthcare |
Definition: Insurance policy funded by a public health system such as a provincial or national health plan. Examples include BC MSP (British Columbia Medical Services Plan) OHIP (Ontario Health Insurance Plan), NHS (National Health Service). Concept Relationships: |
| 3-L | . . . DENTPRG | dental program |
Definition: Definition: A public or government health program that administers and funds coverage for dental care to assist program eligible who meet financial and health status criteria. Concept Relationships: |
| 3-S | . . . DISEASEPRG . . . v:DiseaseProgram |
disease program |
Definition: Definition: A public or government health program that administers and funds coverage for health and social services to assist program eligible who meet financial and health status criteria related to a particular disease. Example: Reproductive health, sexually transmitted disease, and end renal disease programs. Concept Relationships: |
| 4-L | . . . . CANPRG | disease program |
Definition: Definition: A program that provides low-income, uninsured, and underserved women access to timely, high-quality screening and diagnostic services, to detect breast and cervical cancer at the earliest stages. Example: To improve women's access to screening for breast and cervical cancers, Congress passed the Breast and Cervical Cancer Mortality Prevention Act of 1990, which guided CDC in creating the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), which provides access to critical breast and cervical cancer screening services for underserved women in the United States. An estimated 7 to 10% of U.S. women of screening age are eligible to receive NBCCEDP services. Federal guidelines establish an eligibility baseline to direct services to uninsured and underinsured women at or below 250% of federal poverty level; ages 18 to 64 for cervical screening; ages 40 to 64 for breast screening. Concept Relationships: |
| 4-L | . . . . ENDRENAL | end renal program |
Definition: Definition: A public or government program that administers publicly funded coverage of kidney dialysis and kidney transplant services. Example: In the U.S., the Medicare End-stage Renal Disease program (ESRD), the National Kidney Foundation (NKF) American Kidney Fund (AKF) The Organ Transplant Fund. Concept Relationships: |
| 4-L | . . . . HIVAIDS | HIV-AIDS program |
Definition: Definition: Government administered and funded HIV-AIDS program for beneficiaries meeting financial and health status criteria. Administration, funding levels, eligibility criteria, covered benefits, provider types, and financial participation are typically set by a regulatory process. Payer responsibilities for administering the program may be delegated to contractors. Example: In the U.S., the Ryan White program, which is administered by the Health Resources and Services Administration. Concept Relationships: |
| 3-L | . . . MANDPOL | mandatory health program |
Concept Relationships: |
| 3-L | . . . MENTPRG | mental health program |
Definition: Definition: Government administered and funded mental health program for beneficiaries meeting financial and mental health status criteria. Administration, funding levels, eligibility criteria, covered benefits, provider types, and financial participation are typically set by a regulatory process. Payer responsibilities for administering the program may be delegated to contractors. Example: In the U.S., states receive funding for substance use programs from the Substance Abuse Mental Health Administration (SAMHSA). Concept Relationships: |
| 3-L | . . . SAFNET | safety net clinic program |
Definition: Definition: Government administered and funded program to support provision of care to underserved populations through safety net clinics. Example: In the U.S., safety net providers such as federally qualified health centers (FQHC) receive funding under PHSA Section 330 grants administered by the Health Resources and Services Administration. Concept Relationships: |
| 3-L | . . . SUBPRG | substance use program |
Definition: Definition: Government administered and funded substance use program for beneficiaries meeting financial, substance use behavior, and health status criteria. Beneficiaries may be required to enroll as a result of legal proceedings. Administration, funding levels, eligibility criteria, covered benefits, provider types, and financial participation are typically set by a regulatory process. Payer responsibilities for administering the program may be delegated to contractors. Example: In the U.S., states receive funding for substance use programs from the Substance Abuse Mental Health Administration (SAMHSA). Concept Relationships: |
| 3-S | . . . SUBSIDIZ . . . v:SubsidizedHealthProgram |
subsidized health program |
Definition: Definition: A government health program that provides coverage for health services to persons meeting eligibility criteria such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds. Concept Relationships: |
| 4-L | . . . . SUBSIDMC | subsidized managed care program |
Definition: Definition: A government health program that provides coverage through managed care contracts for health services to persons meeting eligibility criteria such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds. Discussion: The structure and business processes for underwriting and administering a subsidized managed care program is further specified by the Underwriter and Payer Role.class and Role.code. Concept Relationships: |
| 4-L | . . . . SUBSUPP | subsidized supplemental health program |
Definition: Definition: A government health program that provides coverage for health services to persons meeting eligibility criteria for a supplemental health policy or program such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds. Example: Supplemental health coverage program may cover the cost of a health program or policy financial participations, such as the copays and the premiums, and may provide coverage for services in addition to those covered under the supplemented health program or policy. In the U.S., Medicaid programs may pay the premium for a covered party who is also covered under the Medicare program or a private health policy. Discussion: The structure and business processes for underwriting and administering a subsidized supplemental retiree health program is further specified by the Underwriter and Payer Role.class and Role.code. Concept Relationships: |
| 2-L | . . WCBPOL | worker's compensation |
Definition: Insurance policy for injuries sustained in the work place or in the course of employment. Concept Relationships: |
| 1-A | . _ActInsuranceTypeCode . v:ActInsuranceTypeCode |
ActInsuranceTypeCode |
Definition: Definition: Set of codes indicating the type of insurance policy. Insurance, in law and economics, is a form of risk management primarily used to hedge against the risk of potential financial loss. Insurance is defined as the equitable transfer of the risk of a potential loss, from one entity to another, in exchange for a premium and duty of care. A policy holder is an individual or an organization enters into a contract with an underwriter which stipulates that, in exchange for payment of a sum of money (a premium), one or more covered parties (insureds) is guaranteed compensation for losses resulting from certain perils under specified conditions. The underwriter analyzes the risk of loss, makes a decision as to whether the risk is insurable, and prices the premium accordingly. A policy provides benefits that indemnify or cover the cost of a loss incurred by a covered party, and may include coverage for services required to remediate a loss. An insurance policy contains pertinent facts about the policy holder, the insurance coverage, the covered parties, and the insurer. A policy may include exemptions and provisions specifying the extent to which the indemnification clause cannot be enforced for intentional tortious conduct of a covered party, e.g., whether the covered parties are jointly or severably insured. Discussion: In contrast to programs, an insurance policy has one or more policy holders, who own the policy. The policy holder may be the covered party, a relative of the covered party, a partnership, or a corporation, e.g., an employer. A subscriber of a self-insured health insurance policy is a policy holder. A subscriber of an employer sponsored health insurance policy is holds a certificate of coverage, but is not a policy holder; the policy holder is the employer. See CoveredRoleType. Concept Relationships: |
| 2-S | . . AUTOPOL . . v:AutomobileInsurancePolicy |
automobile |
Definition: Insurance policy for injuries sustained in an automobile accident. Will also typically covered non-named parties to the policy, such as pedestrians and passengers. Concept Relationships: |
| 3-L | . . . COL | collision coverage policy |
Definition: Definition: An automobile insurance policy under which the insurance company will cover the cost of damages to an automobile owned by the named insured that are caused by accident or intentionally by another party. Concept Relationships: |
| 3-L | . . . UNINSMOT | uninsured motorist policy |
Definition: Definition: An automobile insurance policy under which the insurance company will indemnify a loss for which another motorist is liable if that motorist is unable to pay because he or she is uninsured. Coverage under the policy applies to bodily injury damages only. Injuries to the covered party caused by a hit-and-run driver are also covered. Concept Relationships: |
| 2-L | . . DIS | disability insurance policy |
Definition: Definition: An insurance policy that provides a regular payment to compensate for income lost due to the covered party's inability to work because of illness or injury. Concept Relationships: |
| 2-L | . . EWB | employee welfare benefit plan policy |
Definition: Definition: An insurance policy under a benefit plan run by an employer or employee organization for the purpose of providing benefits other than pension-related to employees and their families. Typically provides health-related benefits, benefits for disability, disease or unemployment, or day care and scholarship benefits, among others. An employer sponsored health policy includes coverage of health care expenses arising from sickness or accidental injury, coverage for on-site medical clinics or for dental or vision benefits, which are typically provided under a separate policy. Coverage excludes health care expenses covered by accident or disability, workers' compensation, liability or automobile insurance. Concept Relationships: |
| 2-L | . . FLEXP | flexible benefit plan policy |
Definition: Definition: An insurance policy that covers qualified benefits under a Flexible Benefit plan such as group medical insurance, long and short term disability income insurance, group term life insurance for employees only up to $50,000 face amount, specified disease coverage such as a cancer policy, dental and/or vision insurance, hospital indemnity insurance, accidental death and dismemberment insurance, a medical expense reimbursement plan and a dependent care reimbursement plan. Discussion: See UnderwriterRoleTypeCode flexible benefit plan which is defined as a benefit plan that allows employees to choose from several life, health, disability, dental, and other insurance plans according to their individual needs. Also known as cafeteria plans. Authorized under Section 125 of the Revenue Act of 1978. Concept Relationships: |
| 2-S | . . LIFE . . v:LifeInsurancePolicy |
life insurance policy |
Definition: Definition: A policy under which the insurer agrees to pay a sum of money upon the occurrence of the covered partys death. In return, the policyholder agrees to pay a stipulated amount called a premium at regular intervals. Life insurance indemnifies the beneficiary for the loss of the insurable interest that a beneficiary has in the life of a covered party. For persons related by blood, a substantial interest established through love and affection, and for all other persons, a lawful and substantial economic interest in having the life of the insured continue. An insurable interest is required when purchasing life insurance on another person. Specific exclusions are often written into the contract to limit the liability of the insurer; for example claims resulting from suicide or relating to war, riot and civil commotion. Discussion:A life insurance policy may be used by the covered party as a source of health care coverage in the case of a viatical settlement, which is the sale of a life insurance policy by the policy owner, before the policy matures. Such a sale, at a price discounted from the face amount of the policy but usually in excess of the premiums paid or current cash surrender value, provides the seller an immediate cash settlement. Generally, viatical settlements involve insured individuals with a life expectancy of less than two years. In countries without state-subsidized healthcare and high healthcare costs (e.g. United States), this is a practical way to pay extremely high health insurance premiums that severely ill people face. Some people are also familiar with life settlements, which are similar transactions but involve insureds with longer life expectancies (two to fifteen years). Concept Relationships: |
| 3-L | . . . ANNU | annuity policy |
Definition: Definition: A policy that, after an initial premium or premiums, pays out a sum at pre-determined intervals. For example, a policy holder may pay $10,000, and in return receive $150 each month until he dies; or $1,000 for each of 14 years or death benefits if he dies before the full term of the annuity has elapsed. Concept Relationships: |
| 3-L | . . . TLIFE | term life insurance policy |
Definition: Definition: Life insurance under which the benefit is payable only if the insured dies during a specified period. If an insured dies during that period, the beneficiary receives the death payments. If the insured survives, the policy ends and the beneficiary receives nothing. Concept Relationships: |
| 3-L | . . . ULIFE | universal life insurance policy |
Definition: Definition: Life insurance under which the benefit is payable upon the insuredaTMs death or diagnosis of a terminal illness. If an insured dies during that period, the beneficiary receives the death payments. If the insured survives, the policy ends and the beneficiary receives nothing Concept Relationships: |
| 2-L | . . PNC | property and casualty insurance policy |
Definition: Definition: A type of insurance that covers damage to or loss of the policyholderaTMs property by providing payments for damages to property damage or the injury or death of living subjects. The terms "casualty" and "liability" insurance are often used interchangeably. Both cover the policyholder's legal liability for damages caused to other persons and/or their property. Concept Relationships: |
| 2-L | . . REI | reinsurance policy |
Definition: Definition: An agreement between two or more insurance companies by which the risk of loss is proportioned. Thus the risk of loss is spread and a disproportionately large loss under a single policy does not fall on one insurance company. Acceptance by an insurer, called a reinsurer, of all or part of the risk of loss of another insurance company. Discussion: Reinsurance is a means by which an insurance company can protect itself against the risk of losses with other insurance companies. Individuals and corporations obtain insurance policies to provide protection for various risks (hurricanes, earthquakes, lawsuits, collisions, sickness and death, etc.). Reinsurers, in turn, provide insurance to insurance companies. For example, an HMO may purchase a reinsurance policy to protect itself from losing too much money from one insured's particularly expensive health care costs. An insurance company issuing an automobile liability policy, with a limit of $100,000 per accident may reinsure its liability in excess of $10,000. A fire insurance company which issues a large policy generally reinsures a portion of the risk with one or several other companies. Also called risk control insurance or stop-loss insurance. Concept Relationships: |
| 2-L | . . SURPL | surplus line insurance policy |
Definition: Definition:
Concept Relationships: |
| 2-L | . . UMBRL | umbrella liability insurance policy |
Definition: Definition: A form of insurance protection that provides additional liability coverage after the limits of your underlying policy are reached. An umbrella liability policy also protects you (the insured) in many situations not covered by the usual liability policies. Concept Relationships: |
| 2-A | . . _ActHealthInsuranceTypeCode . . v:ActHealthInsuranceTypeCode |
ActHealthInsuranceTypeCode |
Definition: Definition: Set of codes indicating the type of health insurance policy that covers health services provided to covered parties. A health insurance policy is a written contract for insurance between the insurance company and the policyholder, and contains pertinent facts about the policy owner (the policy holder), the health insurance coverage, the insured subscribers and dependents, and the insurer. Health insurance is typically administered in accordance with a plan, which specifies (1) the type of health services and health conditions that will be covered under what circumstances (e.g., exclusion of a pre-existing condition, service must be deemed medically necessary; service must not be experimental; service must provided in accordance with a protocol; drug must be on a formulary; service must be prior authorized; or be a referral from a primary care provider); (2) the type and affiliation of providers (e.g., only allopathic physicians, only in network, only providers employed by an HMO); (3) financial participations required of covered parties (e.g., co-pays, coinsurance, deductibles, out-of-pocket); and (4) the manner in which services will be paid (e.g., under indemnity or fee-for-service health plans, the covered party typically pays out-of-pocket and then file a claim for reimbursement, while health plans that have contractual relationships with providers, i.e., network providers, typically do not allow the providers to bill the covered party for the cost of the service until after filing a claim with the payer and receiving reimbursement). Concept Relationships: |
| 3-L | . . . DENTAL | dental care policy |
Definition: Definition: A health insurance policy that that covers benefits for dental services. Concept Relationships: |
| 3-L | . . . DISEASE | disease specific policy |
Definition: Definition: A health insurance policy that covers benefits for healthcare services provided for named conditions under the policy, e.g., cancer, diabetes, or HIV-AIDS. Concept Relationships: |
| 3-L | . . . DRUGPOL | drug policy |
Definition: Definition: A health insurance policy that covers benefits for prescription drugs, pharmaceuticals, and supplies. Concept Relationships: |
| 3-L | . . . EHCPOL | extended healthcare |
Definition: Private insurance policy that provides coverage in addition to other policies (e.g. in addition to a Public Healthcare insurance policy). Concept Relationships: |
| 3-L | . . . HIP | health insurance plan policy |
Definition: Definition: A health insurance policy that covers healthcare benefits by protecting covered parties from medical expenses arising from health conditions, sickness, or accidental injury as well as preventive care. Health insurance policies explicitly exclude coverage for losses insured under a disability policy, workers' compensation program, liability insurance (including automobile insurance); or for medical expenses, coverage for on-site medical clinics or for limited dental or vision benefits when these are provided under a separate policy. Discussion: Health insurance policies are offered by health insurance plans that typically reimburse providers for covered services on a fee-for-service basis, that is, a fee that is the allowable amount that a provider may charge. This is in contrast to managed care plans, which typically prepay providers a per-member/per-month amount or capitation as reimbursement for all covered services rendered. Health insurance plans include indemnity and healthcare services plans. Concept Relationships: |
| 3-L | . . . HSAPOL | health spending account |
Definition: Insurance policy that provides for an allotment of funds replenished on a periodic (e.g. annual) basis. The use of the funds under this policy is at the discretion of the covered party. Concept Relationships: |
| 3-L | . . . LTC | long term care policy |
Definition: Definition: An insurance policy that covers benefits for long-term care services people need when they no longer can care for themselves. This may be due to an accident, disability, prolonged illness or the simple process of aging. Long-term care services assist with activities of daily living including:
Concept Relationships: |
| 3-S | . . . MCPOL . . . v:ManagedCarePolicy |
managed care policy |
Definition: Definition: Government mandated program providing coverage, disability income, and vocational rehabilitation for injuries sustained in the work place or in the course of employment. Employers may either self-fund the program, purchase commercial coverage, or pay a premium to a government entity that administers the program. Employees may be required to pay premiums toward the cost of coverage as well. Managed care policies specifically exclude coverage for losses insured under a disability policy, workers' compensation program, liability insurance (including automobile insurance); or for medical expenses, coverage for on-site medical clinics or for limited dental or vision benefits when these are provided under a separate policy. Discussion: Managed care policies are offered by managed care plans that contract with selected providers or health care organizations to provide comprehensive health care at a discount to covered parties and coordinate the financing and delivery of health care. Managed care uses medical protocols and procedures agreed on by the medical profession to be cost effective, also known as medical practice guidelines. Providers are typically reimbursed for covered services by a capitated amount on a per member per month basis that may reflect difference in the health status and level of services anticipated to be needed by the member. Concept Relationships: |
| 4-L | . . . . HMO | health maintenance organization policy |
Definition: Definition: A policy for a health plan that provides coverage for health care only through contracted or employed physicians and hospitals located in particular geographic or service areas. HMOs emphasize prevention and early detection of illness. Eligibility to enroll in an HMO is determined by where a covered party lives or works. Concept Relationships: |
| 4-L | . . . . POS | point of service policy |
Definition: Definition: A policy for a health plan that has features of both an HMO and a FFS plan. Like an HMO, a POS plan encourages the use its HMO network to maintain discounted fees with participating providers, but recognizes that sometimes covered parties want to choose their own provider. The POS plan allows a covered party to use providers who are not part of the HMO network (non-participating providers). However, there is a greater cost associated with choosing these non-network providers. A covered party will usually pay deductibles and coinsurances that are substantially higher than the payments when he or she uses a plan provider. Use of non-participating providers often requires the covered party to pay the provider directly and then to file a claim for reimbursement, like in an FFS plan. Concept Relationships: |
| 4-L | . . . . PPO | preferred provider organization policy |
Definition: Definition: A network-based, managed care plan that allows a covered party to choose any health care provider. However, if care is received from a "preferred" (participating in-network) provider, there are generally higher benefit coverage and lower deductibles. Concept Relationships: |
| 3-L | . . . MENTPOL | mental health policy |
Definition: Definition: A health insurance policy that covers benefits for mental health services and prescriptions. Concept Relationships: |
| 3-L | . . . POS | point of service policy |
Definition: Definition: A policy for a health plan that has features of both an HMO and a FFS plan. Like an HMO, a POS plan encourages the use its HMO network to maintain discounted fees with participating providers, but recognizes that sometimes covered parties want to choose their own provider. The POS plan allows a covered party to use providers who are not part of the HMO network (non-participating providers). However, there is a greater cost associated with choosing these non-network providers. A covered party will usually pay deductibles and coinsurances that are substantially higher than the payments when he or she uses a plan provider. Use of non-participating providers often requires the covered party to pay the provider directly and then to file a claim for reimbursement, like in an FFS plan. Concept Relationships: |
| 3-L | . . . SUBPOL | substance use policy |
Definition: Definition: A health insurance policy that covers benefits for substance use services. Concept Relationships: |
| 3-L | . . . VISPOL | vision care policy |
Definition: Definition: Set of codes for a policy that provides coverage for health care expenses arising from vision services. A health insurance policy that covers benefits for vision care services, prescriptions, and products. Concept Relationships: |
| 1-A | . _ActProgramTypeCode . v:ActProgramTypeCode |
ActProgramTypeCode |
Definition: Definition: A set of codes used to indicate coverage under a program. A program is an organized structure for administering and funding coverage of a benefit package for covered parties meeting eligibility criteria, typically related to employment, health, financial, and demographic status. Programs are typically established or permitted by legislation with provisions for ongoing government oversight. Regulations may mandate the structure of the program, the manner in which it is funded and administered, covered benefits, provider types, eligibility criteria and financial participation. A government agency may be charged with implementing the program in accordance to the regulation. Risk of loss under a program in most cases would not meet what an underwriter would consider an insurable risk, i.e., the risk is not random in nature, not financially measurable, and likely requires subsidization with government funds. Discussion: Programs do not have policy holders or subscribers. Program eligibles are enrolled based on health status, statutory eligibility, financial status, or age. Program eligibles who are covered parties under the program may be referred to as members, beneficiaries, eligibles, or recipients. Programs risk are underwritten by not for profit organizations such as governmental entities, and the beneficiaries typically do not pay for any or some portion of the cost of coverage. See CoveredPartyRoleType. Concept Relationships: |
| 2-L | . . CHAR | charity program |
Definition: Definition: A program that covers the cost of services provided directly to a beneficiary who typically has no other source of coverage without charge. Concept Relationships: |
| 2-L | . . CRIME | crime victim program |
Definition: Definition: A program that covers the cost of services provided to crime victims for injuries or losses related to the occurrence of a crime. Concept Relationships: |
| 2-L | . . EAP | employee assistance program |
Definition: Definition: An employee assistance program is run by an employer or employee organization for the purpose of providing benefits and covering all or part of the cost for employees to receive counseling, referrals, and advice in dealing with stressful issues in their lives. These may include substance abuse, bereavement, marital problems, weight issues, or general wellness issues. The services are usually provided by a third-party, rather than the company itself, and the company receives only summary statistical data from the service provider. Employee's names and services received are kept confidential. Concept Relationships: |
| 2-L | . . GOVEMP | government employee health program |
Definition: Definition: A set of codes used to indicate a government program that is an organized structure for administering and funding coverage of a benefit package for covered parties meeting eligibility criteria, typically related to employment, health and financial status. Government programs are established or permitted by legislation with provisions for ongoing government oversight. Regulation mandates the structure of the program, the manner in which it is funded and administered, covered benefits, provider types, eligibility criteria and financial participation. A government agency is charged with implementing the program in accordance to the regulation Example: Federal employee health benefit program in the U.S. Concept Relationships: |
| 2-L | . . HIRISK | high risk pool program |
Definition: Definition: A government program that provides health coverage to individuals who are considered medically uninsurable or high risk, and who have been denied health insurance due to a serious health condition. In certain cases, it also applies to those who have been quoted very high premiums a" again, due to a serious health condition. The pool charges premiums for coverage. Because the pool covers high-risk people, it incurs a higher level of claims than premiums can cover. The insurance industry pays into the pool to make up the difference and help it remain viable. Concept Relationships: |
| 2-L | . . IND | indigenous peoples health program |
Definition: Definition: Services provided directly and through contracted and operated indigenous peoples health programs. Example: Indian Health Service in the U.S. Concept Relationships: |
| 2-L | . . MILITARY | military health program |
Definition: Definition: A government program that provides coverage for health services to military personnel, retirees, and dependents. A covered party who is a subscriber can choose from among Fee-for-Service (FFS) plans, and their Preferred Provider Organizations (PPO), or Plans offering a Point of Service (POS) Product, or Health Maintenance Organizations. Example: In the U.S., TRICARE, CHAMPUS. Concept Relationships: |
| 2-S | . . PUBLICPOL . . v:PublicHealthcareProgram |
public healthcare |
Definition: Insurance policy funded by a public health system such as a provincial or national health plan. Examples include BC MSP (British Columbia Medical Services Plan) OHIP (Ontario Health Insurance Plan), NHS (National Health Service). Concept Relationships: |
| 3-L | . . . DENTPRG | dental program |
Definition: Definition: A public or government health program that administers and funds coverage for dental care to assist program eligible who meet financial and health status criteria. Concept Relationships: |
| 3-S | . . . DISEASEPRG . . . v:DiseaseProgram |
disease program |
Definition: Definition: A public or government health program that administers and funds coverage for health and social services to assist program eligible who meet financial and health status criteria related to a particular disease. Example: Reproductive health, sexually transmitted disease, and end renal disease programs. Concept Relationships: |
| 4-L | . . . . CANPRG | disease program |
Definition: Definition: A program that provides low-income, uninsured, and underserved women access to timely, high-quality screening and diagnostic services, to detect breast and cervical cancer at the earliest stages. Example: To improve women's access to screening for breast and cervical cancers, Congress passed the Breast and Cervical Cancer Mortality Prevention Act of 1990, which guided CDC in creating the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), which provides access to critical breast and cervical cancer screening services for underserved women in the United States. An estimated 7 to 10% of U.S. women of screening age are eligible to receive NBCCEDP services. Federal guidelines establish an eligibility baseline to direct services to uninsured and underinsured women at or below 250% of federal poverty level; ages 18 to 64 for cervical screening; ages 40 to 64 for breast screening. Concept Relationships: |
| 4-L | . . . . ENDRENAL | end renal program |
Definition: Definition: A public or government program that administers publicly funded coverage of kidney dialysis and kidney transplant services. Example: In the U.S., the Medicare End-stage Renal Disease program (ESRD), the National Kidney Foundation (NKF) American Kidney Fund (AKF) The Organ Transplant Fund. Concept Relationships: |
| 4-L | . . . . HIVAIDS | HIV-AIDS program |
Definition: Definition: Government administered and funded HIV-AIDS program for beneficiaries meeting financial and health status criteria. Administration, funding levels, eligibility criteria, covered benefits, provider types, and financial participation are typically set by a regulatory process. Payer responsibilities for administering the program may be delegated to contractors. Example: In the U.S., the Ryan White program, which is administered by the Health Resources and Services Administration. Concept Relationships: |
| 3-L | . . . MANDPOL | mandatory health program |
Concept Relationships: |
| 3-L | . . . MENTPRG | mental health program |
Definition: Definition: Government administered and funded mental health program for beneficiaries meeting financial and mental health status criteria. Administration, funding levels, eligibility criteria, covered benefits, provider types, and financial participation are typically set by a regulatory process. Payer responsibilities for administering the program may be delegated to contractors. Example: In the U.S., states receive funding for substance use programs from the Substance Abuse Mental Health Administration (SAMHSA). Concept Relationships: |
| 3-L | . . . SAFNET | safety net clinic program |
Definition: Definition: Government administered and funded program to support provision of care to underserved populations through safety net clinics. Example: In the U.S., safety net providers such as federally qualified health centers (FQHC) receive funding under PHSA Section 330 grants administered by the Health Resources and Services Administration. Concept Relationships: |
| 3-L | . . . SUBPRG | substance use program |
Definition: Definition: Government administered and funded substance use program for beneficiaries meeting financial, substance use behavior, and health status criteria. Beneficiaries may be required to enroll as a result of legal proceedings. Administration, funding levels, eligibility criteria, covered benefits, provider types, and financial participation are typically set by a regulatory process. Payer responsibilities for administering the program may be delegated to contractors. Example: In the U.S., states receive funding for substance use programs from the Substance Abuse Mental Health Administration (SAMHSA). Concept Relationships: |
| 3-S | . . . SUBSIDIZ . . . v:SubsidizedHealthProgram |
subsidized health program |
Definition: Definition: A government health program that provides coverage for health services to persons meeting eligibility criteria such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds. Concept Relationships: |
| 4-L | . . . . SUBSIDMC | subsidized managed care program |
Definition: Definition: A government health program that provides coverage through managed care contracts for health services to persons meeting eligibility criteria such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds. Discussion: The structure and business processes for underwriting and administering a subsidized managed care program is further specified by the Underwriter and Payer Role.class and Role.code. Concept Relationships: |
| 4-L | . . . . SUBSUPP | subsidized supplemental health program |
Definition: Definition: A government health program that provides coverage for health services to persons meeting eligibility criteria for a supplemental health policy or program such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds. Example: Supplemental health coverage program may cover the cost of a health program or policy financial participations, such as the copays and the premiums, and may provide coverage for services in addition to those covered under the supplemented health program or policy. In the U.S., Medicaid programs may pay the premium for a covered party who is also covered under the Medicare program or a private health policy. Discussion: The structure and business processes for underwriting and administering a subsidized supplemental retiree health program is further specified by the Underwriter and Payer Role.class and Role.code. Concept Relationships: |
| 2-L | . . RETIRE | retiree health program |
Definition: Definition: A government mandated program with specific eligibility requirements based on premium contributions made during employment, length of employment, age, and employment status, e.g., being retired, disabled, or a dependent of a covered party under this program. Benefits typically include ambulatory, inpatient, and long-term care, such as hospice care, home health care and respite care. Concept Relationships: |
| 2-L | . . SOCIAL | social service program |
Definition: Definition: A social service program funded by a public or governmental entity. Example: Programs providing habilitation, food, lodging, medicine, transportation, equipment, devices, products, education, training, counseling, alteration of living or work space, and other resources to persons meeting eligibility criteria. Concept Relationships: |
| 2-L | . . VET | veteran health program |
Definition: Definition: Services provided directly and through contracted and operated veteran health programs. Concept Relationships: |
| 2-L | . . WCBPOL | worker's compensation |
Definition: Insurance policy for injuries sustained in the work place or in the course of employment. Concept Relationships: |
| 0-A | _ActDetectedIssueManagementCode v:ActDetectedIssueManagementCode |
ActDetectedIssueManagementCode |
Definition: Codes dealing with the management of Detected Issue observations Concept Relationships: |
| 1-S | . 1 . v:TherapyAppropriateManagementCode |
Therapy Appropriate |
Definition: Confirmed drug therapy appropriate Concept Relationships: |
| 2-L | . . 19 | Consulted Supplier |
Definition: Consulted other supplier/pharmacy, therapy confirmed Concept Relationships: |
| 2-L | . . 2 | Assessed Patient |
Definition: Assessed patient, therapy is appropriate Concept Relationships: |
| 2-L | . . 22 | appropriate indication or diagnosis |
Definition: Description: The patient has the appropriate indication or diagnosis for the action to be taken. Concept Relationships: |
| 2-L | . . 23 | prior therapy documented |
Definition: Description: It has been confirmed that the appropriate pre-requisite therapy has been tried. Concept Relationships: |
| 2-L | . . 3 | Patient Explanation |
Definition: Patient gave adequate explanation Concept Relationships: |
| 2-L | . . 4 | Consulted Other Source |
Definition: Consulted other supply source, therapy still appropriate Concept Relationships: |
| 2-S | . . 5 . . v:ConsultedPrescriberManagementCode |
Consulted Prescriber |
Definition: Consulted prescriber, therapy confirmed Concept Relationships: |
| 3-L | . . . 6 | Prescriber Declined Change |
Definition: Consulted prescriber and recommended change, prescriber declined Concept Relationships: |
| 2-L | . . 7 | Interacting Therapy No Longer Active/Planned |
Definition: Concurrent therapy triggering alert is no longer on-going or planned Concept Relationships: |
| 1-S | . 14 . v:SupplyAppropriateManagementCode |
Supply Appropriate |
Definition: Confirmed supply action appropriate Concept Relationships: |
| 2-L | . . 15 | Replacement |
Definition: Patient's existing supply was lost/wasted Concept Relationships: |
| 2-L | . . 16 | Vacation Supply |
Definition: Supply date is due to patient vacation Concept Relationships: |
| 2-L | . . 17 | Weekend Supply |
Definition: Supply date is intended to carry patient over weekend Concept Relationships: |
| 2-L | . . 18 | Leave of Absence |
Definition: Supply is intended for use during a leave of absence from an institution. Concept Relationships: |
| 2-L | . . 20 | additional quantity on separate dispense |
Definition: Description: Supply is different than expected as an additional quantity has been supplied in a separate dispense. Concept Relationships: |
| 1-S | . 8 . v:OtherActionTakenManagementCode |
Other Action Taken |
Definition: Order is performed as issued, but other action taken to mitigate potential adverse effects Concept Relationships: |
| 2-L | . . 10 | Provided Patient Education |
Definition: Provided education or training to the patient on appropriate therapy use Concept Relationships: |
| 2-L | . . 11 | Added Concurrent Therapy |
Definition: Instituted an additional therapy to mitigate potential negative effects Concept Relationships: |
| 2-L | . . 12 | Temporarily Suspended Concurrent Therapy |
Definition: Suspended existing therapy that triggered interaction for the duration of this therapy Concept Relationships: |
| 2-L | . . 13 | Stopped Concurrent Therapy |
Definition: Aborted existing therapy that triggered interaction. Concept Relationships: |
| 2-L | . . 9 | Instituted Ongoing Monitoring Program |
Definition: Arranged to monitor patient for adverse effects Concept Relationships: |
| 1-A | . _ActAdministrativeDetectedIssueManagementCode . v:ActAdministrativeDetectedIssueManagementCode |
ActAdministrativeDetectedIssueManagementCode |
Definition: Codes dealing with the management of Detected Issue observations for the administrative and patient administrative acts domains. Concept Relationships: |
| 2-A | . . _AuthorizationIssueManagementCode . . v:AuthorizationIssueManagementCode |
Authorization Issue Management Code |
Concept Relationships: |
| 3-S | . . . EMAUTH | emergency authorization override |
Definition: Used to temporarily override normal authorization rules to gain access to data in a case of emergency. Use of this override code will typically be monitored, and a procedure to verify its proper use may be triggered when used. Concept Relationships: |
| 4-L | . . . . 21 | authorization confirmed |
Definition: Description: Indicates that the permissions have been externally verified and the request should be processed. Concept Relationships: |
| 0-A | _ActExposureCode v:ActExposureCode |
ActExposureCode |
Definition: Concepts that identify the type or nature of exposure interaction. Examples include "household", "care giver", "intimate partner", "common space", "common substance", etc. to further describe the nature of interaction. Concept Relationships: |
| 1-L | . CHLDCARE | Day care - Child care Interaction |
Definition: Description: Exposure participants' interaction occurred in a child care setting Concept Relationships: |
| 1-L | . CONVEYNC | Common Conveyance Interaction |
Definition: Description: An interaction where the exposure participants traveled in/on the same vehicle (not necessarily concurrently, e.g. both are passengers of the same plane, but on different flights of that plane). Concept Relationships: |
| 1-L | . HLTHCARE | Health Care Interaction - Not Patient Care |
Definition: Description: Exposure participants' interaction occurred during the course of health care delivery or in a health care delivery setting, but did not involve the direct provision of care (e.g. a janitor cleaning a patient's hospital room). Concept Relationships: |
| 1-L | . HOMECARE | Care Giver Interaction |
Definition: Description: Exposure interaction occurred in context of one providing care for the other, i.e. a babysitter providing care for a child, a home-care aide providing assistance to a paraplegic. Concept Relationships: |
| 1-L | . HOSPPTNT | Hospital Patient Interaction |
Definition: Description: Exposure participants' interaction occurred when both were patients being treated in the same (acute) health care delivery facility. Concept Relationships: |
| 1-L | . HOSPVSTR | Hospital Visitor Interaction |
Definition: Description: Exposure participants' interaction occurred when one visited the other who was a patient being treated in a health care delivery facility. Concept Relationships: |
| 1-L | . HOUSEHLD | Household Interaction |
Definition: Description: Exposure interaction occurred in context of domestic interaction, i.e. both participants reside in the same household. Concept Relationships: |
| 1-L | . INMATE | Inmate Interaction |
Definition: Description: Exposure participants' interaction occurred in the course of one or both participants being incarcerated at a correctional facility Concept Relationships: |
| 1-L | . INTIMATE | Intimate Interaction |
Definition: Description: Exposure interaction was intimate, i.e. participants are intimate companions (e.g. spouses, domestic partners). Concept Relationships: |
| 1-L | . LTRMCARE | Long Term Care Facility Interaction |
Definition: Description: Exposure participants' interaction occurred in the course of one or both participants being resident at a long term care facility (second participant may be a visitor, worker, resident or a physical place or object within the facility). Concept Relationships: |
| 1-L | . PLACE | Common Space Interaction |
Definition: Description: An interaction where the exposure participants were both present in the same location/place/space. Concept Relationships: |
| 1-L | . PTNTCARE | Health Care Interaction - Patient Care |
Definition: Description: Exposure participants' interaction occurred during the course of health care delivery by a provider (e.g. a physician treating a patient in her office). Concept Relationships: |
| 1-L | . SCHOOL2 | School Interaction |
Definition: Description: Exposure participants' interaction occurred in an academic setting (e.g., participants are fellow students, or student and teacher). Concept Relationships: |
| 1-L | . SOCIAL2 | Social/Extended Family Interaction |
Definition: Description: An interaction where the exposure participants are social associates or members of the same extended family Concept Relationships: |
| 1-L | . SUBSTNCE | Common Substance Interaction |
Definition: Description: An interaction where the exposure participants shared or co-used a common substance (e.g. drugs, needles, or common food item). Concept Relationships: |
| 1-L | . TRAVINT | Common Travel Interaction |
Definition: Description: An interaction where the exposure participants traveled together in/on the same vehicle/trip (e.g. concurrent co-passengers). Concept Relationships: |
| 1-L | . WORK2 | Work Interaction |
Definition: Description: Exposure interaction occurred in a work setting, i.e. participants are co-workers. Concept Relationships: |
| 0-A | _ActFinancialTransactionCode v:ActFinancialTransactionCode |
ActFinancialTransactionCode |
Concept Relationships: |
| 1-L | . CHRG | Standard Charge |
Definition: A type of transaction that represents a charge for a service or product. Expressed in monetary terms. Concept Relationships: |
| 1-L | . REV | Standard Charge Reversal |
Definition: A type of transaction that represents a reversal of a previous charge for a service or product. Expressed in monetary terms. It has the opposite effect of a standard charge. Concept Relationships: |
| 0-A | _ActIncidentCode v:ActIncidentCode |
ActIncidentCode |
Definition: Set of codes indicating the type of incident or accident. Concept Relationships: |
| 1-L | . MVA | Motor vehicle accident |
Definition: Incident or accident as the result of a motor vehicle accident Concept Relationships: |
| 1-L | . SCHOOL | School Accident |
Definition: Incident or accident is the result of a school place accident. Concept Relationships: |
| 1-L | . SPT | Sporting Accident |
Definition: Incident or accident is the result of a sporting accident. Concept Relationships: |
| 1-L | . WPA | Workplace accident |
Definition: Incident or accident is the result of a work place accident Concept Relationships: |
| 0-A | _ActInformationAccessCode v:ActInformationAccessCode |
ActInformationAccessCode |
Definition: Description: The type of health information to which the subject of the information or the subject's delegate consents or dissents. Concept Relationships: |
| 1-L | . ACADR | adverse drug reaction access |
Definition: Description: Provide consent to collect, use, disclose, or access adverse drug reaction information for a patient. Concept Relationships: |
| 1-L | . ACALL | all access |
Definition: Description: Provide consent to collect, use, disclose, or access all information for a patient. Concept Relationships: |
| 1-L | . ACALLG | allergy access |
Definition: Description: Provide consent to collect, use, disclose, or access allergy information for a patient. Concept Relationships: |
| 1-L | . ACCONS | informational consent access |
Definition: Description: Provide consent to collect, use, disclose, or access informational consent information for a patient. Concept Relationships: |
| 1-L | . ACDEMO | demographics access |
Definition: Description: Provide consent to collect, use, disclose, or access demographics information for a patient. Concept Relationships: |
| 1-L | . ACDI | diagnostic imaging access |
Definition: Description: Provide consent to collect, use, disclose, or access diagnostic imaging information for a patient. Concept Relationships: |
| 1-L | . ACIMMUN | immunization access |
Definition: Description: Provide consent to collect, use, disclose, or access immunization information for a patient. Concept Relationships: |
| 1-L | . ACLAB | lab test result access |
Definition: Description: Provide consent to collect, use, disclose, or access lab test result information for a patient. Concept Relationships: |
| 1-L | . ACMED | medication access |
Definition: Description: Provide consent to collect, use, disclose, or access medical condition information for a patient. Concept Relationships: |
| 1-L | . ACMEDC | medical condition access |
Definition: Definition: Provide consent to view or access medical condition information for a patient. Concept Relationships: |
| 1-L | . ACMEN | mental health access |
Definition: Description:Provide consent to collect, use, disclose, or access mental health information for a patient. Concept Relationships: |
| 1-L | . ACOBS | common observations access |
Definition: Description: Provide consent to collect, use, disclose, or access common observation information for a patient. Concept Relationships: |
| 1-L | . ACPOLPRG | policy or program information access |
Definition: Description: Provide consent to collect, use, disclose, or access coverage policy or program for a patient. Concept Relationships: |
| 1-L | . ACPROV | provider information access |
Definition: Description: Provide consent to collect, use, disclose, or access provider information for a patient. Concept Relationships: |
| 1-L | . ACPSERV | professional service access |
Definition: Description: Provide consent to collect, use, disclose, or access professional service information for a patient. Concept Relationships: |
| 1-L | . ACSUBSTAB | substance abuse access |
Definition: Description:Provide consent to collect, use, disclose, or access substance abuse information for a patient. Concept Relationships: |
| 0-A | _ActInformationAccessContextCode | ActInformationAccessContextCode |
Definition: Concepts conveying the context in which consent to transfer specified patient health information for collection, access, use or disclosure applies. Concept Relationships: |
| 1-L | . INFAUT | authorized information transfer |
Definition: Description: Information transfer in accordance with subjectaTMs consent directive. Concept Relationships: |
| 1-L | . INFCON | after explicit consent |
Definition: Consent to collect, access, use, or disclose specified patient health information only after explicit consent. Concept Relationships: |
| 1-L | . INFCRT | only on court order |
Definition: Description: Information transfer in accordance with judicial system protocol. Concept Relationships: |
| 1-L | . INFDNG | only if danger to others |
Definition: Consent to collect, access, use, or disclose specified patient health information only if necessary to avert potential danger to other persons. Concept Relationships: |
| 1-L | . INFEMER | only in an emergency |
Definition: Description: Information transfer in accordance with emergency information transfer protocol. Concept Relationships: |
| 1-L | . INFPWR | only if public welfare risk |
Definition: Consent to collect, access, use, or disclose specified patient health information only if necessary to avert potential public welfare risk. Concept Relationships: |
| 1-L | . INFREG | regulatory information transfer |
Definition: Description: Information transfer in accordance with regulatory protocol, e.g., for public health, welfare, and safety. Concept Relationships: |
| 0-A | _ActInformationCategoryCode | ActInformationCategoryCode |
Definition: Definition:Indicates the set of information types which may be manipulated or referenced, such as for recommending access restrictions. Concept Relationships: |
| 1-L | . ALLCAT | all categories |
Definition: Description: All patient information. Concept Relationships: |
| 1-L | . ALLGCAT | allergy category |
Definition: Definition:All information pertaining to a patient's allergy and intolerance records. Concept Relationships: |
| 1-L | . ARCAT | adverse drug reaction category |
Definition: Description: All information pertaining to a patient's adverse drug reactions. Concept Relationships: |
| 1-L | . COBSCAT | common observation category |
Definition: Definition:All information pertaining to a patient's common observation records (height, weight, blood pressure, temperature, etc.). Concept Relationships: |
| 1-L | . DEMOCAT | demographics category |
Definition: Definition:All information pertaining to a patient's demographics (such as name, date of birth, gender, address, etc). Concept Relationships: |
| 1-L | . DICAT | diagnostic image category |
Definition: Definition:All information pertaining to a patient's diagnostic image records (orders & results). Concept Relationships: |
| 1-L | . IMMUCAT | immunization category |
Definition: Definition:All information pertaining to a patient's vaccination records. Concept Relationships: |
| 1-L | . LABCAT | lab test category |
Definition: Description: All information pertaining to a patient's lab test records (orders & results) Concept Relationships: |
| 1-L | . MEDCCAT | medical condition category |
Definition: Definition:All information pertaining to a patient's medical condition records. Concept Relationships: |
| 1-L | . MENCAT | mental health category |
Definition: Description: All information pertaining to a patient's mental health records. Concept Relationships: |
| 1-L | . PSVCCAT | professional service category |
Definition: Definition:All information pertaining to a patient's professional service records (such as smoking cessation, counseling, medication review, mental health). Concept Relationships: |
| 1-L | . RXCAT | medication category |
Definition: Definition:All information pertaining to a patient's medication records (orders, dispenses and other active medications). Concept Relationships: |
| 0-A | _ActInvoiceElementCode v:ActInvoiceElementCode |
ActInvoiceElementCode |
Definition: Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results. Concept Relationships: |
| 1-A | . _ActInvoiceAdjudicationPaymentCode . v:ActInvoiceAdjudicationPaymentCode |
ActInvoiceAdjudicationPaymentCode |
Definition: Codes representing a grouping of invoice elements (totals, sub-totals), reported through a Payment Advice or a Statement of Financial Activity (SOFA). The code can represent summaries by day, location, payee and other cost elements such as bonus, retroactive adjustment and transaction fees. Concept Relationships: |
| 2-A | . . _ActInvoiceAdjudicationPaymentGroupCode | ActInvoiceAdjudicationPaymentGroupCode |
Definition: Codes representing adjustments to a Payment Advice such as retroactive, clawback, garnishee, etc. Concept Relationships: |
| 3-L | . . . ALEC | alternate electronic |
Definition: Payment initiated by the payor as the result of adjudicating a submitted invoice that arrived to the payor from an electronic source that did not provide a conformant set of HL7 messages (e.g. web claim submission). Concept Relationships: |
| 3-L | . . . BONUS | bonus |
Definition: Bonus payments based on performance, volume, etc. as agreed to by the payor. Concept Relationships: |
| 3-L | . . . CFWD | carry forward adjusment |
Definition: An amount still owing to the payor but the payment is 0$ and this cannot be settled until a future payment is made. Concept Relationships: |
| 3-L | . . . EDU | education fees |
Definition: Fees deducted on behalf of a payee for tuition and continuing education. Concept Relationships: |
| 3-L | . . . EPYMT | early payment fee |
Definition: Fees deducted on behalf of a payee for charges based on a shorter payment frequency (i.e. next day versus biweekly payments. Concept Relationships: |
| 3-L | . . . GARN | garnishee |
Definition: Fees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee. Concept Relationships: |
| 3-L | . . . INVOICE | submitted invoice |
Definition: Payment is based on a payment intent for a previously submitted Invoice, based on formal adjudication results.. Concept Relationships: |
| 3-L | . . . PINV | paper invoice |
Definition: Payment initiated by the payor as the result of adjudicating a paper (original, may have been faxed) invoice. Concept Relationships: |
| 3-L | . . . PPRD | prior period adjustment |
Definition: An amount that was owed to the payor as indicated, by a carry forward adjusment, in a previous payment advice Concept Relationships: |
| 3-L | . . . PROA | professional association deduction |
Definition: Professional association fee that is collected by the payor from the practitioner/provider on behalf of the association Concept Relationships: |
| 3-L | . . . RECOV | recovery |
Definition: Retroactive adjustment such as fee rate adjustment due to contract negotiations. Concept Relationships: |
| 3-L | . . . RETRO | retro adjustment |
Definition: Bonus payments based on performance, volume, etc. as agreed to by the payor. Concept Relationships: |
| 3-L | . . . TRAN | transaction fee |
Definition: Fees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee. Concept Relationships: |
| 2-A | . . _ActInvoiceAdjudicationPaymentSummaryCode . . v:ActInvoiceAdjudicationPaymentSummaryCode |
ActInvoiceAdjudicationPaymentSummaryCode |
Definition: Codes representing a grouping of invoice elements (totals, sub-totals), reported through a Payment Advice or a Statement of Financial Activity (SOFA). The code can represent summaries by day, location, payee, etc. Concept Relationships: |
| 3-L | . . . CONT | contract |
Definition: Transaction counts and value totals by Contract Identifier. Concept Relationships: |
| 3-L | . . . DAY | day |
Definition: Transaction counts and value totals for each calendar day within the date range specified. Concept Relationships: |
| 3-L | . . . INVTYPE | invoice type |
Definition: Transaction counts and value totals by invoice type (e.g. RXDINV - Pharmacy Dispense) Concept Relationships: |
| 3-L | . . . LOC | location |
Definition: Transaction counts and value totals by service location (e.g clinic). Concept Relationships: |
| 3-L | . . . MONTH | month |
Definition: Transaction counts and value totals for each calendar month within the date range specified. Concept Relationships: |
| 3-L | . . . PAYEE | payee |
Definition: Transaction counts and value totals by each instance of an invoice payee. Concept Relationships: |
| 3-L | . . . PAYOR | payor |
Definition: Transaction counts and value totals by each instance of an invoice payor. Concept Relationships: |
| 3-L | . . . PERIOD | period |
Definition: Transaction counts and value totals for the date range specified. Concept Relationships: |
| 3-L | . . . PROV | provider |
Definition: Transaction counts and value totals by Provider Identifier. Concept Relationships: |
| 3-L | . . . SENDAPP | sending application |
Definition: Transaction counts and value totals by each instance of a messaging application on a single processor. It is a registered identifier known to the receivers. Concept Relationships: |
| 3-L | . . . WEEK | week |
Definition: Transaction counts and value totals for each calendar week within the date range specified. Concept Relationships: |
| 3-L | . . . YEAR | year |
Definition: Transaction counts and value totals for each calendar year within the date range specified. Concept Relationships: |
| 1-A | . _ActInvoiceDetailCode . v:ActInvoiceDetailCode |
ActInvoiceDetailCode |
Definition: Codes representing a service or product that is being invoiced (billed). The code can represent such concepts as "office visit", "drug X", "wheelchair" and other billable items such as taxes, service charges and discounts. Concept Relationships: |
| 2-A | . . _ActInvoiceDetailClinicalProductCode . . v:ActInvoiceDetailClinicalProductCode |
ActInvoiceDetailClinicalProductCode |
Definition: An identifying data string for healthcare products. Concept Relationships: |
| 3-L | . . . UNSPSC . . . v:UNSPSC |
United Nations Standard Products and Services Classification |
Definition: Description:United Nations Standard Products and Services Classification, managed by Uniform Code Council (UCC): www.unspsc.org Concept Relationships: |
| 2-A | . . _ActInvoiceDetailDrugProductCode . . v:ActInvoiceDetailDrugProductCode |
ActInvoiceDetailDrugProductCode |
Definition: An identifying data string for A substance used as a medication or in the preparation of medication. Concept Relationships: |
| 3-L | . . . GTIN . . . v:GTIN |
Global Trade Item Number |
Definition: Description:Global Trade Item Number is an identifier for trade items developed by GS1 (comprising the former EAN International and Uniform Code Council). Concept Relationships: |
| 3-L | . . . UPC . . . v:UPC |
Universal Product Code |
Definition: Description:Universal Product Code is one of a wide variety of bar code languages widely used in the United States and Canada for items in stores. Concept Relationships: |
| 2-A | . . _ActInvoiceDetailGenericCode . . v:ActInvoiceDetailGenericCode |
ActInvoiceDetailGenericCode |
Definition: The detail item codes to identify charges or changes to the total billing of a claim due to insurance rules and payments. Concept Relationships: |
| 3-A | . . . _ActInvoiceDetailGenericAdjudicatorCode . . . v:ActInvoiceDetailGenericAdjudicatorCode |
ActInvoiceDetailGenericAdjudicatorCode |
Definition: The billable item codes to identify adjudicator specified components to the total billing of a claim. Concept Relationships: |
| 4-L | . . . . COIN | coinsurance |
Definition: That portion of the eligible charges which a covered party must pay for each service and/or product. It is a percentage of the eligible amount for the service/product that is typically charged after the covered party has met the policy deductible. This amount represents the covered party's coinsurance that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results. Concept Relationships: |
| 4-L | . . . . COPAYMENT | patient co-pay |
Definition: That portion of the eligible charges which a covered party must pay for each service and/or product. It is a defined amount per service/product of the eligible amount for the service/product. This amount represents the covered party's copayment that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results. Concept Relationships: |
| 4-L | . . . . DEDUCTIBLE | deductible |
Definition: That portion of the eligible charges which a covered party must pay in a particular period (e.g. annual) before the benefits are payable by the adjudicator. This amount represents the covered party's deductible that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results. Concept Relationships: |
| 4-L | . . . . PAY | payment |
Definition: The guarantor, who may be the patient, pays the entire charge for a service. Reasons for such action may include: there is no insurance coverage for the service (e.g. cosmetic surgery); the patient wishes to self-pay for the service; or the insurer denies payment for the service due to contractual provisions such as the need for prior authorization. Concept Relationships: |
| 4-L | . . . . SPEND | spend down |
Definition: That total amount of the eligible charges which a covered party must periodically pay for services and/or products prior to the Medicaid program providing any coverage. This amount represents the covered party's spend down that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results Concept Relationships: |
| 3-A | . . . _ActInvoiceDetailGenericModifierCode . . . v:ActInvoiceDetailGenericModifierCode |
ActInvoiceDetailGenericModifierCode |
Definition: The billable item codes to identify modifications to a billable item charge. As for example after hours increase in the office visit fee. Concept Relationships: |
| 4-L | . . . . AFTHRS | non-normal hours |
Definition: Premium paid on service fees in compensation for practicing outside of normal working hours. Concept Relationships: |
| 4-L | . . . . ISOL | isolation allowance |
Definition: Premium paid on service fees in compensation for practicing in a remote location. Concept Relationships: |
| 4-L | . . . . OOO | out of office |
Definition: Premium paid on service fees in compensation for practicing at a location other than normal working location. Concept Relationships: |
| 3-A | . . . _ActInvoiceDetailGenericProviderCode . . . v:ActInvoiceDetailGenericProviderCode |
ActInvoiceDetailGenericProviderCode |
Definition: The billable item codes to identify provider supplied charges or changes to the total billing of a claim. Concept Relationships: |
| 4-L | . . . . CANCAPT | cancelled appointment |
Definition: A charge to compensate the provider when a patient cancels an appointment with insufficient time for the provider to make another appointment with another patient. Concept Relationships: |
| 4-L | . . . . DSC | discount |
Definition: A reduction in the amount charged as a percentage of the amount. For example a 5% discount for volume purchase. Concept Relationships: |
| 4-L | . . . . ESA | extraordinary service assessment |
Definition: A premium on a service fee is requested because, due to extenuating circumstances, the service took an extraordinary amount of time or supplies. Concept Relationships: |
| 4-L | . . . . FFSTOP | fee for service top off |
Definition: Under agreement between the parties (payor and provider), a guaranteed level of income is established for the provider over a specific, pre-determined period of time. The normal course of business for the provider is submission of fee-for-service claims. Should the fee-for-service income during the specified period of time be less than the agreed to amount, a top-up amount is paid to the provider equal to the difference between the fee-for-service total and the guaranteed income amount for that period of time. The details of the agreement may specify (or not) a requirement for repayment to the payor in the event that the fee-for-service income exceeds the guaranteed amount. Concept Relationships: |
| 4-L | . . . . FNLFEE | final fee |
Definition: Anticipated or actual final fee associated with treating a patient. Concept Relationships: |
| 4-L | . . . . FRSTFEE | first fee |
Definition: Anticipated or actual initial fee associated with treating a patient. Concept Relationships: |
| 4-L | . . . . MARKUP | markup or up-charge |
Definition: An increase in the amount charged as a percentage of the amount. For example, 12% markup on product cost. Concept Relationships: |
| 4-L | . . . . MISSAPT | missed appointment |
Definition: A charge to compensate the provider when a patient does not show for an appointment. Concept Relationships: |
| 4-L | . . . . PERFEE | periodic fee |
Definition: Anticipated or actual periodic fee associated with treating a patient. For example, expected billing cycle such as monthly, quarterly. The actual period (e.g. monthly, quarterly) is specified in the unit quantity of the Invoice Element. Concept Relationships: |
| 4-L | . . . . PERMBNS | performance bonus |
Definition: The amount for a performance bonus that is being requested from a payor for the performance of certain services (childhood immunizations, influenza immunizations, mammograms, pap smears) on a sliding scale. That is, for 90% of childhood immunizations to a maximum of $2200/yr. An invoice is created at the end of the service period (one year) and a code is submitted indicating the percentage achieved and the dollar amount claimed. Concept Relationships: |
| 4-L | . . . . RESTOCK | restocking fee |
Definition: A charge is requested because the patient failed to pick up the item and it took an amount of time to return it to stock for future use. Concept Relationships: |
| 4-L | . . . . TRAVEL | travel |
Definition: A charge to cover the cost of travel time and/or cost in conjuction with providing a service or product. It may be charged per kilometer or per hour based on the effective agreement. Concept Relationships: |
| 4-L | . . . . URGENT | urgent |
Definition: Premium paid on service fees in compensation for providing an expedited response to an urgent situation. Concept Relationships: |
| 3-A | . . . _ActInvoiceDetailTaxCode . . . v:ActInvoiceDetailTaxCode |
ActInvoiceDetailTaxCode |
Definition: The billable item codes to identify modifications to a billable item charge by a tax factor applied to the amount. As for example 7% provincial sales tax. Concept Relationships: |
| 4-L | . . . . FST | federal sales tax |
Definition: Federal tax on transactions such as the Goods and Services Tax (GST) Concept Relationships: |
| 4-L | . . . . HST | harmonized sales Tax |
Definition: Joint Federal/Provincial Sales Tax Concept Relationships: |
| 4-L | . . . . PST | provincial/state sales tax |
Definition: Tax levied by the provincial or state jurisdiction such as Provincial Sales Tax Concept Relationships: |
| 2-A | . . _ActInvoiceDetailPreferredAccommodationCode . . v:ActInvoiceDetailPreferredAccommodationCode |
ActInvoiceDetailPreferredAccommodationCode |
Definition: An identifying data string for medical facility accommodations. Concept Relationships: |
| 3-A | . . . _ActEncounterAccommodationCode . . . v:ActEncounterAccommodationCode |
ActEncounterAccommodationCode |
Definition: Accommodation type. In Intent mood, represents the accommodation type requested. In Event mood, represents accommodation assigned/used. In Definition mood, represents the available accommodation type. Concept Relationships: |
| 4-A | . . . . _HL7AccommodationCode . . . . v:HL7AccommodationCode |
HL7AccommodationCode |
Definition: Description:Accommodation type. In Intent mood, represents the accommodation type requested. In Event mood, represents accommodation assigned/used. In Definition mood, represents the available accommodation type. Concept Relationships: |
| 5-L | . . . . . I | Isolation |
Definition: Accommodations used in the care of diseases that are transmitted through casual contact or respiratory transmission. Concept Relationships: |
| 5-L | . . . . . P | Private |
Definition: Accommodations in which there is only 1 bed. Concept Relationships: |
| 5-L | . . . . . S | Suite |
Definition: Uniquely designed and elegantly decorated accommodations with many amenities available for an additional charge. Concept Relationships: |
| 5-L | . . . . . SP | Semi-private |
Definition: Accommodations in which there are 2 beds. Concept Relationships: |
| 5-L | . . . . . W | Ward |
Definition: Accommodations in which there are 3 or more beds. Concept Relationships: |
| 1-A | . _ActInvoiceGroupCode . v:ActInvoiceGroupCode |
ActInvoiceGroupCode |
Definition: Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results. Invoice elements of this type signify a grouping of one or more children (detail) invoice elements. They do not have intrinsic costing associated with them, but merely reflect the sum of all costing for it's immediate children invoice elements. Concept Relationships: |
| 2-A | . . _ActInvoiceInterGroupCode . . v:ActInvoiceInterGroupCode |
ActInvoiceInterGroupCode |
Definition: Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results. Invoice elements of this type signify a grouping of one or more children (detail) invoice elements. They do not have intrinsic costing associated with them, but merely reflect the sum of all costing for it's immediate children invoice elements. The domain is only specified for an intermediate invoice element group (non-root or non-top level) for an Invoice. Concept Relationships: |
| 3-L | . . . CPNDDRGING | compound drug invoice group |
Definition: A grouping of invoice element groups and details including the ones specifying the compound ingredients being invoiced. It may also contain generic detail items such as markup. Concept Relationships: |
| 3-L | . . . CPNDINDING | compound ingredient invoice group |
Definition: A grouping of invoice element details including the one specifying an ingredient drug being invoiced. It may also contain generic detail items such as tax or markup. Concept Relationships: |
| 3-L | . . . CPNDSUPING | compound supply invoice group |
Definition: A grouping of invoice element groups and details including the ones specifying the compound supplies being invoiced. It may also contain generic detail items such as markup. Concept Relationships: |
| 3-L | . . . DRUGING | drug invoice group |
Definition: A grouping of invoice element details including the one specifying the drug being invoiced. It may also contain generic detail items such as markup. Concept Relationships: |
| 3-L | . . . FRAMEING | frame invoice group |
Definition: A grouping of invoice element details including the ones specifying the frame fee and the frame dispensing cost that are being invoiced. Concept Relationships: |
| 3-L | . . . LENSING | lens invoice group |
Definition: A grouping of invoice element details including the ones specifying the lens fee and the lens dispensing cost that are being invoiced. Concept Relationships: |
| 3-L | . . . PRDING | product invoice group |
Definition: A grouping of invoice element details including the one specifying the product (good or supply) being invoiced. It may also contain generic detail items such as tax or discount. Concept Relationships: |
| 2-A | . . _ActInvoiceRootGroupCode . . v:ActInvoiceRootGroupCode |
ActInvoiceRootGroupCode |
Definition: Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results. Invoice elements of this type signify a grouping of one or more children (detail) invoice elements. They do not have intrinsic costing associated with them, but merely reflect the sum of all costing for it's immediate children invoice elements. Codes from this domain reflect the type of Invoice such as Pharmacy Dispense, Clinical Service and Clinical Product. The domain is only specified for the root (top level) invoice element group for an Invoice. Concept Relationships: |
| 3-L | . . . CPINV | clinical product invoice |
Definition: Clinical product invoice where the Invoice Grouping contains one or more billable item and is supported by clinical product(s). For example, a crutch or a wheelchair. Concept Relationships: |
| 3-L | . . . CSINV | clinical service invoice |
Definition: Clinical Services Invoice which can be used to describe a single service, multiple services or repeated services. [1] Single Clinical services invoice where the Invoice Grouping contains one billable item and is supported by one clinical service. For example, a single service for an office visit or simple clinical procedure (e.g. knee mobilization). [2] Multiple Clinical services invoice where the Invoice Grouping contains more than one billable item, supported by one or more clinical services. The services can be distinct and over multiple dates, but for the same patient. This type of invoice includes a series of treatments which must be adjudicated together. For example, an adjustment and ultrasound for a chiropractic session where fees are associated for each of the services and adjudicated (invoiced) together. [3] Repeated Clinical services invoice where the Invoice Grouping contains one or more billable item, supported by the same clinical service repeated over a period of time. For example, the same Chiropractic adjustment (service or treatment) delivered on 3 separate occasions over a period of time at the discretion of the provider (e.g. month). Concept Relationships: |
| 3-L | . . . CSPINV | clinical service and product |
Definition: A clinical Invoice Grouping consisting of one or more services and one or more product. Billing for these service(s) and product(s) are supported by multiple clinical billable events (acts). All items in the Invoice Grouping must be adjudicated together to be acceptable to the Adjudicator. For example , a brace (product) invoiced together with the fitting (service). Concept Relationships: |
| 3-L | . . . FININV | financial invoice |
Definition: Invoice Grouping without clinical justification. These will not require identification of participants and associations from a clinical context such as patient and provider. Examples are interest charges and mileage. Concept Relationships: |
| 3-L | . . . OHSINV | oral health service |
Definition: A clinical Invoice Grouping consisting of one or more oral health services. Billing for these service(s) are supported by multiple clinical billable events (acts). All items in the Invoice Grouping must be adjudicated together to be acceptable to the Adjudicator. Concept Relationships: |
| 3-L | . . . PAINV | preferred accommodation invoice |
Definition: HealthCare facility preferred accommodation invoice. Concept Relationships: |
| 3-L | . . . RXCINV | Rx compound invoice |
Definition: Pharmacy dispense invoice for a compound. Concept Relationships: |
| 3-L | . . . RXDINV | Rx dispense invoice |
Definition: Pharmacy dispense invoice not involving a compound Concept Relationships: |
| 3-L | . . . SBFINV | sessional or block fee invoice |
Definition: Clinical services invoice where the Invoice Group contains one billable item for multiple clinical services in one or more sessions. Concept Relationships: |
| 3-L | . . . VRXINV | vision dispense invoice |
Definition: Vision dispense invoice for up to 2 lens (left and right), frame and optional discount. Eye exams are invoiced as a clinical service invoice. Concept Relationships: |
| 0-A | _ActInvoiceElementSummaryCode v:ActInvoiceElementSummaryCode |
ActInvoiceElementSummaryCode |
Definition: Identifies the different types of summary information that can be reported by queries dealing with Statement of Financial Activity (SOFA). The summary information is generally used to help resolve balance discrepancies between providers and payors. Concept Relationships: |
| 1-A | . _InvoiceElementAdjudicated . v:InvoiceElementAdjudicated |
InvoiceElementAdjudicated |
Definition: Total counts and total net amounts adjudicated for all Invoice Groupings that were adjudicated within a time period based on the adjudication date of the Invoice Grouping. Concept Relationships: |
| 2-L | . . ADNFPPELAT | adjud. nullified prior-period electronic amount |
Definition: Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically. Concept Relationships: |
| 2-L | . . ADNFPPELCT | adjud. nullified prior-period electronic count |
Definition: Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically. Concept Relationships: |
| 2-L | . . ADNFPPMNAT | adjud. nullified prior-period manual amount |
Definition: Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually. Concept Relationships: |
| 2-L | . . ADNFPPMNCT | adjud. nullified prior-period manual count |
Definition: Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually. Concept Relationships: |
| 2-L | . . ADNFSPELAT | adjud. nullified same-period electronic amount |
Definition: Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently nullified in the specified period and submitted electronically. Concept Relationships: |
| 2-L | . . ADNFSPELCT | adjud. nullified same-period electronic count |
Definition: Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently nullified in the specified period and submitted electronically. Concept Relationships: |
| 2-L | . . ADNFSPMNAT | adjud. nullified same-period manual amount |
Definition: Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually. Concept Relationships: |
| 2-L | . . ADNFSPMNCT | adjud. nullified same-period manual count |
Definition: Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually. Concept Relationships: |
| 2-L | . . ADNPPPELAT | adjud. non-payee payable prior-period electronic amount |
Definition: Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically. Concept Relationships: |
| 2-L | . . ADNPPPELCT | adjud. non-payee payable prior-period electronic count |
Definition: Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically. Concept Relationships: |
| 2-L | . . ADNPPPMNAT | adjud. non-payee payable prior-period manual amount |
Definition: Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually. Concept Relationships: |
| 2-L | . . ADNPPPMNCT | adjud. non-payee payable prior-period manual count |
Definition: Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually. Concept Relationships: |
| 2-L | . . ADNPSPELAT | adjud. non-payee payable same-period electronic amount |
Definition: Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically. Concept Relationships: |
| 2-L | . . ADNPSPELCT | adjud. non-payee payable same-period electronic count |
Definition: Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically. Concept Relationships: |
| 2-L | . . ADNPSPMNAT | adjud. non-payee payable same-period manual amount |
Definition: Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually. Concept Relationships: |
| 2-L | . . ADNPSPMNCT | adjud. non-payee payable same-period manual count |
Definition: Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually. Concept Relationships: |
| 2-L | . . ADPPPPELAT | adjud. payee payable prior-period electronic amount |
Definition: Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically. Concept Relationships: |
| 2-L | . . ADPPPPELCT | adjud. payee payable prior-period electronic count |
Definition: Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically. Concept Relationships: |
| 2-L | . . ADPPPPMNAT | adjud. payee payable prior-period manual amout |
Definition: Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually. Concept Relationships: |
| 2-L | . . ADPPPPMNCT | adjud. payee payable prior-period manual count |
Definition: Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually. Concept Relationships: |
| 2-L | . . ADPPSPELAT | adjud. payee payable same-period electronic amount |
Definition: Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically. Concept Relationships: |
| 2-L | . . ADPPSPELCT | adjud. payee payable same-period electronic count |
Definition: Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically. Concept Relationships: |
| 2-L | . . ADPPSPMNAT | adjud. payee payable same-period manual amount |
Definition: Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually. Concept Relationships: |
| 2-L | . . ADPPSPMNCT | adjud. payee payable same-period manual count |
Definition: Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually. Concept Relationships: |
| 2-L | . . ADRFPPELAT | adjud. refused prior-period electronic amount |
Definition: Identifies the total net amount of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted electronically. Concept Relationships: |
| 2-L | . . ADRFPPELCT | adjud. refused prior-period electronic count |
Definition: Identifies the total number of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted electronically. Concept Relationships: |
| 2-L | . . ADRFPPMNAT | adjud. refused prior-period manual amount |
Definition: Identifies the total net amount of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted manually. Concept Relationships: |
| 2-L | . . ADRFPPMNCT | adjud. refused prior-period manual count |
Definition: Identifies the total number of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted manually. Concept Relationships: |
| 2-L | . . ADRFSPELAT | adjud. refused same-period electronic amount |
Definition: Identifies the total net amount of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted electronically. Concept Relationships: |
| 2-L | . . ADRFSPELCT | adjud. refused same-period electronic count |
Definition: Identifies the total number of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted electronically. Concept Relationships: |
| 2-L | . . ADRFSPMNAT | adjud. refused same-period manual amount |
Definition: Identifies the total net amount of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted manually. Concept Relationships: |
| 2-L | . . ADRFSPMNCT | adjud. refused same-period manual count |
Definition: Identifies the total number of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted manually. Concept Relationships: |
| 1-A | . _InvoiceElementPaid . v:InvoiceElementPaid |
InvoiceElementPaid |
Definition: Total counts and total net amounts paid for all Invoice Groupings that were paid within a time period based on the payment date. Concept Relationships: |
| 2-L | . . PDNFPPELAT | paid nullified prior-period electronic amount |
Definition: Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently nullified in the specified period and submitted electronically. Concept Relationships: |
| 2-L | . . PDNFPPELCT | paid nullified prior-period electronic count |
Definition: Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently nullified in the specified period and submitted electronically. Concept Relationships: |
| 2-L | . . PDNFPPMNAT | paid nullified prior-period manual amount |
Definition: Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently nullified in the specified period and submitted manually. Concept Relationships: |
| 2-L | . . PDNFPPMNCT | paid nullified prior-period manual count |
Definition: Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently nullified in the specified period and submitted manually. Concept Relationships: |
| 2-L | . . PDNFSPELAT | paid nullified same-period electronic amount |
Definition: Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently nullified in the specified period and submitted electronically. Concept Relationships: |
| 2-L | . . PDNFSPELCT | paid nullified same-period electronic count |
Definition: Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently cancelled in the specified period and submitted electronically. Concept Relationships: |
| 2-L | . . PDNFSPMNAT | paid nullified same-period manual amount |
Definition: Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently nullified in the specified period and submitted manually. Concept Relationships: |
| 2-L | . . PDNFSPMNCT | paid nullified same-period manual count |
Definition: Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently nullified in the specified period and submitted manually. Concept Relationships: |
| 2-L | . . PDNPPPELAT | paid non-payee payable prior-period electronic amount |
Definition: Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically. Concept Relationships: |
| 2-L | . . PDNPPPELCT | paid non-payee payable prior-period electronic count |
Definition: Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically. Concept Relationships: |
| 2-L | . . PDNPPPMNAT | paid non-payee payable prior-period manual amount |
Definition: Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually. Concept Relationships: |
| 2-L | . . PDNPPPMNCT | paid non-payee payable prior-period manual count |
Definition: Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually. Concept Relationships: |
| 2-L | . . PDNPSPELAT | paid non-payee payable same-period electronic amount |
Definition: Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically. Concept Relationships: |
| 2-L | . . PDNPSPELCT | paid non-payee payable same-period electronic count |
Definition: Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically. Concept Relationships: |
| 2-L | . . PDNPSPMNAT | paid non-payee payable same-period manual amount |
Definition: Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually. Concept Relationships: |
| 2-L | . . PDNPSPMNCT | paid non-payee payable same-period manual count |
Definition: Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually. Concept Relationships: |
| 2-L | . . PDPPPPELAT | paid payee payable prior-period electronic amount |
Definition: Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically. Concept Relationships: |
| 2-L | . . PDPPPPELCT | paid payee payable prior-period electronic count |
Definition: Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically. Concept Relationships: |
| 2-L | . . PDPPPPMNAT | paid payee payable prior-period manual amount |
Definition: Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually. Concept Relationships: |
| 2-L | . . PDPPPPMNCT | paid payee payable prior-period manual count |
Definition: Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually. Concept Relationships: |
| 2-L | . . PDPPSPELAT | paid payee payable same-period electronic amount |
Definition: Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically. Concept Relationships: |
| 2-L | . . PDPPSPELCT | paid payee payable same-period electronic count |
Definition: Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically. Concept Relationships: |
| 2-L | . . PDPPSPMNAT | paid payee payable same-period manual amount |
Definition: Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually. Concept Relationships: |
| 2-L | . . PDPPSPMNCT | paid payee payable same-period manual count |
Definition: Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually. Concept Relationships: |
| 1-A | . _InvoiceElementSubmitted . v:InvoiceElementSubmitted |
InvoiceElementSubmitted |
Definition: Total counts and total net amounts billed for all Invoice Groupings that were submitted within a time period. Adjudicated invoice elements are included. Concept Relationships: |
| 2-L | . . SBBLELAT | submitted billed electronic amount |
Definition: Identifies the total net amount billed for all submitted Invoice Groupings within a time period and submitted electronically. Adjudicated invoice elements are included. Concept Relationships: |
| 2-L | . . SBBLELCT | submitted billed electronic count |
Definition: Identifies the total number of submitted Invoice Groupings within a time period and submitted electronically. Adjudicated invoice elements are included. Concept Relationships: |
| 2-L | . . SBNFELAT | submitted nullified electronic amount |
Definition: Identifies the total net amount billed for all submitted Invoice Groupings that were nullified within a time period and submitted electronically. Adjudicated invoice elements are included. Concept Relationships: |
| 2-L | . . SBNFELCT | submitted cancelled electronic count |
Definition: Identifies the total number of submitted Invoice Groupings that were nullified within a time period and submitted electronically. Adjudicated invoice elements are included. Concept Relationships: |
| 2-L | . . SBPDELAT | submitted pending electronic amount |
Definition: Identifies the total net amount billed for all submitted Invoice Groupings that are pended or held by the payor, within a time period and submitted electronically. Adjudicated invoice elements are not included. Concept Relationships: |
| 2-L | . . SBPDELCT | submitted pending electronic count |
Definition: Identifies the total number of submitted Invoice Groupings that are pended or held by the payor, within a time period and submitted electronically. Adjudicated invoice elements are not included. Concept Relationships: |
| 0-A | _ActInvoiceOverrideCode v:ActInvoiceOverrideCode |
ActInvoiceOverrideCode |
Definition: Includes coded responses that will occur as a result of the adjudication of an electronic invoice at a summary level and provides guidance on interpretation of the referenced adjudication results. Concept Relationships: |
| 1-L | . COVGE | coverage problem |
Definition: Insurance coverage problems have been encountered. Additional explanation information to be supplied. Concept Relationships: |
| 1-L | . EFORM | electronic form to follow |
Definition: Electronic form with supporting or additional information to follow. Concept Relationships: |
| 1-L | . FAX | fax to follow |
Definition: Fax with supporting or additional information to follow. Concept Relationships: |
| 1-L | . GFTH | good faith indicator |
Definition: The medical service was provided to a patient in good faith that they had medical coverage, although no evidence of coverage was available before service was rendered. Concept Relationships: |
| 1-L | . LATE | late invoice |
Definition: Knowingly over the payor's published time limit for this invoice possibly due to a previous payor's delays in processing. Additional reason information will be supplied. Concept Relationships: |
| 1-L | . MANUAL | manual review |
Definition: Manual review of the invoice is requested. Additional information to be supplied. This may be used in the case of an appeal. Concept Relationships: |
| 1-L | . OOJ | out of jurisdiction |
Definition: The medical service and/or product was provided to a patient that has coverage in another jurisdiction. Concept Relationships: |
| 1-L | . ORTHO | orthodontic service |
Definition: The service provided is required for orthodontic purposes. If the covered party has orthodontic coverage, then the service may be paid. Concept Relationships: |
| 1-L | . PAPER | paper documentation to follow |
Definition: Paper documentation (or other physical format) with supporting or additional information to follow. Concept Relationships: |
| 1-L | . PIE | public insurance exhausted |
Definition: Public Insurance has been exhausted. Invoice has not been sent to Public Insuror and therefore no Explanation Of Benefits (EOB) is provided with this Invoice submission. Concept Relationships: |
| 1-L | . PYRDELAY | delayed by a previous payor |
Definition: Allows provider to explain lateness of invoice to a subsequent payor. Concept Relationships: |
| 1-L | . REFNR | referral not required |
Definition: Rules of practice do not require a physician's referral for the provider to perform a billable service. Concept Relationships: |
| 1-L | . REPSERV | repeated service |
Definition: The same service was delivered within a time period that would usually indicate a duplicate billing. However, the repeated service is a medical necessity and therefore not a duplicate. Concept Relationships: |
| 1-L | . UNRELAT | unrelated service |
Definition: The service provided is not related to another billed service. For example, 2 unrelated services provided on the same day to the same patient which may normally result in a refused payment for one of the items. Concept Relationships: |
| 1-L | . VERBAUTH | verbal authorization |
Definition: The provider has received a verbal permission from an authoritative source to perform the service or supply the item being invoiced. Concept Relationships: |
| 0-A | _ActListCode v:ActListCode |
ActListCode |
Definition: Provides codes associated with ActClass value of LIST (working list) Concept Relationships: |
| 1-S | . MEDLIST . v:ActMedicationList |
medication list |
Definition: List of medications. Concept Relationships: |
| 2-L | . . CURMEDLIST | current medication list |
Definition: List of current medications. Concept Relationships: |
| 2-L | . . DISCMEDLIST | discharge medication list |
Definition: List of discharge medications. Concept Relationships: |
| 2-L | . . HISTMEDLIST | medication history |
Definition: Historical list of medications. Concept Relationships: |
| 1-A | . _ActObservationList . v:ActObservationList |
ActObservationList |
Concept Relationships: |
| 2-L | . . CARELIST | care plan |
Definition: List of acts representing a care plan. The acts can be in a varierty of moods including event (EVN) to record acts that have been carried out as part of the care plan. Concept Relationships: |
| 2-S | . . CONDLIST . . v:ActConditionList |
condition list |
Definition: List of condition observations. Concept Relationships: |
| 3-L | . . . INTOLIST | intolerance list |
Definition: List of intolerance observations. Concept Relationships: |
| 3-L | . . . PROBLIST | problem list |
Definition: List of problem observations. Concept Relationships: |
| 3-L | . . . RISKLIST | risk factors |
Definition: List of risk factor observations. Concept Relationships: |
| 2-L | . . GOALLIST | goal list |
Definition: List of observations in goal mood. Concept Relationships: |
| 1-A | . _ActTherapyDurationWorkingListCode . v:ActTherapyDurationWorkingListCode |
ActTherapyDurationWorkingListCode |
Definition: Codes used to identify different types of 'duration-based' working lists. Examples include "Continuous/Chronic", "Short-Term" and "As-Needed". Concept Relationships: |
| 2-A | . . _ActMedicationTherapyDurationWorkingListCode . . v:ActMedicationTherapyDurationWorkingListCode |
act medication therapy duration working list |
Definition: Definition:A collection of concepts that identifies different types of 'duration-based' mediation working lists. Examples:"Continuous/Chronic" "Short-Term" and "As Needed" Concept Relationships: |
| 3-L | . . . ACU | short term/acute |
Definition: Definition:A list of medications which the patient is only expected to consume for the duration of the current order or limited set of orders and which is not expected to be renewed. Concept Relationships: |
| 3-L | . . . CHRON | continuous/chronic |
Definition: Definition:A list of medications which are expected to be continued beyond the present order and which the patient should be assumed to be taking unless explicitly stopped. Concept Relationships: |
| 3-L | . . . ONET | one time |
Definition: Definition:A list of medications which the patient is intended to be administered only once. Concept Relationships: |
| 3-L | . . . PRN | as needed |
Definition: Definition:A list of medications which the patient will consume intermittently based on the behavior of the condition for which the medication is indicated. Concept Relationships: |
| 0-A | _ActMonitoringProtocolCode v:ActMonitoringProtocolCode |
ActMonitoringProtocolCode |
Definition: Identifies types of monitoring programs Concept Relationships: |
| 1-L | . CTLSUB . v:ControlledSubstanceMonitoringProtocol |
Controlled Substance |
Definition: A monitoring program that focuses on narcotics and/or commonly abused substances that are subject to legal restriction. Concept Relationships: |
| 1-L | . INV | investigational |
Definition: Definition:A monitoring program that focuses on a drug which is under investigation and has not received regulatory approval for the condition being investigated Concept Relationships: |
| 1-L | . LU | limited use |
Definition: Description:A drug that can be prescribed (and reimbursed) only if it meets certain criteria. Concept Relationships: |
| 1-L | . OTC | non prescription medicine |
Definition: Medicines designated in this way may be supplied for patient use without a prescription. The exact form of categorisation will vary in different realms. Concept Relationships: |
| 1-L | . RX | prescription only medicine |
Definition: Some form of prescription is required before the related medicine can be supplied for a patient. The exact form of regulation will vary in different realms. Concept Relationships: |
| 1-L | . SA | special authorization |
Definition: Definition:A drug that requires prior approval (to be reimbursed) before being dispensed Concept Relationships: |
| 1-L | . SAC | special access |
Definition: Description:A drug that requires special access permission to be prescribed and dispensed. Concept Relationships: |
| 0-A | _ActNonObservationIndicationCode | ActNonObservationIndicationCode |
Definition: Description:Concepts representing indications (reasons for clinical action) other than diagnosis and symptoms. Concept Relationships: |
| 1-L | . IND01 | imaging study requiring contrast |
Definition: Description:Contrast agent required for imaging study. Concept Relationships: |
| 1-L | . IND02 | colonoscopy prep |
Definition: Description:Provision of prescription or direction to consume a product for purposes of bowel clearance in preparation for a colonoscopy. Concept Relationships: |
| 1-L | . IND03 | prophylaxis |
Definition: Description:Provision of medication as a preventative measure during a treatment or other period of increased risk. Concept Relationships: |
| 1-L | . IND04 | surgical prophylaxis |
Definition: Description:Provision of medication during pre-operative phase; e.g., antibiotics before dental surgery or bowel prep before colon surgery. Concept Relationships: |
| 1-L | . IND05 | pregnancy prophylaxis |
Definition: Description:Provision of medication for pregnancy --e.g., vitamins, antibiotic treatments for vaginal tract colonization, etc. Concept Relationships: |
| 0-A | _ActObservationVerificationType v:ActObservationVerificationType |
act observation verification |
Definition: Identifies the type of verification investigation being undertaken with respect to the subject of the verification activity. Examples:
Concept Relationships: |
| 1-L | . VFPAPER | verify paper |
Definition: Definition:Indicates that the paper version of the record has, should be or is being verified against the electronic version. Concept Relationships: |
| 1-L | . VRFPAPER | verify paper |
Definition: Definition:Indicates that the paper version of the record has, should be or is being verified against the electronic version. Concept Relationships: |
| 0-A | _ActPaymentCode v:ActPaymentCode |
ActPaymentCode |
Definition: Code identifying the method or the movement of payment instructions. Codes are drawn from X12 data element 591 (PaymentMethodCode) Concept Relationships: |
| 1-L | . ACH | Automated Clearing House |
Definition: Automated Clearing House (ACH). Concept Relationships: |
| 1-L | . CHK | Cheque |
Definition: A written order to a bank to pay the amount specified from funds on deposit. Concept Relationships: |
| 1-L | . DDP | Direct Deposit |
Definition: Electronic Funds Transfer (EFT) deposit into the payee's bank account Concept Relationships: |
| 1-L | . NON | Non-Payment Data |
Definition: Non-Payment Data. Concept Relationships: |
| 0-A | _ActPharmacySupplyType v:ActPharmacySupplyType |
ActPharmacySupplyType |
Definition: Identifies types of dispensing events Concept Relationships: |
| 1-L | . DF | Daily Fill |
Definition: A fill providing sufficient supply for one day Concept Relationships: |
| 1-S | . EM . v:EmergencyPharmacySupplyType |
Emergency Supply |
Definition: A supply action where there is no 'valid' order for the supplied medication. E.g. Emergency vacation supply, weekend supply (when prescriber is unavailable to provide a renewal prescription) Concept Relationships: |
| 2-L | . . SO | Script Owing |
Definition: An emergency supply where the expectation is that a formal order authorizing the supply will be provided at a later date. Concept Relationships: |
| 1-S | . FF . v:FirstFillPharmacySupplyType |
First Fill |
Definition: The initial fill against an order. (This includes initial fills against refill orders.) Concept Relationships: |
| 2-S | . . FFC | First Fill - Complete |
Definition: A first fill where the quantity supplied is equal to one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets). Concept Relationships: |
| 3-L | . . . FFCS | first fill complete, partial strength |
Definition: A first fill where the quantity supplied is equal to one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets) and also where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets). Concept Relationships: |
| 2-L | . . FFP | First Fill - Part Fill |
Definition: A first fill where the quantity supplied is less than one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.) Concept Relationships: |
| 2-L | . . FFPS | first fill, part fill, partial strength |
Definition: A first fill where the quantity supplied is less than one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.) and also where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets) Concept Relationships: |
| 2-S | . . FFSS | first fill, partial strength |
Definition: A first fill where the strength supplied is less than the ordered strength. (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets). Concept Relationships: |
| 3-L | . . . FFCS | first fill complete, partial strength |
Definition: A first fill where the quantity supplied is equal to one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets) and also where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets). Concept Relationships: |
| 3-L | . . . FFPS | first fill, part fill, partial strength |
Definition: A first fill where the quantity supplied is less than one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.) and also where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets) Concept Relationships: |
| 3-L | . . . TFS | trial fill partial strength |
Definition: A fill where a small portion is provided to allow for determination of the therapy effectiveness and patient tolerance and also where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets). Concept Relationships: |
| 2-S | . . TF | Trial Fill |
Definition: A fill where a small portion is provided to allow for determination of the therapy effectiveness and patient tolerance. Concept Relationships: |
| 3-L | . . . TFS | trial fill partial strength |
Definition: A fill where a small portion is provided to allow for determination of the therapy effectiveness and patient tolerance and also where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets). Concept Relationships: |
| 1-L | . FS | Floor stock |
Definition: A supply action to restock a smaller more local dispensary. Concept Relationships: |
| 1-L | . MS | Manufacturer Sample |
Definition: A supply of a manufacturer sample Concept Relationships: |
| 1-S | . RF . v:RefillPharmacySupplyType |
Refill |
Definition: A fill against an order that has already been filled (or partially filled) at least once. Concept Relationships: |
| 2-L | . . DF | Daily Fill |
Definition: A fill providing sufficient supply for one day Concept Relationships: |
| 2-S | . . RFC | Refill - Complete |
Definition: A refill where the quantity supplied is equal to one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets.) Concept Relationships: |
| 3-L | . . . RFCS | refill complete partial strength |
Definition: A refill where the quantity supplied is equal to one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets.) and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets). Concept Relationships: |
| 2-S | . . RFF | Refill (First fill this facility) |
Definition: The first fill against an order that has already been filled at least once at another facility. Concept Relationships: |
| 3-L | . . . RFFS | refill partial strength (first fill this facility) |
Definition: The first fill against an order that has already been filled at least once at another facility and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets). Concept Relationships: |
| 2-S | . . RFP | Refill - Part Fill |
Definition: A refill where the quantity supplied is less than one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.) Concept Relationships: |
| 3-L | . . . RFPS | refill part fill partial strength |
Definition: A refill where the quantity supplied is less than one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.) and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets). Concept Relationships: |
| 2-L | . . RFS | refill partial strength |
Definition: A fill against an order that has already been filled (or partially filled) at least once and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets). Concept Relationships: |
| 2-S | . . TB | Trial Balance |
Definition: A fill where the remainder of a 'complete' fill is provided after a trial fill has been provided. Concept Relationships: |
| 3-L | . . . TBS | trial balance partial strength |
Definition: A fill where the remainder of a 'complete' fill is provided after a trial fill has been provided and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets). Concept Relationships: |
| 2-L | . . UD | Unit Dose |
Definition: A supply action that provides sufficient material for a single dose. Concept Relationships: |
| 1-L | . UD | Unit Dose |
Definition: A supply action that provides sufficient material for a single dose. Concept Relationships: |
| 1-L | . UDE | unit dose equivalent |
Definition: A supply action that provides sufficient material for a single dose via multiple products. E.g. 2 50mg tablets for a 100mg unit dose. Concept Relationships: |
| 0-A | _ActPolicyType v:ActPolicyType |
ActPolicyType |
Definition: Description:Types of policies that further specify the ActClassPolicy value set. Concept Relationships: |
| 1-L | . COVPOL | benefit policy |
Definition: Description:A mandate, obligation, requirement, rule, or expectation unilaterally imposed on benefit coverage under a policy or program by a sponsor, underwriter or payor on:
Examples:A clinical protocol imposed by a payer to which a provider must adhere in order to be paid for providing the service. A formulary from which a provider must select prescribed drugs in order for the patient to incur a lower copay. Concept Relationships: |
| 0-A | _ActProductAcquisitionCode v:ActProductAcquisitionCode |
ActProductAcquisitionCode |
Definition: The method that a product is obtained for use by the subject of the supply act (e.g. patient). Product examples are consumable or durable goods. Concept Relationships: |
| 1-S | . LOAN . v:Loan |
Loan |
Definition: Temporary supply of a product without transfer of ownership for the product. Concept Relationships: |
| 2-L | . . RENT | Rent |
Definition: Temporary supply of a product with financial compensation, without transfer of ownership for the product. Concept Relationships: |
| 1-S | . TRANSFER . v:Transfer |
Transfer |
Definition: Transfer of ownership for a product. Concept Relationships: |
| 2-L | . . SALE | Sale |
Definition: Transfer of ownership for a product for financial compensation. Concept Relationships: |
| 0-A | _ActSpecimenTransportCode | ActSpecimenTransportCode |
Definition: Transportation of a specimen. Concept Relationships: |
| 1-L | . SREC | specimen received |
Definition: Description:Specimen has been received by the participating organization/department. Concept Relationships: |
| 1-L | . SSTOR | specimen in storage |
Definition: Description:Specimen has been placed into storage at a participating location. Concept Relationships: |
| 1-L | . STRAN | specimen in transit |
Definition: Description:Specimen has been put in transit to a participating receiver. Concept Relationships: |
| 0-A | _ActSpecimenTreatmentCode v:ActSpecimenTreatmentCode |
ActSpecimenTreatmentCode |
Definition: Set of codes related to specimen treatments Concept Relationships: |
| 1-L | . ACID | Acidification |
Definition: The lowering of specimen pH through the addition of an acid Concept Relationships: |
| 1-L | . ALK | Alkalization |
Definition: The act rendering alkaline by impregnating with an alkali; a conferring of alkaline qualities. Concept Relationships: |
| 1-L | . DEFB | Defibrination |
Definition: The removal of fibrin from whole blood or plasma through physical or chemical means Concept Relationships: |
| 1-L | . FILT | Filtration |
Definition: The passage of a liquid through a filter, accomplished by gravity, pressure or vacuum (suction). Concept Relationships: |
| 1-L | . LDLP | LDL Precipitation |
Concept Relationships: |
| 1-L | . NEUT | Neutralization |
Definition: The act or process by which an acid and a base are combined in such proportions that the resulting compound is neutral. Concept Relationships: |
| 1-L | . RECA | Recalcification |
Definition: The addition of calcium back to a specimen after it was removed by chelating agents Concept Relationships: |
| 1-L | . UFIL | Ultrafiltration |
Definition: The filtration of a colloidal substance through a semipermeable medium that allows only the passage of small molecules. Concept Relationships: |
| 0-A | _ActSubstanceAdministrationCode v:ActSubstanceAdministrationCode |
ActSubstanceAdministrationCode |
Definition: Description: Describes the type of substance administration being performed. This should not be used to carry codes for identification of products. Use an associated role or entity to carry such information. Concept Relationships: |
| 1-L | . DRUG | Drug therapy |
Definition: The introduction of a drug into a subject with the intention of altering its biologic state with the intent of improving its health status. Concept Relationships: |
| 1-L | . FD | food |
Definition: Description: The introduction of material into a subject with the intent of providing nutrition or other dietary supplements (e.g. minerals or vitamins). Concept Relationships: |
| 1-L | . IMMUNIZ . v:ActSubstanceAdministrationImmunizationCode |
Immunization |
Definition: The introduction of an immunogen with the intent of stimulating an immune response, aimed at preventing subsequent infections by more viable agents. Concept Relationships: |
| 0-A | _ActTaskCode v:ActTaskCode |
ActTaskCode |
Definition: Description: A task or action that a user may perform in a clinical information system (e.g., medication order entry, laboratory test results review, problem list entry). Concept Relationships: |
| 1-S | . OE . v:ActTaskOrderEntryCode |
order entry task |
Definition: A clinician creates a request for a service to be performed for a given patient. Concept Relationships: |
| 2-L | . . LABOE | laboratory test order entry task |
Definition: A clinician creates a request for a laboratory test to be done for a given patient. Concept Relationships: |
| 2-L | . . MEDOE | medication order entry task |
Definition: A clinician creates a request for the administration of one or more medications to a given patient. Concept Relationships: |
| 1-S | . PATDOC . v:ActTaskPatientDocumentationCode |
patient documentation task |
Definition: A person enters documentation about a given patient. Concept Relationships: |
| 2-L | . . ALLERLREV | allergy list review |
Definition: Description: A person reviews a list of known allergies of a given patient. Concept Relationships: |
| 2-S | . . CLINNOTEE . . v:ActTaskClinicalNoteEntryCode |
clinical note entry task |
Definition: A clinician enters a clinical note about a given patient Concept Relationships: |
| 3-L | . . . DIAGLISTE | diagnosis list entry task |
Definition: A clinician enters a diagnosis for a given patient. Concept Relationships: |
| 3-L | . . . DISCHSUME | discharge summary entry task |
Definition: A clinician enters a discharge summary for a given patient. Concept Relationships: |
| 3-L | . . . PATREPE | pathology report entry task |
Definition: A pathologist enters a report for a given patient. Concept Relationships: |
| 3-L | . . . PROBLISTE | problem list entry task |
Definition: A clinician enters a problem for a given patient. Concept Relationships: |
| 3-L | . . . RADREPE | radiology report entry task |
Definition: A radiologist enters a report for a given patient. Concept Relationships: |
| 2-L | . . IMMLREV | immunization list review |
Definition: Description: A person reviews a list of immunizations due or received for a given patient. Concept Relationships: |
| 2-S | . . REMLREV | reminder list review |
Definition: Description: A person reviews a list of health care reminders for a given patient. Concept Relationships: |
| 3-L | . . . WELLREMLREV | wellness reminder list review |
Definition: Description: A person reviews a list of wellness or preventive care reminders for a given patient. Concept Relationships: |
| 1-S | . PATINFO . v:ActTaskPatientInformationReviewCode |
patient information review task |
Definition: A person (e.g., clinician, the patient herself) reviews patient information in the electronic medical record. Concept Relationships: |
| 2-L | . . ALLERLE | allergy list entry |
Definition: Description: A person enters a known allergy for a given patient. Concept Relationships: |
| 2-S | . . CLINNOTEREV . . v:ActTaskClinicalNoteReviewCode |
clinical note review task |
Definition: A person reviews a clinical note of a given patient. Concept Relationships: |
| 3-L | . . . DISCHSUMREV | discharge summary review task |
Definition: A person reviews a discharge summary of a given patient. Concept Relationships: |
| 2-L | . . DIAGLISTREV | diagnosis list review task |
Definition: A person reviews a list of diagnoses of a given patient. Concept Relationships: |
| 2-L | . . IMMLE | immunization list entry |
Definition: Description: A person enters an immunization due or received for a given patient. Concept Relationships: |
| 2-L | . . LABRREV | laboratory results review task |
Definition: A person reviews a list of laboratory results of a given patient. Concept Relationships: |
| 2-S | . . MICRORREV . . v:ActTaskMicrobiologyResultsReviewCode |
microbiology results review task |
Definition: A person reviews a list of microbiology results of a given patient. Concept Relationships: |
| 3-L | . . . MICROORGRREV | microbiology organisms results review task |
Definition: A person reviews organisms of microbiology results of a given patient. Concept Relationships: |
| 3-L | . . . MICROSENSRREV | microbiology sensitivity test results review task |
Definition: A person reviews the sensitivity test of microbiology results of a given patient. Concept Relationships: |
| 2-S | . . MLREV . . v:ActTaskMedicationListReviewCode |
medication list review task |
Definition: A person reviews a list of medication orders submitted to a given patient Concept Relationships: |
| 3-L | . . . MARWLREV | medication administration record work list review task |
Definition: A clinician reviews a work list of medications to be administered to a given patient. Concept Relationships: |
| 2-L | . . OREV | orders review task |
Definition: A person reviews a list of orders submitted to a given patient. Concept Relationships: |
| 2-L | . . PATREPREV | pathology report review task |
Definition: A person reviews a pathology report of a given patient. Concept Relationships: |
| 2-L | . . PROBLISTREV | problem list review task |
Definition: A person reviews a list of problems of a given patient. Concept Relationships: |
| 2-L | . . RADREPREV | radiology report review task |
Definition: A person reviews a radiology report of a given patient. Concept Relationships: |
| 2-S | . . REMLE | reminder list entry |
Definition: Description: A person enters a health care reminder for a given patient. Concept Relationships: |
| 3-L | . . . WELLREMLE | wellness reminder list entry |
Definition: Description: A person enters a wellness or preventive care reminder for a given patient. Concept Relationships: |
| 2-S | . . RISKASSESS . . v:ActTaskRiskAssessmentInstrumentCode |
risk assessment instrument task |
Definition: A person reviews a Risk Assessment Instrument report of a given patient. Concept Relationships: |
| 3-L | . . . FALLRISK | falls risk assessment instrument task |
Definition: A person reviews a Falls Risk Assessment Instrument report of a given patient. Concept Relationships: |
| 0-A | _ActTransportationModeCode v:ActTransportationModeCode |
ActTransportationModeCode |
Definition: Characterizes how a transportation act was or will be carried out. Examples: Via private transport, via public transit, via courier. Concept Relationships: |
| 1-A | . _ActPatientTransportationModeCode . v:ActPatientTransportationModeCode |
ActPatientTransportationModeCode |
Definition: Definition: Characterizes how a patient was or will be transported to the site of a patient encounter. Examples: Via ambulance, via public transit, on foot. Concept Relationships: |
| 2-L | . . AFOOT | pedestrian transport |
Concept Relationships: |
| 2-S | . . AMBT . . v:Ambulance |
ambulance transport |
Concept Relationships: |
| 3-L | . . . AMBAIR | fixed-wing ambulance transport |
Concept Relationships: |
| 3-L | . . . AMBGRND | ground ambulance transport |
Concept Relationships: |
| 3-L | . . . AMBHELO | helicopter ambulance transport |
Concept Relationships: |
| 2-L | . . LAWENF | law enforcement transport |
Concept Relationships: |
| 2-L | . . PRVTRN | private transport |
Concept Relationships: |
| 2-L | . . PUBTRN | public transport |
Concept Relationships: |
| 0-A | _ObservationType v:ObservationType |
ObservationType |
Definition: Identifies the kinds of observations that can be performed Concept Relationships: |
| 1-L | . ADVERSE_REACTION | Adverse Reaction |
Definition: Indicates that the observation is of an unexpected negative occurrence in the subject suspected to result from the subject's exposure to one or more agents. Observation values would be the symptom resulting from the reaction. Concept Relationships: |
| 1-L | . ASSERTION | Assertion |
Definition: Description:Refines classCode OBS to indicate an observation in which observation.value contains a finding or other nominalized statement, where the encoded information in Observation.value is not altered by Observation.code. For instance, observation.code="ASSERTION" and observation.value="fracture of femur present" is an assertion of a clinical finding of femur fracture. Concept Relationships: |
| 1-L | . CASESER | case seriousness criteria |
Definition: Definition:An observation that provides a characterization of the level of harm to an investigation subject as a result of a reaction or event. Concept Relationships: |
| 1-S | . DX . v:ObservationDiagnosisTypes |
ObservationDiagnosisTypes |
Definition: Includes all codes defining types of indications such as diagnosis, symptom and other indications such as contrast agents for lab tests. Concept Relationships: |
| 2-L | . . ADMDX | admitting diagnosis |
Definition: Admitting diagnosis are the diagnoses documented for administrative purposes as the basis for a hospital admission. Concept Relationships: |
| 2-L | . . DISDX | discharge diagnosis |
Definition: Discharge diagnosis are the diagnoses documented for administrative purposes as the time of hospital discharge. Concept Relationships: |
| 2-L | . . INTDX | intermediate diagnosis |
Definition: Intermediate diagnoses are those diagnoses documented for administrative purposes during the course of a hospital stay. Concept Relationships: |
| 2-L | . . NOI | nature of injury |
Definition: The type of injury that the injury coding specifies. Concept Relationships: |
| 1-L | . GISTIER | GIS tier |
Definition: Description: Accuracy determined as per the GIS tier code system. Concept Relationships: |
| 1-L | . HHOBS | household situation observation |
Definition: Indicates that the observation is of a person’s living situation in a household including the household composition and circumstances. Concept Relationships: |
| 1-S | . ISSUE . v:ActDetectedIssueCode |
detected issue |
Definition: Description:There is a clinical issue for the therapy that makes continuation of the therapy inappropriate. Concept Relationships: |
| 2-A | . . _ActAdministrativeDetectedIssueCode . . v:ActAdministrativeDetectedIssueCode |
ActAdministrativeDetectedIssueCode |
Definition: Identifies types of detectyed issues for Act class "ALRT" for the administrative and patient administrative acts domains. Concept Relationships: |
| 3-A | . . . _ActAdministrativeAuthorizationDetectedIssueCode . . . v:ActAdministrativeAuthorizationDetectedIssueCode |
ActAdministrativeAuthorizationDetectedIssueCode |
Concept Relationships: |
| 4-L | . . . . NAT | Insufficient authorization |
Definition: The requesting party has insufficient authorization to invoke the interaction. Concept Relationships: |
| 4-L | . . . . SUPPRESSED | record suppressed |
Definition: Description: One or more records in the query response have been suppressed due to consent or privacy restrictions. Concept Relationships: |
| 4-S | . . . . VALIDAT . . . . v:ValidationIssue |
validation issue |
Definition: Description:The specified element did not pass business-rule validation. Concept Relationships: |
| 5-L | . . . . . BUS | business constraint violation |
Definition: Description:A local business rule relating multiple elements has been violated. Concept Relationships: |
| 5-S | . . . . . CODE_INVAL . . . . . v:CodeIsNotValid |
code is not valid |
Definition: Description:The specified code is not valid against the list of codes allowed for the element. Concept Relationships: |
| 6-L | . . . . . . CODE_DEPREC | code has been deprecated |
Definition: Description:The specified code has been deprecated and should no longer be used. Select another code from the code system. Concept Relationships: |
| 5-S | . . . . . COMPLY . . . . . v:ComplianceDetectedIssueCode . . . . . v:ComplianceAlert |
Compliance Alert |
Definition: There may be an issue with the patient complying with the intentions of the proposed therapy Concept Relationships: |
| 6-L | . . . . . . ABUSE | commonly abused/misused alert |
Definition: Description:The proposed therapy is frequently misused or abused and therefore should be used with caution and/or monitoring. Concept Relationships: |
| 6-S | . . . . . . DUPTHPY . . . . . . v:DuplicateTherapyAlert |
Duplicate Therapy Alert |
Definition: The proposed therapy appears to duplicate an existing therapy Concept Relationships: |
| 7-L | . . . . . . . DUPTHPCLS | duplicate therapeutic alass alert |
Definition: Description:The proposed therapy appears to have the same intended therapeutic benefit as an existing therapy, though the specific mechanisms of action vary. Concept Relationships: |
| 7-L | . . . . . . . DUPTHPGEN | duplicate generic alert |
Definition: Description:The proposed therapy appears to have the same intended therapeutic benefit as an existing therapy and uses the same mechanisms of action as the existing therapy. Concept Relationships: |
| 6-L | . . . . . . FRAUD | potential fraud |
Definition: Description:The request is suspected to have a fraudulent basis. Concept Relationships: |
| 6-L | . . . . . . PLYDOC | Poly-orderer Alert |
Definition: A similar or identical therapy was recently ordered by a different practitioner. Concept Relationships: |
| 6-L | . . . . . . PLYPHRM | Poly-supplier Alert Poly-pharmacy Alert |
Definition: This patient was recently supplied a similar or identical therapy from a different pharmacy or supplier. Concept Relationships: |
| 5-S | . . . . . DOSE . . . . . v:DosageProblemDetectedIssueCode . . . . . v:DosageProblem |
Dosage problem |
Definition: Proposed dosage instructions for therapy differ from standard practice. Concept Relationships: |
| 6-L | . . . . . . DOSECOND | dosage-condition alert |
Definition: Description:Proposed dosage is inappropriate due to patient's medical condition. Concept Relationships: |
| 6-S | . . . . . . DOSEDUR . . . . . . v:DoseDurationDetectedIssueCode |
Dose-Duration Alert |
Definition: Proposed length of therapy differs from standard practice. Concept Relationships: |
| 7-S | . . . . . . . DOSEDURH . . . . . . . v:DoseDurationHighDetectedIssueCode |
Dose-Duration High Alert |
Definition: Proposed length of therapy is longer than standard practice Concept Relationships: |
| 8-L | . . . . . . . . DOSEDURHIND | Dose-Duration High for Indication Alert |
Definition: Proposed length of therapy is longer than standard practice for the identified indication or diagnosis Concept Relationships: |
| 7-S | . . . . . . . DOSEDURL . . . . . . . v:DoseDurationLowDetectedIssueCode |
Dose-Duration Low Alert |
Definition: Proposed length of therapy is shorter than that necessary for therapeutic effect Concept Relationships: |
| 8-L | . . . . . . . . DOSEDURLIND | Dose-Duration Low for Indication Alert |
Definition: Proposed length of therapy is shorter than standard practice for the identified indication or diagnosis Concept Relationships: |
| 6-S | . . . . . . DOSEH . . . . . . v:DoseHighDetectedIssueCode |
High Dose Alert |
Definition: Proposed dosage exceeds standard practice Concept Relationships: |
| 7-L | . . . . . . . DOSEHIND | High Dose for Indication Alert |
Concept Relationships: |
| 7-L | . . . . . . . DOSEHINDA | High Dose for Age Alert |
Definition: Proposed dosage exceeds standard practice for the patient's age Concept Relationships: |
| 7-L | . . . . . . . DOSEHINDSA | High Dose for Height/Surface Area Alert |
Definition: Proposed dosage exceeds standard practice for the patient's height or body surface area Concept Relationships: |
| 7-L | . . . . . . . DOSEHINDW | High Dose for Weight Alert |
Definition: Proposed dosage exceeds standard practice for the patient's weight Concept Relationships: |
| 6-S | . . . . . . DOSEIVL . . . . . . v:DoseIntervalDetectedIssueCode |
Dose-Interval Alert |
Definition: Proposed dosage interval/timing differs from standard practice Concept Relationships: |
| 7-L | . . . . . . . DOSEIVLIND | Dose-Interval for Indication Alert |
Definition: Proposed dosage interval/timing differs from standard practice for the identified indication or diagnosis Concept Relationships: |
| 6-S | . . . . . . DOSEL . . . . . . v:DoseLowDetectedIssueCode |
Low Dose Alert |
Definition: Proposed dosage is below suggested therapeutic levels Concept Relationships: |
| 7-L | . . . . . . . DOSELIND | Low Dose for Indication Alert |
Concept Relationships: |
| 7-L | . . . . . . . DOSELINDA | Low Dose for Age Alert |
Definition: Proposed dosage is below suggested therapeutic levels for the patient's age Concept Relationships: |
| 7-L | . . . . . . . DOSELINDSA | Low Dose for Height/Surface Area Alert |
Definition: Proposed dosage is below suggested therapeutic levels for the patient's height or body surface area Concept Relationships: |
| 7-L | . . . . . . . DOSELINDW | Low Dose for Weight Alert |
Definition: Proposed dosage is below suggested therapeutic levels for the patient's weight Concept Relationships: |
| 6-L | . . . . . . MDOSE | maximum dosage reached |
Definition: Description:The maximum quantity of this drug allowed to be administered within a particular time-range (month, year, lifetime) has been reached or exceeded. Concept Relationships: |
| 5-L | . . . . . FORMAT | invalid format |
Definition: Description:The element does not follow the formatting or type rules defined for the field. Concept Relationships: |
| 5-L | . . . . . ILLEGAL | illegal |
Definition: Description:The request is missing elements or contains elements which cause it to not meet the legal standards for actioning. Concept Relationships: |
| 5-L | . . . . . KEY204 | Unknown key identifier |
Definition: The ID of the patient, order, etc., was not found. Used for transactions other than additions, e.g. transfer of a non-existent patient. Concept Relationships: |
| 5-L | . . . . . KEY205 | Duplicate key identifier |
Definition: The ID of the patient, order, etc., already exists. Used in response to addition transactions (Admit, New Order, etc.). Concept Relationships: |
| 5-S | . . . . . LEN_RANGE . . . . . v:LengthOutOfRange |
length out of range |
Definition: Description:The length of the data specified falls out of the range defined for the element. Concept Relationships: |
| 6-L | . . . . . . LEN_LONG | length is too long |
Definition: Description:The length of the data specified is greater than the maximum length defined for the element. Concept Relationships: |
| 6-L | . . . . . . LEN_SHORT | length is too short |
Definition: Description:The length of the data specified is less than the minimum length defined for the element. Concept Relationships: |
| 5-L | . . . . . MISSCOND | conditional element missing |
Definition: Description:The specified element must be specified with a non-null value under certain conditions. In this case, the conditions are true but the element is still missing or null. Concept Relationships: |
| 5-L | . . . . . MISSMAND | mandatory element missing |
Definition: Description:The specified element is mandatory and was not included in the instance. Concept Relationships: |
| 5-L | . . . . . NODUPS | duplicate values are not permitted |
Definition: Description:More than one element with the same value exists in the set. Duplicates not permission in this set in a set. Concept Relationships: |
| 5-L | . . . . . NOPERSIST | element will not be persisted |
Definition: Description: Element in submitted message will not persist in data storage based on detected issue. Concept Relationships: |
| 5-S | . . . . . OBSA . . . . . v:ObservationDetectedIssueCode . . . . . v:ObservationAlert |
Observation Alert |
Definition: Proposed therapy may be inappropriate or contraindicated due to conditions or characteristics of the patient Concept Relationships: |
| 6-S | . . . . . . AGE . . . . . . v:AgeDetectedIssueCode |
Age Alert |
Definition: Proposed therapy may be inappropriate or contraindicated due to patient age Concept Relationships: |
| 7-L | . . . . . . . DOSEHINDA | High Dose for Age Alert |
Definition: Proposed dosage exceeds standard practice for the patient's age Concept Relationships: |
| 7-L | . . . . . . . DOSELINDA | Low Dose for Age Alert |
Definition: Proposed dosage is below suggested therapeutic levels for the patient's age Concept Relationships: |
| 6-S | . . . . . . COND . . . . . . v:ConditionDetectedIssueCode |
Condition Alert |
Definition: Proposed therapy may be inappropriate or contraindicated due to an existing/recent patient condition or diagnosis Concept Relationships: |
| 7-L | . . . . . . . HGHT |
Concept Relationships: |
|
| 7-L | . . . . . . . LACT | Lactation Alert |
Definition: Proposed therapy may be inappropriate or contraindicated when breast-feeding Concept Relationships: |
| 7-L | . . . . . . . PREG | Pregnancy Alert |
Definition: Proposed therapy may be inappropriate or contraindicated during pregnancy Concept Relationships: |
| 7-L | . . . . . . . WGHT |
Concept Relationships: |
|
| 6-L | . . . . . . CREACT | common reaction alert |
Definition: Description:Proposed therapy may be inappropriate or contraindicated because of a common but non-patient specific reaction to the product. Example:There is no record of a specific sensitivity for the patient, but the presence of the sensitivity is common and therefore caution is warranted. Concept Relationships: |
| 6-L | . . . . . . GEN | Genetic Alert |
Definition: Proposed therapy may be inappropriate or contraindicated due to patient genetic indicators. Concept Relationships: |
| 6-L | . . . . . . GEND | Gender Alert |
Definition: Proposed therapy may be inappropriate or contraindicated due to patient gender. Concept Relationships: |
| 6-L | . . . . . . LAB | Lab Alert |
Definition: Proposed therapy may be inappropriate or contraindicated due to recent lab test results Concept Relationships: |
| 6-S | . . . . . . REACT . . . . . . v:ReactionDetectedIssueCode |
Reaction Alert |
Definition: Proposed therapy may be inappropriate or contraindicated based on the potential for a patient reaction to the proposed product Concept Relationships: |
| 7-L | . . . . . . . ALGY | Allergy Alert |
Definition: Proposed therapy may be inappropriate or contraindicated because of a recorded patient allergy to the proposed product. (Allergies are immune based reactions.) Concept Relationships: |
| 7-L | . . . . . . . INT | Intolerance Alert |
Definition: Proposed therapy may be inappropriate or contraindicated because of a recorded patient intolerance to the proposed product. (Intolerances are non-immune based sensitivities.) Concept Relationships: |
| 6-S | . . . . . . RREACT . . . . . . v:RelatedReactionDetectedIssueCode |
Related Reaction Alert |
Definition: Proposed therapy may be inappropriate or contraindicated because of a potential patient reaction to a cross-sensitivity related product. Concept Relationships: |
| 7-L | . . . . . . . RALG | Related Allergy Alert |
Definition: Proposed therapy may be inappropriate or contraindicated because of a recorded patient allergy to a cross-sensitivity related product. (Allergies are immune based reactions.) Concept Relationships: |
| 7-L | . . . . . . . RAR | Related Prior Reaction Alert |
Definition: Proposed therapy may be inappropriate or contraindicated because of a recorded prior adverse reaction to a cross-sensitivity related product. Concept Relationships: |
| 7-L | . . . . . . . RINT | Related Intolerance Alert |
Definition: Proposed therapy may be inappropriate or contraindicated because of a recorded patient intolerance to a cross-sensitivity related product. (Intolerances are non-immune based sensitivities.) Concept Relationships: |
| 5-S | . . . . . REP_RANGE . . . . . v:RepetitionsOutOfRange |
repetitions out of range |
Definition: Description:The number of repeating elements falls outside the range of the allowed number of repetitions. Concept Relationships: |
| 6-L | . . . . . . MAXOCCURS | repetitions above maximum |
Definition: Description:The number of repeating elements is above the maximum number of repetitions allowed. Concept Relationships: |
| 6-L | . . . . . . MINOCCURS | repetitions below minimum |
Definition: Description:The number of repeating elements is below the minimum number of repetitions allowed. Concept Relationships: |
| 3-A | . . . _ActAdministrativeRuleDetectedIssueCode . . . v:ActAdministrativeRuleDetectedIssueCode |
ActAdministrativeRuleDetectedIssueCode |
Concept Relationships: |
| 4-L | . . . . KEY204 | Unknown key identifier |
Definition: The ID of the patient, order, etc., was not found. Used for transactions other than additions, e.g. transfer of a non-existent patient. Concept Relationships: |
| 4-L | . . . . KEY205 | Duplicate key identifier |
Definition: The ID of the patient, order, etc., already exists. Used in response to addition transactions (Admit, New Order, etc.). Concept Relationships: |
| 4-L | . . . . KEY206 | non-matching identification |
Definition: Description: Metadata associated with the identification (e.g. name or gender) does not match the identification being verified. Concept Relationships: |
| 4-L | . . . . OBSOLETE | obsolete record returned |
Definition: Description: One or more records in the query response have a status of 'obsolete'. Concept Relationships: |
| 2-A | . . _ActSuppliedItemDetectedIssueCode . . v:ActSuppliedItemDetectedIssueCode |
ActSuppliedItemDetectedIssueCode |
Definition: Identifies types of detected issues regarding the administration or supply of an item to a patient. Concept Relationships: |
| 3-L | . . . HISTORIC | record recorded as historical |
Definition: Description: While the record was accepted in the repository, there is a more recent version of a record of this type. Concept Relationships: |
| 3-S | . . . PATPREF | violates stated preferences |
Definition: Definition:The proposed therapy goes against preferences or consent constraints recorded in the patient's record. Concept Relationships: |
| 4-L | . . . . PATPREFALT | violates stated preferences, alternate available |
Definition: Definition:The proposed therapy goes against preferences or consent constraints recorded in the patient's record. An alternate therapy meeting those constraints is available. Concept Relationships: |
| 3-A | . . . _AdministrationDetectedIssueCode . . . v:AdministrationDetectedIssueCode |
AdministrationDetectedIssueCode |
Definition: Administration of the proposed therapy may be inappropriate or contraindicated as proposed Concept Relationships: |
| 4-S | . . . . COMPLY . . . . v:ComplianceDetectedIssueCode . . . . v:ComplianceAlert |
Compliance Alert |
Definition: There may be an issue with the patient complying with the intentions of the proposed therapy Concept Relationships: |
| 5-L | . . . . . ABUSE | commonly abused/misused alert |
Definition: Description:The proposed therapy is frequently misused or abused and therefore should be used with caution and/or monitoring. Concept Relationships: |
| 5-S | . . . . . DUPTHPY . . . . . v:DuplicateTherapyAlert |
Duplicate Therapy Alert |
Definition: The proposed therapy appears to duplicate an existing therapy Concept Relationships: |
| 6-L | . . . . . . DUPTHPCLS | duplicate therapeutic alass alert |
Definition: Description:The proposed therapy appears to have the same intended therapeutic benefit as an existing therapy, though the specific mechanisms of action vary. Concept Relationships: |
| 6-L | . . . . . . DUPTHPGEN | duplicate generic alert |
Definition: Description:The proposed therapy appears to have the same intended therapeutic benefit as an existing therapy and uses the same mechanisms of action as the existing therapy. Concept Relationships: |
| 5-L | . . . . . FRAUD | potential fraud |
Definition: Description:The request is suspected to have a fraudulent basis. Concept Relationships: |
| 5-L | . . . . . PLYDOC | Poly-orderer Alert |
Definition: A similar or identical therapy was recently ordered by a different practitioner. Concept Relationships: |
| 5-L | . . . . . PLYPHRM | Poly-supplier Alert Poly-pharmacy Alert |
Definition: This patient was recently supplied a similar or identical therapy from a different pharmacy or supplier. Concept Relationships: |
| 4-L | . . . . DACT | drug action detected issue |
Definition: Description:Proposed therapy may be contraindicated or ineffective based on an existing or recent drug therapy. Concept Relationships: |
| 4-S | . . . . DOSE . . . . v:DosageProblemDetectedIssueCode . . . . v:DosageProblem |
Dosage problem |
Definition: Proposed dosage instructions for therapy differ from standard practice. Concept Relationships: |
| 5-L | . . . . . DOSECOND | dosage-condition alert |
Definition: Description:Proposed dosage is inappropriate due to patient's medical condition. Concept Relationships: |
| 5-S | . . . . . DOSEDUR . . . . . v:DoseDurationDetectedIssueCode |
Dose-Duration Alert |
Definition: Proposed length of therapy differs from standard practice. Concept Relationships: |
| 6-S | . . . . . . DOSEDURH . . . . . . v:DoseDurationHighDetectedIssueCode |
Dose-Duration High Alert |
Definition: Proposed length of therapy is longer than standard practice Concept Relationships: |
| 7-L | . . . . . . . DOSEDURHIND | Dose-Duration High for Indication Alert |
Definition: Proposed length of therapy is longer than standard practice for the identified indication or diagnosis Concept Relationships: |
| 6-S | . . . . . . DOSEDURL . . . . . . v:DoseDurationLowDetectedIssueCode |
Dose-Duration Low Alert |
Definition: Proposed length of therapy is shorter than that necessary for therapeutic effect Concept Relationships: |
| 7-L | . . . . . . . DOSEDURLIND | Dose-Duration Low for Indication Alert |
Definition: Proposed length of therapy is shorter than standard practice for the identified indication or diagnosis Concept Relationships: |
| 5-S | . . . . . DOSEH . . . . . v:DoseHighDetectedIssueCode |
High Dose Alert |
Definition: Proposed dosage exceeds standard practice Concept Relationships: |
| 6-L | . . . . . . DOSEHIND | High Dose for Indication Alert |
Concept Relationships: |
| 6-L | . . . . . . DOSEHINDA | High Dose for Age Alert |
Definition: Proposed dosage exceeds standard practice for the patient's age Concept Relationships: |
| 6-L | . . . . . . DOSEHINDSA | High Dose for Height/Surface Area Alert |
Definition: Proposed dosage exceeds standard practice for the patient's height or body surface area Concept Relationships: |
| 6-L | . . . . . . DOSEHINDW | High Dose for Weight Alert |
Definition: Proposed dosage exceeds standard practice for the patient's weight Concept Relationships: |
| 5-S | . . . . . DOSEIVL . . . . . v:DoseIntervalDetectedIssueCode |
Dose-Interval Alert |
Definition: Proposed dosage interval/timing differs from standard practice Concept Relationships: |
| 6-L | . . . . . . DOSEIVLIND | Dose-Interval for Indication Alert |
Definition: Proposed dosage interval/timing differs from standard practice for the identified indication or diagnosis Concept Relationships: |
| 5-S | . . . . . DOSEL . . . . . v:DoseLowDetectedIssueCode |
Low Dose Alert |
Definition: Proposed dosage is below suggested therapeutic levels Concept Relationships: |
| 6-L | . . . . . . DOSELIND | Low Dose for Indication Alert |
Concept Relationships: |
| 6-L | . . . . . . DOSELINDA | Low Dose for Age Alert |
Definition: Proposed dosage is below suggested therapeutic levels for the patient's age Concept Relationships: |
| 6-L | . . . . . . DOSELINDSA | Low Dose for Height/Surface Area Alert |
Definition: Proposed dosage is below suggested therapeutic levels for the patient's height or body surface area Concept Relationships: |
| 6-L | . . . . . . DOSELINDW | Low Dose for Weight Alert |
Definition: Proposed dosage is below suggested therapeutic levels for the patient's weight Concept Relationships: |
| 5-L | . . . . . MDOSE | maximum dosage reached |
Definition: Description:The maximum quantity of this drug allowed to be administered within a particular time-range (month, year, lifetime) has been reached or exceeded. Concept Relationships: |
| 4-S | . . . . DUPTHPY . . . . v:DuplicateTherapyAlert |
Duplicate Therapy Alert |
Definition: The proposed therapy appears to duplicate an existing therapy Concept Relationships: |
| 5-L | . . . . . DUPTHPCLS | duplicate therapeutic alass alert |
Definition: Description:The proposed therapy appears to have the same intended therapeutic benefit as an existing therapy, though the specific mechanisms of action vary. Concept Relationships: |
| 5-L | . . . . . DUPTHPGEN | duplicate generic alert |
Definition: Description:The proposed therapy appears to have the same intended therapeutic benefit as an existing therapy and uses the same mechanisms of action as the existing therapy. Concept Relationships: |
| 4-S | . . . . TIME . . . . v:TimingDetectedIssueCode |
timing detected issue |
Definition: Description:Proposed therapy may be inappropriate or ineffective based on the proposed start or end time. Concept Relationships: |
| 5-L | . . . . . ALRTENDLATE | end too late alert |
Definition: Definition:Proposed therapy may be inappropriate or ineffective because the end of administration is too close to another planned therapy. Concept Relationships: |
| 5-L | . . . . . ALRTSTRTLATE | start too late alert |
Definition: Definition:Proposed therapy may be inappropriate or ineffective because the start of administration is too late after the onset of the condition. Concept Relationships: |
| 4-A | . . . . _AppropriatenessDetectedIssueCode . . . . v:AppropriatenessDetectedIssueCode |
AppropriatenessDetectedIssueCode |
Concept Relationships: |
| 5-S | . . . . . OBSA . . . . . v:ObservationDetectedIssueCode . . . . . v:ObservationAlert |
Observation Alert |
Definition: Proposed therapy may be inappropriate or contraindicated due to conditions or characteristics of the patient Concept Relationships: |
| 6-S | . . . . . . AGE . . . . . . v:AgeDetectedIssueCode |
Age Alert |
Definition: Proposed therapy may be inappropriate or contraindicated due to patient age Concept Relationships: |
| 7-L | . . . . . . . DOSEHINDA | High Dose for Age Alert |
Definition: Proposed dosage exceeds standard practice for the patient's age Concept Relationships: |
| 7-L | . . . . . . . DOSELINDA | Low Dose for Age Alert |
Definition: Proposed dosage is below suggested therapeutic levels for the patient's age Concept Relationships: |
| 6-S | . . . . . . COND . . . . . . v:ConditionDetectedIssueCode |
Condition Alert |
Definition: Proposed therapy may be inappropriate or contraindicated due to an existing/recent patient condition or diagnosis Concept Relationships: |
| 7-L | . . . . . . . HGHT |
Concept Relationships: |
|
| 7-L | . . . . . . . LACT | Lactation Alert |
Definition: Proposed therapy may be inappropriate or contraindicated when breast-feeding Concept Relationships: |
| 7-L | . . . . . . . PREG | Pregnancy Alert |
Definition: Proposed therapy may be inappropriate or contraindicated during pregnancy Concept Relationships: |
| 7-L | . . . . . . . WGHT |
Concept Relationships: |
|
| 6-L | . . . . . . CREACT | common reaction alert |
Definition: Description:Proposed therapy may be inappropriate or contraindicated because of a common but non-patient specific reaction to the product. Example:There is no record of a specific sensitivity for the patient, but the presence of the sensitivity is common and therefore caution is warranted. Concept Relationships: |
| 6-L | . . . . . . GEN | Genetic Alert |
Definition: Proposed therapy may be inappropriate or contraindicated due to patient genetic indicators. Concept Relationships: |
| 6-L | . . . . . . GEND | Gender Alert |
Definition: Proposed therapy may be inappropriate or contraindicated due to patient gender. Concept Relationships: |
| 6-L | . . . . . . LAB | Lab Alert |
Definition: Proposed therapy may be inappropriate or contraindicated due to recent lab test results Concept Relationships: |
| 6-S | . . . . . . REACT . . . . . . v:ReactionDetectedIssueCode |
Reaction Alert |
Definition: Proposed therapy may be inappropriate or contraindicated based on the potential for a patient reaction to the proposed product Concept Relationships: |
| 7-L | . . . . . . . ALGY | Allergy Alert |
Definition: Proposed therapy may be inappropriate or contraindicated because of a recorded patient allergy to the proposed product. (Allergies are immune based reactions.) Concept Relationships: |
| 7-L | . . . . . . . INT | Intolerance Alert |
Definition: Proposed therapy may be inappropriate or contraindicated because of a recorded patient intolerance to the proposed product. (Intolerances are non-immune based sensitivities.) Concept Relationships: |
| 6-S | . . . . . . RREACT . . . . . . v:RelatedReactionDetectedIssueCode |
Related Reaction Alert |
Definition: Proposed therapy may be inappropriate or contraindicated because of a potential patient reaction to a cross-sensitivity related product. Concept Relationships: |
| 7-L | . . . . . . . RALG | Related Allergy Alert |
Definition: Proposed therapy may be inappropriate or contraindicated because of a recorded patient allergy to a cross-sensitivity related product. (Allergies are immune based reactions.) Concept Relationships: |
| 7-L | . . . . . . . RAR | Related Prior Reaction Alert |
Definition: Proposed therapy may be inappropriate or contraindicated because of a recorded prior adverse reaction to a cross-sensitivity related product. Concept Relationships: |
| 7-L | . . . . . . . RINT | Related Intolerance Alert |
Definition: Proposed therapy may be inappropriate or contraindicated because of a recorded patient intolerance to a cross-sensitivity related product. (Intolerances are non-immune based sensitivities.) Concept Relationships: |
| 5-L | . . . . . PREVINEF | previously ineffective |
Definition: Definition:The same or similar treatment has previously been attempted with the patient without achieving a positive effect. Concept Relationships: |
| 5-A | . . . . . _InteractionDetectedIssueCode . . . . . v:InteractionDetectedIssueCode |
InteractionDetectedIssueCode |
Concept Relationships: |
| 6-L | . . . . . . FOOD | Food Interaction Alert |
Definition: Proposed therapy may interact with certain foods Concept Relationships: |
| 6-S | . . . . . . TPROD . . . . . . v:TherapeuticProductDetectedIssueCode |
Therapeutic Product Alert |
Definition: Proposed therapy may interact with an existing or recent therapeutic product Concept Relationships: |
| 7-L | . . . . . . . DRG | Drug Interaction Alert |
Definition: Proposed therapy may interact with an existing or recent drug therapy Concept Relationships: |
| 7-L | . . . . . . . NHP | Natural Health Product Alert |
Definition: Proposed therapy may interact with existing or recent natural health product therapy Concept Relationships: |
| 7-L | . . . . . . . NONRX | Non-Prescription Interaction Alert |
Definition: Proposed therapy may interact with a non-prescription drug (e.g. alcohol, tobacco, Aspirin) Concept Relationships: |
| 3-A | . . . _SupplyDetectedIssueCode . . . v:SupplyDetectedIssueCode |
SupplyDetectedIssueCode |
Definition: Supplying the product at this time may be inappropriate or indicate compliance issues with the associated therapy Concept Relationships: |
| 4-L | . . . . ALLDONE | already performed |
Definition: Definition:The requested action has already been performed and so this request has no effect Concept Relationships: |
| 4-S | . . . . FULFIL | fulfillment alert |
Definition: Definition:The therapy being performed is in some way out of alignment with the requested therapy. Concept Relationships: |
| 5-L | . . . . . NOTACTN | no longer actionable |
Definition: Definition:The status of the request being fulfilled has changed such that it is no longer actionable. This may be because the request has expired, has already been completely fulfilled or has been otherwise stopped or disabled. (Not used for 'suspended' orders.) Concept Relationships: |
| 5-S | . . . . . NOTEQUIV | not equivalent alert |
Definition: Definition:The therapy being performed is not sufficiently equivalent to the therapy which was requested. Concept Relationships: |
| 6-L | . . . . . . NOTEQUIVGEN | not generically equivalent alert |
Definition: Definition:The therapy being performed is not generically equivalent (having the identical biological action) to the therapy which was requested. Concept Relationships: |
| 6-L | . . . . . . NOTEQUIVTHER | not therapeutically equivalent alert |
Definition: Definition:The therapy being performed is not therapeutically equivalent (having the same overall patient effect) to the therapy which was requested. Concept Relationships: |
| 5-S | . . . . . TIMING | event timing incorrect alert |
Definition: Definition:The therapy is being performed at a time which diverges from the time the therapy was requested Concept Relationships: |
| 6-L | . . . . . . INTERVAL | outside requested time |
Definition: Definition:The therapy action is being performed outside the bounds of the time period requested Concept Relationships: |
| 6-L | . . . . . . MINFREQ | too soon within frequency based on the usage |
Definition: Definition:The therapy action is being performed too soon after the previous occurrence based on the requested frequency Concept Relationships: |
| 4-L | . . . . HELD | held/suspended alert |
Definition: Definition:There should be no actions taken in fulfillment of a request that has been held or suspended. Concept Relationships: |
| 4-L | . . . . TOOLATE | Refill Too Late Alert |
Definition: The patient is receiving a subsequent fill significantly later than would be expected based on the amount previously supplied and the therapy dosage instructions Concept Relationships: |
| 4-L | . . . . TOOSOON | Refill Too Soon Alert |
Definition: The patient is receiving a subsequent fill significantly earlier than would be expected based on the amount previously supplied and the therapy dosage instructions Concept Relationships: |
| 1-L | . KSUBJ | knowledge subject |
Definition: Concept Relationships: |
| 1-L | . KSUBT | knowledge subtopic |
Definition: Concept Relationships: |
| 1-S | . OINT . v:ObservationIntoleranceType |
intolerance |
Definition: Hypersensitivity resulting in an adverse reaction upon exposure to an agent. Concept Relationships: |
| 2-S | . . ALG . . v:ObservationAllergyType |
Allergy |
Definition: Hypersensitivity to an agent caused by an immunologic response to an initial exposure Concept Relationships: |
| 3-L | . . . DALG | Drug Allergy |
Definition: An allergy to a pharmaceutical product. Concept Relationships: |
| 3-L | . . . EALG | Environmental Allergy |
Definition: An allergy to a substance other than a drug or a food. E.g. Latex, pollen, etc. Concept Relationships: |
| 3-L | . . . FALG | Food Allergy |
Definition: An allergy to a substance generally consumed for nutritional purposes. Concept Relationships: |
| 2-S | . . DINT . . v:ObservationDrugIntoleranceType |
Drug Intolerance |
Definition: Hypersensitivity resulting in an adverse reaction upon exposure to a drug. Concept Relationships: |
| 3-L | . . . DALG | Drug Allergy |
Definition: An allergy to a pharmaceutical product. Concept Relationships: |
| 3-L | . . . DNAINT | Drug Non-Allergy Intolerance |
Definition: Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure Concept Relationships: |
| 2-S | . . EINT . . v:ObservationEnvironmentalIntoleranceType |
Environmental Intolerance |
Definition: Hypersensitivity resulting in an adverse reaction upon exposure to environmental conditions. Concept Relationships: |
| 3-L | . . . EALG | Environmental Allergy |
Definition: An allergy to a substance other than a drug or a food. E.g. Latex, pollen, etc. Concept Relationships: |
| 3-L | . . . ENAINT | Environmental Non-Allergy Intolerance |
Definition: Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure Concept Relationships: |
| 2-S | . . FINT . . v:ObservationFoodIntoleranceType |
Food Intolerance |
Definition: Hypersensitivity resulting in an adverse reaction upon exposure to food. Concept Relationships: |
| 3-L | . . . FALG | Food Allergy |
Definition: An allergy to a substance generally consumed for nutritional purposes. Concept Relationships: |
| 3-L | . . . FNAINT | Food Non-Allergy Intolerance |
Definition: Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure Concept Relationships: |
| 2-S | . . NAINT . . v:ObservationNonAllergyIntoleranceType |
Non-Allergy Intolerance |
Definition: Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure Concept Relationships: |
| 3-L | . . . DNAINT | Drug Non-Allergy Intolerance |
Definition: Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure Concept Relationships: |
| 3-L | . . . ENAINT | Environmental Non-Allergy Intolerance |
Definition: Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure Concept Relationships: |
| 3-L | . . . FNAINT | Food Non-Allergy Intolerance |
Definition: Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure Concept Relationships: |
| 1-L | . SEV | Severity Observation |
Definition: Indicates a subjective evaluation of the criticality associated with another observation. Concept Relationships: |
| 1-A | . _ActSpecObsCode . v:ActSpecObsCode |
ActSpecObsCode |
Definition: Identifies the type of observation that is made about a specimen that may affect its processing, analysis or further result interpretation Concept Relationships: |
| 2-L | . . ARTBLD | ActSpecObsArtBldCode |
Definition: Describes the artificial blood identifier that is associated with the specimen. Concept Relationships: |
| 2-S | . . DILUTION . . v:ActSpecObsDilutionCode |
ActSpecObsDilutionCode |
Definition: An observation that reports the dilution of a sample. Concept Relationships: |
| 3-L | . . . AUTO-HIGH | Auto-High Dilution |
Definition: The dilution of a sample performed by automated equipment. The value is specified by the equipment Concept Relationships: |
| 3-L | . . . AUTO-LOW | Auto-Low Dilution |
Definition: The dilution of a sample performed by automated equipment. The value is specified by the equipment Concept Relationships: |
| 3-L | . . . PRE | Pre-Dilution |
Definition: The dilution of the specimen made prior to being loaded onto analytical equipment Concept Relationships: |
| 3-L | . . . RERUN | Rerun Dilution |
Definition: The value of the dilution of a sample after it had been analyzed at a prior dilution value Concept Relationships: |
| 2-L | . . EVNFCTS | ActSpecObsEvntfctsCode |
Definition: Domain provides codes that qualify the ActLabObsEnvfctsCode domain. (Environmental Factors) Concept Relationships: |
| 2-S | . . INTFR . . v:ActSpecObsInterferenceCode |
ActSpecObsInterferenceCode |
Definition: An observation that relates to factors that may potentially cause interference with the observation Concept Relationships: |
| 3-L | . . . FIBRIN | Fibrin |
Definition: The Fibrin Index of the specimen. In the case of only differentiating between Absent and Present, recommend using 0 and 1 Concept Relationships: |
| 3-L | . . . HEMOLYSIS | Hemolysis |
Definition: An observation of the hemolysis index of the specimen in g/L Concept Relationships: |
| 3-L | . . . ICTERUS | Icterus |
Definition: An observation that describes the icterus index of the specimen. It is recommended to use mMol/L of bilirubin Concept Relationships: |
| 3-L | . . . LIPEMIA | Lipemia |
Definition: An observation used to describe the Lipemia Index of the specimen. It is recommended to use the optical turbidity at 600 nm (in absorbance units). Concept Relationships: |
| 2-S | . . VOLUME . . v:ActSpecObsVolumeCode |
ActSpecObsVolumeCode |
Definition: An observation that reports the volume of a sample. Concept Relationships: |
| 3-L | . . . AVAILABLE | Available Volume |
Definition: The available quantity of specimen. This is the current quantity minus any planned consumption (e.g., tests that are planned) Concept Relationships: |
| 3-L | . . . CONSUMPTION | Consumption Volume |
Definition: The quantity of specimen that is used each time the equipment uses this substance Concept Relationships: |
| 3-L | . . . CURRENT | Current Volume |
Definition: The current quantity of the specimen, i.e., initial quantity minus what has been actually used. Concept Relationships: |
| 3-L | . . . INITIAL | Initial Volume |
Definition: The initial quantity of the specimen in inventory Concept Relationships: |
| 1-A | . _AnnotationType . v:AnnotationType |
AnnotationType |
Concept Relationships: |
| 2-S | . . _ActPatientAnnotationType . . v:ActPatientAnnotationType |
ActPatientAnnotationType |
Definition: Description:Provides a categorization for annotations recorded directly against the patient . Concept Relationships: |
| 3-L | . . . ANNDI | diagnostic image note |
Definition: Description:A note that is specific to a patient's diagnostic images, either historical, current or planned. Concept Relationships: |
| 3-L | . . . ANNGEN | general note |
Definition: Description:A general or uncategorized note. Concept Relationships: |
| 3-L | . . . ANNIMM | immunization note |
Definition: Concept Relationships: |
| 3-L | . . . ANNLAB | laboratory note |
Definition: Description:A note that is specific to a patient's laboratory results, either historical, current or planned. Concept Relationships: |
| 3-L | . . . ANNMED | medication note |
Definition: Description:A note that is specific to a patient's medications, either historical, current or planned. Concept Relationships: |
| 1-A | . _GeneticObservationType . v:GeneticObservationType |
GeneticObservationType |
Definition: Description: None provided Concept Relationships: |
| 2-L | . . GENE | gene |
Definition: Description: A DNA segment that contributes to phenotype/function. In the absence of demonstrated function a gene may be characterized by sequence, transcription or homology Concept Relationships: |
| 1-S | . _ImmunizationObservationType . v:ImmunizationObservationType |
ImmunizationObservationType |
Definition: Description: Observation codes which describe characteristics of the immunization material. Concept Relationships: |
| 2-L | . . OBSANTC | antigen count |
Definition: Description: Indicates the valid antigen count. Concept Relationships: |
| 2-L | . . OBSANTV | antigen validity |
Definition: Description: Indicates whether an antigen is valid or invalid. Concept Relationships: |
| 1-A | . _IndividualCaseSafetyReportType . v:IndividualCaseSafetyReportType |
Individual Case Safety Report Type |
Definition: A code that is used to indicate the type of case safety report received from sender. The current code example reference is from the International Conference on Harmonisation (ICH) Expert Workgroup guideline on Clinical Safety Data Management: Data Elements for Transmission of Individual Case Safety Reports. The unknown/unavailable option allows the transmission of information from a secondary sender where the initial sender did not specify the type of report. Example concepts include: Spontaneous, Report from study, Other. Concept Relationships: |
| 2-L | . . PAT_ADV_EVNT | patient adverse event |
Definition: Concept Relationships: |
| 2-L | . . VAC_PROBLEM | vaccine product problem |
Definition: Concept Relationships: |
| 1-A | . _LOINCObservationActContextAgeType | LOINCObservationActContextAgeType |
Definition: Definition:The set of LOINC codes for the act of determining the period of time that has elapsed since an entity was born or created. Concept Relationships: |
| 2-L | . . 21611-9 | age patient qn est |
Definition: Definition:Estimated age. Concept Relationships: |
| 2-L | . . 21612-7 | age patient qn reported |
Definition: Definition:Reported age. Concept Relationships: |
| 2-L | . . 29553-5 | age patient qn calc |
Definition: Definition:Calculated age. Concept Relationships: |
| 2-L | . . 30525-0 | age patient qn definition |
Definition: Definition:General specification of age with no implied method of determination. Concept Relationships: |
| 2-L | . . 30972-4 | age at onset of adverse event |
Definition: Definition:Age at onset of associated adverse event; no implied method of determination. Concept Relationships: |
| 1-A | . _MedicationObservationType | MedicationObservationType |
Concept Relationships: |
| 2-L | . . REP_HALF_LIFE | representative half-life |
Definition: Description:This observation represents an 'average' or 'expected' half-life typical of the product. Concept Relationships: |
| 2-L | . . SPLCOATING | coating |
Definition: Definition: A characteristic of an oral solid dosage form of a medicinal product, indicating whether it has one or more coatings such as sugar coating, film coating, or enteric coating. Only coatings to the external surface or the dosage form should be considered (for example, coatings to individual pellets or granules inside a capsule or tablet are excluded from consideration). Constraints: The Observation.value must be a Boolean (BL) with true for the presence or false for the absence of one or more coatings on a solid dosage form. Concept Relationships: |
| 2-L | . . SPLCOLOR | color |
Definition: Definition: A characteristic of an oral solid dosage form of a medicinal product, specifying the color or colors that most predominantly define the appearance of the dose form. SPLCOLOR is not an FDA specification for the actual color of solid dosage forms or the names of colors that can appear in labeling. Constraints: The Observation.value must be a single coded value or a list of multiple coded values, specifying one or more distinct colors that approximate of the color(s) of distinct areas of the solid dosage form, such as the different sides of a tablet or one-part capsule, or the different halves of a two-part capsule. Bands on banded capsules, regardless of the color, are not considered when assigning an SPLCOLOR. Imprints on the dosage form, regardless of their color are not considered when assigning an SPLCOLOR. If more than one color exists on a particular side or half, then the most predominant color on that side or half is recorded. If the gelatin capsule shell is colorless and transparent, use the predominant color of the contents that appears through the colorless and transparent capsule shell. Colors can include: Black;Gray;White;Red;Pink;Purple;Green;Yellow;Orange;Brown;Blue;Turquoise. Concept Relationships: |
| 2-L | . . SPLIMAGE | image |
Definition: Description: A characteristic representing a single file reference that contains two or more views of the same dosage form of the product; in most cases this should represent front and back views of the dosage form, but occasionally additional views might be needed in order to capture all of the important physical characteristics of the dosage form. Any imprint and/or symbol should be clearly identifiable, and the viewer should not normally need to rotate the image in order to read it. Images that are submitted with SPL should be included in the same directory as the SPL file. Concept Relationships: |
| 2-L | . . SPLIMPRINT | imprint |
Definition: Definition: A characteristic of an oral solid dosage form of a medicinal product, specifying the alphanumeric text that appears on the solid dosage form, including text that is embossed, debossed, engraved or printed with ink. The presence of other non-textual distinguishing marks or symbols is recorded by SPLSYMBOL. Examples: Included in SPLIMPRINT are alphanumeric text that appears on the bands of banded capsules and logos and other symbols that can be interpreted as letters or numbers. Constraints: The Observation.value must be of type Character String (ST). Excluded from SPLIMPRINT are internal and external cut-outs in the form of alphanumeric text and the letter 'R' with a circle around it (when referring to a registered trademark) and the letters 'TM' (when referring to a 'trade mark'). To record text, begin on either side or part of the dosage form. Start at the top left and progress as one would normally read a book. Enter a semicolon to show separation between words or line divisions. Concept Relationships: |
| 2-L | . . SPLSCORING | scoring |
Definition: Definition: A characteristic of an oral solid dosage form of a medicinal product, specifying the number of equal pieces that the solid dosage form can be divided into using score line(s). Example: One score line creating two equal pieces is given a value of 2, two parallel score lines creating three equal pieces is given a value of 3. Constraints: Whether three parallel score lines create four equal pieces or two intersecting score lines create two equal pieces using one score line and four equal pieces using both score lines, both have the scoring value of 4. Solid dosage forms that are not scored are given a value of 1. Solid dosage forms that can only be divided into unequal pieces are given a null-value with nullFlavor other (OTH). Concept Relationships: |
| 2-L | . . SPLSHAPE | shape |
Definition: Description: A characteristic of an oral solid dosage form of a medicinal product, specifying the two dimensional representation of the solid dose form, in terms of the outside perimeter of a solid dosage form when the dosage form, resting on a flat surface, is viewed from directly above, including slight rounding of corners. SPLSHAPE does not include embossing, scoring, debossing, or internal cut-outs. SPLSHAPE is independent of the orientation of the imprint and logo. Shapes can include: Triangle (3 sided); Square; Round; Semicircle; Pentagon (5 sided); Diamond; Double circle; Bullet; Hexagon (6 sided); Rectangle; Gear; Capsule; Heptagon (7 sided); Trapezoid; Oval; Clover; Octagon (8 sided); Tear; Freeform. Concept Relationships: |
| 2-L | . . SPLSIZE | size |
Definition: Definition: A characteristic of an oral solid dosage form of a medicinal product, specifying the longest single dimension of the solid dosage form as a physical quantity in the dimension of length (e.g., 3 mm). The length is should be specified in millimeters and should be rounded to the nearest whole millimeter. Example: SPLSIZE for a rectangular shaped tablet is the length and SPLSIZE for a round shaped tablet is the diameter. Concept Relationships: |
| 2-L | . . SPLSYMBOL | symbol |
Definition: Definition: A characteristic of an oral solid dosage form of a medicinal product, to describe whether or not the medicinal product has a mark or symbol appearing on it for easy and definite recognition. Score lines, letters, numbers, and internal and external cut-outs are not considered marks or symbols. See SPLSCORING and SPLIMPRINT for these characteristics. Constraints: The Observation.value must be a Boolean (BL) with <u>true</u> indicating the presence and <u>false</u> for the absence of marks or symbols. Example: Concept Relationships: |
| 1-A | . _ObservationIssueTriggerCodedObservationType . v:ObservationIssueTriggerCodedObservationType |
ObservationIssueTriggerCodedObservationType |
Definition: Distinguishes the kinds of coded observations that could be the trigger for clinical issue detection. These are observations that are not measurable, but instead can be defined with codes. Coded observation types include: Allergy, Intolerance, Medical Condition, Pregnancy status, etc. Concept Relationships: |
| 2-A | . . _CaseTransmissionMode . . v:CaseTransmissionMode |
case transmission mode |
Definition: Code for the mechanism by which disease was acquired by the living subject involved in the public health case. Includes sexually transmitted, airborne, bloodborne, vectorborne, foodborne, zoonotic, nosocomial, mechanical, dermal, congenital, environmental exposure, indeterminate. Concept Relationships: |
| 3-L | . . . AIRTRNS | airborne transmission |
Definition: Communication of an agent from a living subject or environmental source to a living subject through indirect contact via oral or nasal inhalation. Concept Relationships: |
| 3-L | . . . ANANTRNS | animal to animal transmission |
Definition: Communication of an agent from one animal to another proximate animal. Concept Relationships: |
| 3-L | . . . ANHUMTRNS | animal to human transmission |
Definition: Communication of an agent from an animal to a proximate person. Concept Relationships: |
| 3-L | . . . BDYFLDTRNS | body fluid contact transmission |
Definition: Communication of an agent from one living subject to another living subject through direct contact with any body fluid. Concept Relationships: |
| 3-L | . . . BLDTRNS | blood borne transmission |
Definition: Communication of an agent to a living subject through direct contact with blood or blood products whether the contact with blood is part of a therapeutic procedure or not. Concept Relationships: |
| 3-L | . . . DERMTRNS | transdermal transmission |
Definition: Communication of an agent from a living subject or environmental source to a living subject via agent migration through intact skin. Concept Relationships: |
| 3-L | . . . ENVTRNS | environmental exposure transmission |
Definition: Communication of an agent from an environmental surface or source to a living subject by direct contact. Concept Relationships: |
| 3-L | . . . FECTRNS | fecal-oral transmission |
Definition: Communication of an agent from a living subject or environmental source to a living subject through oral contact with material contaminated by person or animal fecal material. Concept Relationships: |
| 3-L | . . . FOMTRNS | fomite transmission |
Definition: Communication of an agent from an non-living material to a living subject through direct contact. Concept Relationships: |
| 3-L | . . . FOODTRNS | food-borne transmission |
Definition: Communication of an agent from a food source to a living subject via oral consumption. Concept Relationships: |
| 3-L | . . . HUMHUMTRNS | human to human transmission |
Definition: Communication of an agent from a person to a proximate person. Concept Relationships: |
| 3-L | . . . INDTRNS | indeterminate disease transmission mode |
Definition: Communication of an agent to a living subject via an undetermined route. Concept Relationships: |
| 3-L | . . . LACTTRNS | lactation transmission |
Definition: Communication of an agent from one living subject to another living subject through direct contact with mammalian milk or colostrum. Concept Relationships: |
| 3-L | . . . NOSTRNS | nosocomial transmission |
Definition: Communication of an agent from any entity to a living subject while the living subject is in the patient role in a healthcare facility. Concept Relationships: |
| 3-L | . . . PARTRNS | parenteral transmission |
Definition: Communication of an agent from a living subject or environmental source to a living subject where the acquisition of the agent is not via the alimentary canal. Concept Relationships: |
| 3-L | . . . PLACTRNS | transplacental transmission |
Definition: Communication of an agent from a living subject to the progeny of that living subject via agent migration across the maternal-fetal placental membranes while in utero. Concept Relationships: |
| 3-L | . . . SEXTRNS | sexual transmission |
Definition: Communication of an agent from one living subject to another living subject through direct contact with genital or oral tissues as part of a sexual act. Concept Relationships: |
| 3-L | . . . TRNSFTRNS | transfusion transmission |
Definition: Communication of an agent from one living subject to another living subject through direct contact with blood or blood products where the contact with blood is part of a therapeutic procedure. Concept Relationships: |
| 3-L | . . . VECTRNS | vector-borne transmission |
Definition: Communication of an agent from a living subject acting as a required intermediary in the agent transmission process to a recipient living subject via direct contact. Concept Relationships: |
| 3-L | . . . WATTRNS | water-borne transmission |
Definition: Communication of an agent from a contaminated water source to a living subject whether the water is ingested as a food or not. The route of entry of the water may be through any bodily orifice. Concept Relationships: |
| 1-S | . _ObservationQualityMeasureAttribute . v:ObservationQualityMeasureAttribute |
ObservationQualityMeasureAttribute |
Definition: Codes used to define various metadata aspects of a health quality measure. Concept Relationships: |
| 2-L | . . COPY | copyright |
Definition: Copyright Information (e.g. copyright year, copyright holder). Concept Relationships: |
| 2-L | . . DISC | disclaimer |
Definition: A statement intended to specify or delimit the scope of rights and obligations associated with the measure. Concept Relationships: |
| 2-L | . . KEY | keyword |
Definition: A significant word that aids in discoverability. Concept Relationships: |
| 2-L | . . MSRADJ | health quality measure risk adjustment |
Definition: The method of adjusting for clinical severity and conditions present at the start of care that can influence patient outcomes, to make valid comparisons of outcome measures across providers. Indicates whether a measure is subject to the statistical process for reducing, removing, or clarifying the influences of confounding factors to allow more useful comparisons. Concept Relationships: |
| 2-L | . . MSRAGG | health quality measure data aggregation |
Definition: Indicates, for the measure, how data will be analyzed and statistically reported for quality improvement and public reporting activities. Note: This does not identify the type of data (patient-level or aggregate) that will be transmitted to the measure adopter / warehouse. Examples: "Aggregate rate generated from count data reported as a proportion (for example, rate-based measures which report summary data generated from the number of Cesarean sections as a proportion of deliveries)", "Aggregate rate generated from count data reported as a ratio (e.g., bloodstream infection per 1,000 line days)", "Aggregate measures of central tendency (e.g., continuous variables which report means and medians such as length of stay)". Concept Relationships: |
| 2-L | . . MSRIMPROV | health quality measure improvement notation |
Definition: Information on whether an increase or decrease in score is the preferred result. This should reflect information on which way is better, an increase or decrease in score. Concept Relationships: |
| 2-L | . . MSRSCORE | health quality measure scoring |
Definition: Indicates the type of scoring (e.g. proportion, ratio) used by a health quality measure. Concept Relationships: |
| 2-L | . . MSRSET | health quality measure care setting |
Definition: Location(s) in which care being measured is rendered Usage Note: MSRSET is used rather than RoleCode because the setting applies to what is being measured, as opposed to participating directly in the health quality measure documantion itself). Concept Relationships: |
| 2-L | . . MSRTOPIC | health quality measure topic type |
Definition: Concept Relationships: |
| 2-L | . . MSRTYPE | health quality measure type |
Definition: Indicates whether the measure is used to examine a process or an outcome over time. Examples: Process, Outcome. Concept Relationships: |
| 2-L | . . RAT | rationale |
Definition: Description of why this measure is important, particularly from a clinical perspective. Concept Relationships: |
| 2-L | . . REF | reference |
Definition: Bibliographic citation. May include general references, related clinical practice guidelines, sources of evidence, etc. Concept Relationships: |
| 2-L | . . USE | notice of use |
Definition: Usage notes. Concept Relationships: |
| 1-A | . _ObservationSequenceType . v:ObservationSequenceType |
ObservationSequenceType |
Concept Relationships: |
| 2-L | . . TIME_ABSOLUTE | absolute time sequence |
Definition: A sequence of values in the "absolute" time domain. This is the same time domain that all HL7 timestamps use. It is time as measured by the Gregorian calendar Concept Relationships: |
| 2-L | . . TIME_RELATIVE | relative time sequence |
Definition: A sequence of values in a "relative" time domain. The time is measured relative to the earliest effective time in the Observation Series containing this sequence. Concept Relationships: |
| 1-A | . _ObservationSeriesType . v:ObservationSeriesType |
ObservationSeriesType |
Concept Relationships: |
| 2-A | . . _ECGObservationSeriesType . . v:ECGObservationSeriesType |
ECGObservationSeriesType |
Concept Relationships: |
| 3-L | . . . REPRESENTATIVE_BEAT | ECG representative beat waveforms |
Definition: This Observation Series type contains waveforms of a "representative beat" (a.k.a. "median beat" or "average beat"). The waveform samples are measured in relative time, relative to the beginning of the beat as defined by the Observation Series effective time. The waveforms are not directly acquired from the subject, but rather algorithmically derived from the "rhythm" waveforms. Concept Relationships: |
| 3-L | . . . RHYTHM | ECG rhythm waveforms |
Definition: This Observation type contains ECG "rhythm" waveforms. The waveform samples are measured in absolute time (a.k.a. "subject time" or "effective time"). These waveforms are usually "raw" with some minimal amount of noise reduction and baseline filtering applied. Concept Relationships: |
| 1-S | . _PatientImmunizationRelatedObservationType . v:PatientImmunizationRelatedObservationType |
PatientImmunizationRelatedObservationType |
Definition: Description: Reporting codes that are related to an immunization event. Concept Relationships: |
| 2-L | . . CLSSRM | classroom |
Definition: Description: The class room associated with the patient during the immunization event. Concept Relationships: |
| 2-L | . . GRADE | grade |
Definition: Description: The school grade or level the patient was in when immunized. Concept Relationships: |
| 2-L | . . SCHL | school |
Definition: Description: The school the patient attended when immunized. Concept Relationships: |
| 2-L | . . SCHLDIV | school division |
Definition: Description: The school division or district associated with the patient during the immunization event. Concept Relationships: |
| 2-L | . . TEACHER | teacher |
Definition: Description: The patient's teacher when immunized. Concept Relationships: |
| 0-A | _ROIOverlayShape v:ROIOverlayShape |
ROIOverlayShape |
Definition: Shape of the region on the object being referenced Concept Relationships: |
| 1-L | . CIRCLE | circle |
Definition: A circle defined by two (column,row) pairs. The first point is the center of the circle and the second point is a point on the perimeter of the circle. Concept Relationships: |
| 1-L | . ELLIPSE | ellipse |
Definition: An ellipse defined by four (column,row) pairs, the first two points specifying the endpoints of the major axis and the second two points specifying the endpoints of the minor axis. Concept Relationships: |
| 1-L | . POINT | point |
Definition: A single point denoted by a single (column,row) pair, or multiple points each denoted by a (column,row) pair. Concept Relationships: |
| 1-L | . POLY | polyline |
Definition: A series of connected line segments with ordered vertices denoted by (column,row) pairs; if the first and last vertices are the same, it is a closed polygon. Concept Relationships: |
Last Published: 20120831 10:21 AM
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