V3-ParticipationFunction.xml

This code is used to specify the exact function an actor had in a service in all necessary detail. This domain may include local extensions (CWE).

Raw XML

<ValueSet xmlns="http://hl7.org/fhir">
  <id value="v3-ParticipationFunction"/>
  <meta>
    <lastUpdated value="2014-12-11T00:00:00.000+11:00"/>
    <profile value="http://hl7.org/fhir/Profile/valueset-shareable-definition"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><!-- Snipped for brevity --></div>
  </text>
  <extension url="http://hl7.org/fhir/ExtensionDefinition/valueset-oid">
    <valueUri value="urn:oid:2.16.840.1.113883.1.11.10267"/>
  </extension>
  <url value="http://hl7.org/fhir/v3/vs/ParticipationFunction"/>
  <version value="2014-12-11"/>
  <name value="v3 Code System ParticipationFunction"/>
  <publisher value="HL7, Inc"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://hl7.org"/>
    </telecom>
  </contact>
  <description value=" This code is used to specify the exact function an actor had in a service in all necessary
     detail. This domain may include local extensions (CWE)."/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2014-12-11"/>
  <define>
    <extension url="http://hl7.org/fhir/ExtensionDefinition/valueset-oid">
      <valueUri value="urn:oid:2.16.840.1.113883.5.88"/>
    </extension>
    <system value="http://hl7.org/fhir/v3/ParticipationFunction"/>
    <caseSensitive value="true"/>
    <concept>
      <code value="_AuthorizedParticipationFunction"/>
      <abstract value="true"/>
      <display value="AuthorizedParticipationFunction"/>
      <definition value="This code is used to specify the exact function an actor is authorized to have in a service
         in all necessary detail."/>
      <concept>
        <code value="_AuthorizedReceiverParticipationFunction"/>
        <abstract value="true"/>
        <display value="AuthorizedReceiverParticipationFunction"/>
        <definition value="This code is used to specify the exact function an actor is authorized to have as a receiver
           of information that is the subject of a consent directive or consent override."/>
        <concept>
          <code value="AUCG"/>
          <abstract value="false"/>
          <display value="caregiver information receiver"/>
          <definition value="Description:Caregiver authorized to receive patient health information."/>
        </concept>
        <concept>
          <code value="AULR"/>
          <abstract value="false"/>
          <display value="legitimate relationship information receiver"/>
          <definition value="Description:Provider with legitimate relationship authorized to receive patient health
             information."/>
        </concept>
        <concept>
          <code value="AUTM"/>
          <abstract value="false"/>
          <display value="care team information receiver"/>
          <definition value="Description:Member of care team authorized to receive patient health information."/>
        </concept>
        <concept>
          <code value="AUWA"/>
          <abstract value="false"/>
          <display value="work area information receiver"/>
          <definition value="Description:Entities within specified work area authorized to receive patient health information."/>
        </concept>
      </concept>
      <concept>
        <code value="_ConsenterParticipationFunction"/>
        <abstract value="true"/>
        <display value="ConsenterParticipationFunction"/>
        <definition value="This code is used to specify the exact function an actor is authorized to have in authoring
           a consent directive."/>
        <concept>
          <code value="GRDCON"/>
          <abstract value="false"/>
          <display value="legal guardian consent author"/>
          <definition value="Description:Legal guardian of the subject of consent authorized to author a consent directive
             for the subject of consent."/>
        </concept>
        <concept>
          <code value="POACON"/>
          <abstract value="false"/>
          <display value="healthcare power of attorney consent author"/>
          <definition value="Description:Person authorized with healthcare power of attorney to author a  consent directive
             for the subject of consent."/>
        </concept>
        <concept>
          <code value="PRCON"/>
          <abstract value="false"/>
          <display value="personal representative consent author"/>
          <definition value="Description:Personal representative of the subject of consent authorized to author a consent
             directive for the subject of consent."/>
        </concept>
        <concept>
          <code value="PROMSK"/>
          <abstract value="false"/>
          <display value="authorized provider masking author"/>
          <definition value="Definition:Provider authorized to mask information to protect the patient, a third party,
             or to ensure that the provider has consulted with the patient prior to release of this
             information."/>
        </concept>
        <concept>
          <code value="SUBCON"/>
          <abstract value="false"/>
          <display value="subject of consent author"/>
          <definition value="Description:Subject of consent authorized to author a consent directive."/>
        </concept>
      </concept>
      <concept>
        <code value="_OverriderParticipationFunction"/>
        <abstract value="true"/>
        <display value="OverriderParticipationFunction"/>
        <definition value="This code is used to specify the exact function an actor is authorized to have in authoring
           a consent override."/>
        <concept>
          <code value="AUCOV"/>
          <abstract value="false"/>
          <display value="consent overrider"/>
          <definition value="Description:Entity authorized to override a consent directive."/>
        </concept>
        <concept>
          <code value="AUEMROV"/>
          <abstract value="false"/>
          <display value="emergency overrider"/>
          <definition value="Description:Entity  authorized to override a consent directive or privacy policy in an
             emergency."/>
        </concept>
      </concept>
    </concept>
    <concept>
      <code value="_CoverageParticipationFunction"/>
      <abstract value="true"/>
      <display value="CoverageParticipationFunction"/>
      <definition value="Definition: Set of codes indicating the manner in which sponsors, underwriters, and payers
         participate in a policy or program."/>
      <concept>
        <code value="_PayorParticipationFunction"/>
        <abstract value="true"/>
        <display value="PayorParticipationFunction"/>
        <definition value="Definition: Set of codes indicating the manner in which payors participate in a policy
           or program.&lt;/"/>
        <concept>
          <code value="CLMADJ"/>
          <abstract value="false"/>
          <display value="claims adjudication"/>
          <definition value="Definition: Manages all operations required to adjudicate fee for service claims or managed
             care encounter reports."/>
        </concept>
        <concept>
          <code value="ENROLL"/>
          <abstract value="false"/>
          <display value="enrollment broker"/>
          <definition value="Definition: Managing the enrollment of covered parties."/>
        </concept>
        <concept>
          <code value="FFSMGT"/>
          <abstract value="false"/>
          <display value="ffs management"/>
          <definition value="Definition: Managing all operations required to administer a fee for service or indemnity
             health plan including enrolling covered parties and providing customer service, provider
             contracting, claims payment, care management and utilization review."/>
        </concept>
        <concept>
          <code value="MCMGT"/>
          <abstract value="false"/>
          <display value="managed care management"/>
          <definition value="Definition: Managing all operations required to administer a managed care plan including
             enrolling covered parties and providing customer service,, provider contracting, claims
             payment, care management and utilization review."/>
        </concept>
        <concept>
          <code value="PROVMGT"/>
          <abstract value="false"/>
          <display value="provider management"/>
          <definition value="Definition: Managing provider contracting, provider services, credentialing, profiling,
             performance measures, and ensuring network adequacy."/>
        </concept>
        <concept>
          <code value="UMGT"/>
          <abstract value="false"/>
          <display value="utilization management"/>
          <definition value="Definition: Managing utilization of services by ensuring that providers adhere to, e.g.,
             payeraTMs clinical protocols for medical appropriateness and standards of medical necessity.
              May include management of authorizations for services and referrals."/>
        </concept>
      </concept>
      <concept>
        <code value="_SponsorParticipationFunction"/>
        <abstract value="true"/>
        <display value="SponsorParticipationFunction"/>
        <definition value="Definition: Set of codes indicating the manner in which sponsors participate in a policy
           or program. NOTE: use only when the Sponsor is not further specified with a SponsorRoleType
           as being either a fully insured sponsor or a self insured sponsor."/>
        <concept>
          <code value="FULINRD"/>
          <abstract value="false"/>
          <display value="fully insured"/>
          <definition value="Definition: Responsibility taken by a sponsor to contract with one or more underwriters
             for the assumption of full responsibility for the risk and administration of a policy
             or program."/>
        </concept>
        <concept>
          <code value="SELFINRD"/>
          <abstract value="false"/>
          <display value="self insured"/>
          <definition value="Definition: Responsibility taken by a sponsor to organize the underwriting of risk and
             administration of a policy or program."/>
        </concept>
      </concept>
      <concept>
        <code value="_UnderwriterParticipationFunction"/>
        <abstract value="true"/>
        <display value="UnderwriterParticipationFunction"/>
        <definition value="Definition: Set of codes indicating the manner in which underwriters participate in a
           policy or program."/>
        <concept>
          <code value="PAYORCNTR"/>
          <abstract value="false"/>
          <display value="payor contracting"/>
          <definition value="Definition: Contracting for the provision and administration of health services to payors
             while retaining the risk for coverage.  Contracting may be for all provision and administration;
             or for provision of certain types of services; for provision of services by region; and
             by types of administration, e.g., claims adjudication, enrollment, provider management,
             and utilization management.  Typically done by underwriters for sponsors who need coverage
             provided to covered parties in multiple regions.  The underwriter may act as the payor
             in some, but not all of the regions in which coverage is provided."/>
        </concept>
        <concept>
          <code value="REINS"/>
          <abstract value="false"/>
          <display value="reinsures"/>
          <definition value="Definition: Underwriting reinsurance for another underwriter for the policy or program."/>
        </concept>
        <concept>
          <code value="RETROCES"/>
          <abstract value="false"/>
          <display value="retrocessionaires"/>
          <definition value="Definition: Underwriting reinsurance for another reinsurer."/>
        </concept>
        <concept>
          <code value="SUBCTRT"/>
          <abstract value="false"/>
          <display value="subcontracting risk"/>
          <definition value="Definition: Delegating risk for a policy or program to one or more subcontracting underwriters,
             e.g., a major health insurer may delegate risk for provision of coverage under a national
             health plan to other underwriters by region ."/>
        </concept>
        <concept>
          <code value="UNDERWRTNG"/>
          <abstract value="false"/>
          <display value="underwriting"/>
          <definition value="Definition: Provision of underwriting analysis for another underwriter without assumption
             of risk."/>
        </concept>
      </concept>
    </concept>
    <concept>
      <code value="ADMPHYS"/>
      <abstract value="false"/>
      <display value="admitting physician"/>
      <definition value="A physician who admitted a patient to a hospital or other care unit that is the context
         of this service."/>
    </concept>
    <concept>
      <code value="ANEST"/>
      <abstract value="false"/>
      <display value="anesthesist"/>
      <definition value="In a typical anesthesia setting an anesthesiologist or anesthesia resident in charge of
         the anesthesia and life support, but only a witness to the surgical procedure itself.
          To clarify responsibilities anesthesia should always be represented as a separate service
         related to the surgery."/>
    </concept>
    <concept>
      <code value="ANRS"/>
      <abstract value="false"/>
      <display value="anesthesia nurse"/>
      <definition value="In a typical anesthesia setting the nurse principally assisting the anesthesiologist during
         the critical periods."/>
    </concept>
    <concept>
      <code value="ASSEMBLER"/>
      <abstract value="false"/>
      <display value="assembly software"/>
      <definition value="A device that operates on custodian's algorithms for data extraction of existing information
         for purpose of generating a new artifact.                                            
                   UsageConstraint: ASSEMBLER ParticipationFunction should be used with DEV (device)
         ParticipationType."/>
    </concept>
    <concept>
      <code value="ATTPHYS"/>
      <abstract value="false"/>
      <display value="attending physician"/>
      <definition value="A physician who is primarily responsible for a patient during the hospitalization, which
         is the context of the service."/>
    </concept>
    <concept>
      <code value="DISPHYS"/>
      <abstract value="false"/>
      <display value="discharging physician"/>
      <definition value="A physician who discharged a patient from a hospital or other care unit that is the context
         of this service."/>
    </concept>
    <concept>
      <code value="FASST"/>
      <abstract value="false"/>
      <display value="first assistant surgeon"/>
      <definition value="In a typical surgery setting the assistant facing the primary surgeon.  The first assistant
         performs parts of the operation and assists in others (e.g., incision, approach, electrocoutering,
         ligatures, sutures)."/>
    </concept>
    <concept>
      <code value="MDWF"/>
      <abstract value="false"/>
      <display value="midwife"/>
      <definition value="A person (usually female) helping a woman deliver a baby. Responsibilities vary locally,
         ranging from a mere optional assistant to a full required participant, responsible for
         (normal) births and pre- and post-natal care for both mother and baby."/>
    </concept>
    <concept>
      <code value="NASST"/>
      <abstract value="false"/>
      <display value="nurse assistant"/>
      <definition value="In a typical surgery setting the non-sterile nurse handles material supply from the stock,
         forwards specimen to pathology, and helps with other non-sterile tasks (e.g., phone calls,
         etc.)."/>
    </concept>
    <concept>
      <code value="PCP"/>
      <abstract value="false"/>
      <display value="primary care physician"/>
      <definition value="The healthcare provider that holds primary responsibility for the overall care of a patient."/>
    </concept>
    <concept>
      <code value="PRISURG"/>
      <abstract value="false"/>
      <display value="primary surgeon"/>
      <definition value="In a typical surgery setting the primary performing surgeon."/>
    </concept>
    <concept>
      <code value="REVIEWER"/>
      <abstract value="false"/>
      <display value="reviewer"/>
      <definition value="A verifier who is accountable for reviewing and asserting that the verification of an
         Act complies with jurisdictional or organizational policy.                           
                                   UsageConstraint: UsageConstraint:  Specifies the exact function
         that an actor is authorized to have as a verifier of an Act.  Connotes that a specialized
         verifier asserts compliance for veracity of the review per jurisdictional or organizational
         policy.  E.g., The Provider who takes responsibility for authenticity of a record submitted
         to a payer.                          REVIEW ParticipationFunction should be used with
         VFR (verifier)"/>
    </concept>
    <concept>
      <code value="RNDPHYS"/>
      <abstract value="false"/>
      <display value="rounding physician"/>
      <definition value="A physician who made rounds on a patient in a hospital or other care center."/>
    </concept>
    <concept>
      <code value="SASST"/>
      <abstract value="false"/>
      <display value="second assistant surgeon"/>
      <definition value="In a typical surgery setting the assistant who primarily holds the hooks."/>
    </concept>
    <concept>
      <code value="SNRS"/>
      <abstract value="false"/>
      <display value="scrub nurse"/>
      <definition value="In a typical surgery setting the nurse in charge of the instrumentation."/>
    </concept>
    <concept>
      <code value="TASST"/>
      <abstract value="false"/>
      <display value="third assistant"/>
      <definition value="In a typical surgery setting there is rarely a third assistant (e.g., in some Hip operations
         the third assistant postures the affected leg)."/>
    </concept>
  </define>
</ValueSet>