DSTU2 Ballot Source

This page is part of the FHIR Specification (v0.5.0: DSTU 2 Ballot 2). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R4 R3 R2

V3-ActReason.xml

Raw XML (canonical form)

A set of codes specifying the motivation, cause, or rationale of an Act, when such rationale is not reasonably represented as an ActRelationship of type "has reason" linking to another Act. Examples: Example reasons that might qualify for being coded in this field might be: "routine requirement", "infectious disease reporting requirement", "on patient request", "required by law".

Raw XML

<ValueSet xmlns="http://hl7.org/fhir">
  <id value="v3-ActReason"/>
  <meta>
    <lastUpdated value="2015-03-23T00:00:00.000+11:00"/>
    <profile value="http://hl7.org/fhir/StructureDefinition/valueset-shareable-definition"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><!-- Snipped for brevity --></div>
  </text>
  <url value="http://hl7.org/fhir/v3/vs/ActReason"/>
  <version value="2015-03-23"/>
  <name value="v3 Code System ActReason"/>
  <publisher value="HL7, Inc"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://hl7.org"/>
    </telecom>
  </contact>
  <description value=" A set of codes specifying the motivation, cause, or rationale of an Act, when such rationale
     is not reasonably represented as an ActRelationship of type &quot;has reason&quot; linking
     to another Act.  Examples: Example reasons that might qualify for being coded in this
     field might be: &quot;routine requirement&quot;, &quot;infectious disease reporting requirement&quot
    ;, &quot;on patient request&quot;, &quot;required by law&quot;."/>
  <status value="active"/>
  <experimental value="false"/>
  <date value="2015-03-23"/>
  <define>
    <extension url="http://hl7.org/fhir/StructureDefinition/valueset-oid">
      <valueUri value="urn:oid:2.16.840.1.113883.5.8"/>
    </extension>
    <system value="http://hl7.org/fhir/v3/ActReason"/>
    <caseSensitive value="true"/>
    <concept>
      <code value="_ActAccommodationReason"/>
      <abstract value="true"/>
      <display value="ActAccommodationReason"/>
      <definition value="Identifies the reason the patient is assigned to this accommodation type"/>
      <concept>
        <code value="ACCREQNA"/>
        <abstract value="false"/>
        <display value="Accommodation Requested Not Available"/>
        <definition value="Accommodation requested is not available."/>
      </concept>
      <concept>
        <code value="FLRCNV"/>
        <abstract value="false"/>
        <display value="Floor Convenience"/>
        <definition value="Accommodation is assigned for floor convenience."/>
      </concept>
      <concept>
        <code value="MEDNEC"/>
        <abstract value="false"/>
        <display value="Medical Necessity"/>
        <definition value="Required for medical reasons(s)."/>
      </concept>
      <concept>
        <code value="PAT"/>
        <abstract value="false"/>
        <display value="Patient request"/>
        <definition value="The Patient requested the action"/>
      </concept>
    </concept>
    <concept>
      <code value="_ActCoverageReason"/>
      <abstract value="true"/>
      <display value="ActCoverageReason"/>
      <definition value="Description:Codes used to specify reasons or criteria relating to coverage provided under
         a policy or program.  May be used to convey reasons pertaining to coverage contractual
         provisions, including criteria for eligibility, coverage limitations, coverage maximums,
         or financial participation required of covered parties."/>
      <concept>
        <code value="_EligibilityActReasonCode"/>
        <abstract value="true"/>
        <display value="EligibilityActReasonCode"/>
        <definition value="Identifies the reason or rational for why a person is eligibile for benefits under an
           insurance policy or progam.                                                       Examples:
            A person is a claimant under an automobile insurance policy are client deceased &amp;
           adopted client has been given a new policy identifier.  A new employee is eligible for
           health insurance as an employment benefit.  A person meets a government program eligibility
           criteria for financial, age or health status."/>
        <concept>
          <code value="_ActIneligibilityReason"/>
          <abstract value="true"/>
          <display value="ActIneligibilityReason"/>
          <definition value="Identifies the reason or rational for why a person is not eligibile for benefits under
             an insurance policy.                          Examples are client deceased &amp; adopted
             client has been given a new policy identifier."/>
          <concept>
            <code value="COVSUS"/>
            <abstract value="false"/>
            <display value="coverage suspended"/>
            <definition value="When a client has no contact with the health system for an extended period, coverage is
               suspended.  Client will be reinstated to original start date upon proof of identification,
               residency etc.                          Example: Coverage may be suspended during a strike
               situation, when employer benefits for employees are not covered (i.e. not in effect)."/>
          </concept>
          <concept>
            <code value="DECSD"/>
            <abstract value="false"/>
            <display value="deceased"/>
            <definition value="Client deceased."/>
          </concept>
          <concept>
            <code value="REGERR"/>
            <abstract value="false"/>
            <display value="registered in error"/>
            <definition value="Client was registered in error."/>
          </concept>
        </concept>
        <concept>
          <code value="_CoverageEligibilityReason"/>
          <abstract value="true"/>
          <display value="CoverageEligibilityReason"/>
          <definition value="Definition: Identifies the reason or rational for why a person is eligibile for benefits
             under an insurance policy or progam.                                                 
                  Examples:  A person is a claimant under an automobile insurance policy are client
             deceased &amp; adopted client has been given a new policy identifier.  A new employee
             is eligible for health insurance as an employment benefit.  A person meets a government
             program eligibility criteria for financial, age or health status."/>
          <concept>
            <code value="AGE"/>
            <abstract value="false"/>
            <display value="age eligibility"/>
            <definition value="A person becomes eligible for a program based on age.                                
                                    Example:  In the U.S., a person who is 65 years of age or older is
               eligible for Medicare."/>
          </concept>
          <concept>
            <code value="CRIME"/>
            <abstract value="false"/>
            <display value="crime victim"/>
            <definition value="A person becomes eligible for insurance or a program because of crime related health condition
               or injury.                                                       Example:  A person is
               a claimant under the U.S. Crime Victims Compensation program."/>
          </concept>
          <concept>
            <code value="DIS"/>
            <abstract value="false"/>
            <display value="disability"/>
            <definition value="A person becomes a claimant under a disability income insurance policy or a disability
               rehabilitation program because of a health condition or injury which limits the person's
               ability to earn an income or function without institutionalization."/>
          </concept>
          <concept>
            <code value="EMPLOY"/>
            <abstract value="false"/>
            <display value="employment benefit"/>
            <definition value="A person becomes eligible for insurance provided as an employment benefit based on employment
               status."/>
          </concept>
          <concept>
            <code value="FINAN"/>
            <abstract value="false"/>
            <display value="financial eligibility"/>
            <definition value="A person becomes eligible for a program based on financial criteria.                 
                                                   Example:  A person whose family income is below a
               financial threshold for eligibility for Medicaid or SCHIP."/>
          </concept>
          <concept>
            <code value="HEALTH"/>
            <abstract value="false"/>
            <display value="health status"/>
            <definition value="A person becomes eligible for a program because of a qualifying health condition or injury.
                                                                     Examples:  A person is determined
               to have a qualifying health conditions include pregnancy, HIV/AIDs, tuberculosis, end
               stage renal disease, breast or cervical cancer, or other condition requiring specialized
               health services, hospice, institutional or community based care provided under a program"/>
          </concept>
          <concept>
            <code value="MULTI"/>
            <abstract value="false"/>
            <display value="multiple criteria eligibility"/>
            <definition value="A person becomes eligible for a program based on more than one criterion.            
                                                        Examples:  In the U.S., a child whose familiy
               income meets Medicaid financial thresholds and whose age is less than 18 is eligible for
               the Early and Periodic Screening, Diagnostic, and Treatment program (EPSDT).  A person
               whose family income meets Medicaid financial thresholds and whose age is 65 years or older
               is eligible for Medicaid and Medicare, and are referred to as dual eligibles."/>
          </concept>
          <concept>
            <code value="PNC"/>
            <abstract value="false"/>
            <display value="property and casualty condition"/>
            <definition value="A person becomes a claimant under a property and casualty insurance policy because of
               a related health condition or injury resulting from a circumstance covered under the terms
               of the policy.                                                       Example:  A person
               is a claimant under a homeowners insurance policy because of an injury sustained on the
               policyholderaTMs premises."/>
          </concept>
          <concept>
            <code value="STATUTORY"/>
            <abstract value="false"/>
            <display value="statutory eligibility"/>
            <definition value="A person becomes eligible for a program based on statutory criteria.                 
                                                   Examples:  A person is a member of an indigenous group,
               a veteran of military service, or  in the U.S., a recipient of adoption assistance and
               foster care under Title IV-E of the Social Security."/>
          </concept>
          <concept>
            <code value="VEHIC"/>
            <abstract value="false"/>
            <display value="motor vehicle accident victim"/>
            <definition value="A person becomes a claimant under a motor vehicle accident insurance because of a motor
               vehicle accident related health condition or injury."/>
          </concept>
          <concept>
            <code value="WORK"/>
            <abstract value="false"/>
            <display value="work related"/>
            <definition value="A person becomes eligible for insurance or a program because of a work related health
               condition or injury.                                                       Example:  A
               person is a claimant under the U.S. Black Lung Program."/>
          </concept>
        </concept>
      </concept>
    </concept>
    <concept>
      <code value="_ActInformationManagementReason"/>
      <abstract value="true"/>
      <display value="ActInformationManagementReason"/>
      <definition value="Description:The rationale or purpose for an act relating to information management, such
         as archiving information for the purpose of complying with an enterprise data retention
         policy."/>
      <concept>
        <code value="_ActHealthInformationManagementReason"/>
        <abstract value="true"/>
        <display value="ActHealthInformationManagementReason"/>
        <definition value="Description:The rationale or purpose for an act relating to health information management,
           such as archiving information for the purpose of complying with an organization policy
           or jurisdictional law relating to  data retention."/>
        <concept>
          <code value="_ActConsentInformationAccessOverrideReason"/>
          <abstract value="true"/>
          <display value="ActConsentInformationAccessOverrideReason"/>
          <definition value="To perform one or more operations on information to which the patient has not consented
             as deemed necessary by authorized entities for providing care in the best interest of
             the patient; providing immediately needed health care for an emergent condition;  or for
             protecting public or third party safety.                                             
                     Usage Notes: Used to convey the reason that a provider or other entity may or
             has accessed personal healthcare information.  Typically, this involves overriding the
             subject's consent directives."/>
          <concept>
            <code value="OVRER"/>
            <abstract value="false"/>
            <display value="emergency treatment override"/>
            <definition value="To perform one or more operations on information to which the patient has not consented
               by authorized entities for treating a condition which poses an immediate threat to the
               patient's health and which requires immediate medical intervention.                  
                                                  Usage Notes: The patient is unable to provide consent,
               but the provider determines they have an urgent healthcare related reason to access the
               record."/>
          </concept>
          <concept>
            <code value="OVRPJ"/>
            <abstract value="false"/>
            <display value="professional judgment override"/>
            <definition value="To perform one or more operations on information to which the patient declined to consent
               for providing health care.                                                      Usage
               Notes: The patient, while able to give consent, has not.  However the provider believes
               it is in the patient's interest to access the record without patient consent."/>
          </concept>
          <concept>
            <code value="OVRPS"/>
            <abstract value="false"/>
            <display value="public safety override"/>
            <definition value="To perform one or more operations on information to which the patient has not consented
               for public safety reasons.                                                      Usage
               Notes: The patient, while able to give consent, has not.  However, the provider believes
               that access to masked patient information is justified because of concerns related to
               public safety."/>
          </concept>
          <concept>
            <code value="OVRTPS"/>
            <abstract value="false"/>
            <display value="third party safety override"/>
            <definition value="To perform one or more operations on information to which the patient has not consented
               for third party safety.                                                        Usage Notes:
               The patient, while able to give consent, has not.  However, the provider believes that
               access to masked patient information is justified because of concerns related to the health
               and safety of one or more third parties."/>
          </concept>
        </concept>
        <concept>
          <code value="PurposeOfUse"/>
          <abstract value="false"/>
          <display value="purpose of use"/>
          <definition value="Reason for performing one or more operations on information, which may be permitted by
             source system's security policy in accordance with one or more privacy policies and consent
             directives.                                                      Usage Notes: The rationale
             or purpose for an act relating to the management of personal health information, such
             as collecting personal health information for research or public health purposes."/>
          <concept>
            <code value="HMARKT"/>
            <abstract value="false"/>
            <display value="healthcare marketing"/>
            <definition value="To perform one or more operations on information for marketing services and products related
               to health care."/>
          </concept>
          <concept>
            <code value="HOPERAT"/>
            <abstract value="false"/>
            <display value="healthcare operations"/>
            <definition value="To perform one or more operations on information used for conducting administrative and
               contractual activities related to the provision of health care."/>
            <concept>
              <code value="DONAT"/>
              <abstract value="false"/>
              <display value="donation"/>
              <definition value="To perform one or more operations on information used for cadaveric organ, eye or tissue
                 donation."/>
            </concept>
            <concept>
              <code value="FRAUD"/>
              <abstract value="false"/>
              <display value="fraud"/>
              <definition value="To perform one or more operations on information used for fraud detection and prevention
                 processes."/>
            </concept>
            <concept>
              <code value="GOV"/>
              <abstract value="false"/>
              <display value="government"/>
              <definition value="To perform one or more operations on information used within government processes."/>
            </concept>
            <concept>
              <code value="HACCRED"/>
              <abstract value="false"/>
              <display value="health accreditation"/>
              <definition value="To perform one or more operations on information for conducting activities related to
                 meeting accreditation criteria."/>
            </concept>
            <concept>
              <code value="HCOMPL"/>
              <abstract value="false"/>
              <display value="health compliance"/>
              <definition value="To perform one or more operations on information used for conducting activities required
                 to meet a mandate."/>
            </concept>
            <concept>
              <code value="HDECD"/>
              <abstract value="false"/>
              <display value="decedent"/>
              <definition value="To perform one or more operations on information used for handling deceased patient matters."/>
            </concept>
            <concept>
              <code value="HDIRECT"/>
              <abstract value="false"/>
              <display value="directory"/>
              <definition value="To perform one or more operation operations on information used to manage a patient directory.
                                                                      Examples:                       
                                                                         facility                     
                       enterprise                            payer                            health information
                 exchange patient directory"/>
            </concept>
            <concept>
              <code value="HLEGAL"/>
              <abstract value="false"/>
              <display value="legal"/>
              <definition value="To perform one or more operations on information for conducting activities required by
                 legal proceeding."/>
            </concept>
            <concept>
              <code value="HOUTCOMS"/>
              <abstract value="false"/>
              <display value="health outcome measure"/>
              <definition value="To perform one or more operations on information used for assessing results and comparative
                 effectiveness achieved by health care practices and interventions."/>
            </concept>
            <concept>
              <code value="HPRGRP"/>
              <abstract value="false"/>
              <display value="health program reporting"/>
              <definition value="To perform one or more operations on information used for conducting activities to meet
                 program accounting requirements."/>
            </concept>
            <concept>
              <code value="HQUALIMP"/>
              <abstract value="false"/>
              <display value="health quality improvement"/>
              <definition value="To perform one or more operations on information used for conducting administrative activities
                 to improve health care quality."/>
            </concept>
            <concept>
              <code value="HSYSADMIN"/>
              <abstract value="false"/>
              <display value="health system administration"/>
              <definition value="To perform one or more operations on information to administer the electronic systems
                 used for the delivery of health care."/>
            </concept>
            <concept>
              <code value="MEMADMIN"/>
              <abstract value="false"/>
              <display value="member administration"/>
              <definition value="To perform one or more operations on information to administer health care coverage to
                 an enrollee under a policy or program."/>
            </concept>
            <concept>
              <code value="PATADMIN"/>
              <abstract value="false"/>
              <display value="patient administration"/>
              <definition value="To perform one or more operations on information used for operational activities conducted
                 to administer the delivery of health care to a patient."/>
            </concept>
            <concept>
              <code value="PATSFTY"/>
              <abstract value="false"/>
              <display value="patient safety"/>
              <definition value="To perform one or more operations on information in processes related to ensuring the
                 safety of health care."/>
            </concept>
            <concept>
              <code value="PERFMSR"/>
              <abstract value="false"/>
              <display value="performance measure"/>
              <definition value="To perform one or more operations on information used for monitoring performance of recommended
                 health care practices and interventions."/>
            </concept>
            <concept>
              <code value="RECORDMGT"/>
              <abstract value="false"/>
              <display value="records management"/>
              <definition value="To perform one or more operations on information used within the health records management
                 process."/>
            </concept>
            <concept>
              <code value="TRAIN"/>
              <abstract value="false"/>
              <display value="training"/>
              <definition value="To perform one or more operations on information used in training and education."/>
            </concept>
          </concept>
          <concept>
            <code value="HPAYMT"/>
            <abstract value="false"/>
            <display value="healthcare payment"/>
            <definition value="To perform one or more operations on information for conducting financial or contractual
               activities related to payment for provision of health care."/>
            <concept>
              <code value="CLMATTCH"/>
              <abstract value="false"/>
              <display value="claim attachment"/>
              <definition value="To perform one or more operations on information for provision of additional clinical
                 evidence in support of a request for coverage or payment for health services."/>
            </concept>
            <concept>
              <code value="COVAUTH"/>
              <abstract value="false"/>
              <display value="coverage authorization"/>
              <definition value="To perform one or more operations on information for conducting prior authorization or
                 predetermination of coverage for services."/>
            </concept>
            <concept>
              <code value="COVERAGE"/>
              <abstract value="false"/>
              <display value="coverage under policy or program"/>
              <definition value="To perform one or more operations on information for conducting activities related to
                 coverage under a program or policy."/>
              <concept>
                <code value="ELIGDTRM"/>
                <abstract value="false"/>
                <display value="eligibility determination"/>
                <definition value="To perform one or more operations on information used for conducting eligibility determination
                   for coverage in a program or policy.  May entail review of financial status or disability
                   assessment."/>
              </concept>
              <concept>
                <code value="ELIGVER"/>
                <abstract value="false"/>
                <display value="eligibility verification"/>
                <definition value="To perform one or more operations on information used for conducting eligibility verification
                   of coverage in a program or policy.  May entail provider contacting coverage source (e.g.,
                   government health program such as workers compensation or health plan) for confirmation
                   of enrollment, eligibility for specific services, and any applicable copays."/>
              </concept>
              <concept>
                <code value="ENROLLM"/>
                <abstract value="false"/>
                <display value="enrollment"/>
                <definition value="To perform one or more operations on information used for enrolling a covered party in
                   a program or policy.  May entail recording of covered party's and any dependent's demographic
                   information and benefit choices."/>
              </concept>
            </concept>
            <concept>
              <code value="REMITADV"/>
              <abstract value="false"/>
              <display value="remittance advice"/>
              <definition value="To perform one or more operations on information about the amount remitted for a health
                 care claim."/>
            </concept>
          </concept>
          <concept>
            <code value="HRESCH"/>
            <abstract value="false"/>
            <display value="healthcare research"/>
            <definition value="To perform one or more operations on information for conducting scientific investigations
               to obtain health care knowledge."/>
            <concept>
              <code value="CLINTRCH"/>
              <abstract value="false"/>
              <display value="clinical trial research"/>
              <definition value="To perform one or more operations on information for conducting scientific investigations
                 in accordance with clinical trial protocols to obtain health care knowledge."/>
            </concept>
          </concept>
          <concept>
            <code value="PATRQT"/>
            <abstract value="false"/>
            <display value="patient requested"/>
            <definition value="To perform one or more operations on information in response to a patient's request."/>
            <concept>
              <code value="FAMRQT"/>
              <abstract value="false"/>
              <display value="family requested"/>
              <definition value="To perform one or more operations on information in response to a request by a family
                 member authorized by the patient."/>
            </concept>
            <concept>
              <code value="PWATRNY"/>
              <abstract value="false"/>
              <display value="power of attorney"/>
              <definition value="To perform one or more operations on information in response to a request by a person
                 appointed as the patient's legal representative."/>
            </concept>
            <concept>
              <code value="SUPNWK"/>
              <abstract value="false"/>
              <display value="support network"/>
              <definition value="To perform one or more operations on information in response to a request by a person
                 authorized by the patient."/>
            </concept>
          </concept>
          <concept>
            <code value="PUBHLTH"/>
            <abstract value="false"/>
            <display value="public health"/>
            <definition value="To perform one or more operations on information for conducting public health activities,
               such as the reporting of notifiable conditions."/>
            <concept>
              <code value="DISASTER"/>
              <abstract value="false"/>
              <display value="disaster"/>
              <definition value="To perform one or more operations on information used for provision of immediately needed
                 health care to a population of living subjects located in a disaster zone."/>
            </concept>
            <concept>
              <code value="THREAT"/>
              <abstract value="false"/>
              <display value="threat"/>
              <definition value="To perform one or more operations on information used to prevent injury or disease to
                 living subjects who may be the target of violence."/>
            </concept>
          </concept>
          <concept>
            <code value="TREAT"/>
            <abstract value="false"/>
            <display value="treatment"/>
            <definition value="To perform one or more operations on information for provision of health care."/>
            <concept>
              <code value="CAREMGT"/>
              <abstract value="false"/>
              <display value="Care Management"/>
              <definition value="To perform one or more operations on information for provision of health care coordination."/>
            </concept>
            <concept>
              <code value="CLINTRL"/>
              <abstract value="false"/>
              <display value="clinical trial"/>
              <definition value="To perform health care as part of the clinical trial protocol."/>
            </concept>
            <concept>
              <code value="ETREAT"/>
              <abstract value="false"/>
              <display value="Emergency Treatment"/>
              <definition value="To perform one or more operations on information for provision of immediately needed health
                 care for an emergent condition."/>
            </concept>
            <concept>
              <code value="POPHLTH"/>
              <abstract value="false"/>
              <display value="population health"/>
              <definition value="To perform one or more operations on information for provision of health care to a population
                 of living subjects, e.g., needle exchange program."/>
            </concept>
          </concept>
        </concept>
      </concept>
      <concept>
        <code value="_ActInformationPrivacyReason"/>
        <abstract value="true"/>
        <display value="ActInformationPrivacyReason"/>
        <definition value="Description:The rationale or purpose for an act relating to the management of personal
           information, such as disclosing personal tax information for the purpose of complying
           with a court order."/>
        <concept>
          <code value="MARKT"/>
          <abstract value="false"/>
          <display value="marketing"/>
          <definition value="Description:"/>
        </concept>
        <concept>
          <code value="OPERAT"/>
          <abstract value="false"/>
          <display value="operations"/>
          <definition value="Description:Administrative and contractual processes required to support an activity,
             product, or service"/>
          <concept>
            <code value="LEGAL"/>
            <abstract value="false"/>
            <display value="subpoena"/>
            <definition value="Definition:To provide information as a result of a subpoena."/>
          </concept>
          <concept>
            <code value="ACCRED"/>
            <abstract value="false"/>
            <display value="accreditation"/>
            <definition value="Description:Operational activities conducted for the purposes of meeting of criteria defined
               by an accrediting entity for an activity, product, or service"/>
          </concept>
          <concept>
            <code value="COMPL"/>
            <abstract value="false"/>
            <display value="compliance"/>
            <definition value="Description:Operational activities required to meet a mandate related to an activity,
               product, or service"/>
          </concept>
          <concept>
            <code value="ENADMIN"/>
            <abstract value="false"/>
            <display value="entity administration"/>
            <definition value="Description:Operational activities conducted to administer information relating to entities
               involves with an activity, product, or service"/>
          </concept>
          <concept>
            <code value="OUTCOMS"/>
            <abstract value="false"/>
            <display value="outcome measure"/>
            <definition value="Description:Operational activities conducted for the purposes of assessing the results
               of an activity, product, or service"/>
          </concept>
          <concept>
            <code value="PRGRPT"/>
            <abstract value="false"/>
            <display value="program reporting"/>
            <definition value="Description:Operational activities conducted to meet program accounting requirements related
               to an activity, product, or service"/>
          </concept>
          <concept>
            <code value="QUALIMP"/>
            <abstract value="false"/>
            <display value="quality improvement"/>
            <definition value="Description:Operational activities conducted for the purposes of improving the quality
               of an activity, product, or service"/>
          </concept>
          <concept>
            <code value="SYSADMN"/>
            <abstract value="false"/>
            <display value="system administration"/>
            <definition value="Description:Operational activities conducted to administer the electronic systems used
               for an activity, product, or service"/>
          </concept>
        </concept>
        <concept>
          <code value="PAYMT"/>
          <abstract value="false"/>
          <display value="payment"/>
          <definition value="Description:Administrative, financial, and contractual processes related to payment for
             an activity, product, or service"/>
        </concept>
        <concept>
          <code value="RESCH"/>
          <abstract value="false"/>
          <display value="research"/>
          <definition value="Description:Investigative activities conducted for the purposes of obtaining knowledge"/>
        </concept>
        <concept>
          <code value="SRVC"/>
          <abstract value="false"/>
          <display value="service"/>
          <definition value="Description:Provision of a service, product, or capability to an individual or organization"/>
        </concept>
      </concept>
    </concept>
    <concept>
      <code value="_ActInvalidReason"/>
      <abstract value="false"/>
      <display value="ActInvalidReason"/>
      <definition value="Description: Types of reasons why a substance is invalid for use."/>
      <concept>
        <code value="ADVSTORAGE"/>
        <abstract value="false"/>
        <display value="adverse storage condition"/>
        <definition value="Description: Storage conditions caused the substance to be ineffective."/>
        <concept>
          <code value="COLDCHNBRK"/>
          <abstract value="false"/>
          <display value="cold chain break"/>
          <definition value="Description: Cold chain was not maintained for the substance."/>
        </concept>
      </concept>
      <concept>
        <code value="EXPLOT"/>
        <abstract value="false"/>
        <display value="expired lot"/>
        <definition value="Description: The lot from which the substance was drawn was expired."/>
      </concept>
      <concept>
        <code value="OUTSIDESCHED"/>
        <abstract value="false"/>
        <display value="administered outside recommended schedule or practice"/>
        <definition value="The substance was administered outside of the recommended schedule or practice."/>
      </concept>
      <concept>
        <code value="PRODRECALL"/>
        <abstract value="false"/>
        <display value="product recall"/>
        <definition value="Description: The substance was recalled by the manufacturer."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActInvoiceCancelReason"/>
      <abstract value="true"/>
      <display value="ActInvoiceCancelReason"/>
      <definition value="Domain specifies the codes used to describe reasons why a Provider is cancelling an Invoice
         or Invoice Grouping."/>
      <concept>
        <code value="INCCOVPTY"/>
        <abstract value="false"/>
        <display value="incorrect covered party as patient"/>
        <definition value="The covered party (patient) specified with the Invoice is not correct."/>
      </concept>
      <concept>
        <code value="INCINVOICE"/>
        <abstract value="false"/>
        <display value="incorrect billing"/>
        <definition value="The billing information, specified in the Invoice Elements, is not correct.  This could
           include incorrect costing for items included in the Invoice."/>
      </concept>
      <concept>
        <code value="INCPOLICY"/>
        <abstract value="false"/>
        <display value="incorrect policy"/>
        <definition value="The policy specified with the Invoice is not correct.  For example, it may belong to another
           Adjudicator or Covered Party."/>
      </concept>
      <concept>
        <code value="INCPROV"/>
        <abstract value="false"/>
        <display value="incorrect provider"/>
        <definition value="The provider specified with the Invoice is not correct."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActNoImmunizationReason"/>
      <abstract value="true"/>
      <display value="ActNoImmunizationReason"/>
      <definition value="A coded description of the reason for why a patient did not receive a scheduled immunization.
                                  (important for public health strategy"/>
      <concept>
        <code value="IMMUNE"/>
        <abstract value="false"/>
        <display value="immunity"/>
        <definition value="Definition:Testing has shown that the patient already has immunity to the agent targeted
           by the immunization."/>
      </concept>
      <concept>
        <code value="MEDPREC"/>
        <abstract value="false"/>
        <display value="medical precaution"/>
        <definition value="Definition:The patient currently has a medical condition for which the vaccine is contraindicated
           or for which precaution is warranted."/>
      </concept>
      <concept>
        <code value="OSTOCK"/>
        <abstract value="false"/>
        <display value="product out of stock"/>
        <definition value="Definition:There was no supply of the product on hand to perform the service."/>
      </concept>
      <concept>
        <code value="PATOBJ"/>
        <abstract value="false"/>
        <display value="patient objection"/>
        <definition value="Definition:The patient or their guardian objects to receiving the vaccine."/>
      </concept>
      <concept>
        <code value="PHILISOP"/>
        <abstract value="false"/>
        <display value="philosophical objection"/>
        <definition value="Definition:The patient or their guardian objects to receiving the vaccine because of philosophical
           beliefs."/>
      </concept>
      <concept>
        <code value="RELIG"/>
        <abstract value="false"/>
        <display value="religious objection"/>
        <definition value="Definition:The patient or their guardian objects to receiving the vaccine on religious
           grounds."/>
      </concept>
      <concept>
        <code value="VACEFF"/>
        <abstract value="false"/>
        <display value="vaccine efficacy concerns"/>
        <definition value="Definition:The intended vaccine has expired or is otherwise believed to no longer be effective.
                                                                Example:Due to temperature exposure."/>
      </concept>
      <concept>
        <code value="VACSAF"/>
        <abstract value="false"/>
        <display value="vaccine safety concerns"/>
        <definition value="Definition:The patient or their guardian objects to receiving the vaccine because of concerns
           over its safety."/>
      </concept>
    </concept>
    <concept>
      <code value="_ActSupplyFulfillmentRefusalReason"/>
      <abstract value="true"/>
      <display value="ActSupplyFulfillmentRefusalReason"/>
      <definition value="Indicates why a fulfiller refused to fulfill a supply order, and considered it important
         to notify other providers of their decision.  E.g. &quot;Suspect fraud&quot;, &quot;Possible
         abuse&quot;, &quot;Contraindicated&quot;.                          (used when capturing
         'refusal to fill' annotations)"/>
      <concept>
        <code value="FRR01"/>
        <abstract value="false"/>
        <display value="order stopped"/>
        <definition value="Definition:The order has been stopped by the prescriber but this fact has not necessarily
           captured electronically.                                                      Example:A
           verbal stop, a fax, etc."/>
      </concept>
      <concept>
        <code value="FRR02"/>
        <abstract value="false"/>
        <display value="stale-dated order"/>
        <definition value="Definition:Order has not been fulfilled within a reasonable amount of time, and may not
           be current."/>
      </concept>
      <concept>
        <code value="FRR03"/>
        <abstract value="false"/>
        <display value="incomplete data"/>
        <definition value="Definition:Data needed to safely act on the order which was expected to become available
           independent of the order is not yet available                                        
                        Example:Lab results, diagnostic imaging, etc."/>
      </concept>
      <concept>
        <code value="FRR04"/>
        <abstract value="false"/>
        <display value="product unavailable"/>
        <definition value="Definition:Product not available or manufactured. Cannot supply."/>
      </concept>
      <concept>
        <code value="FRR05"/>
        <abstract value="false"/>
        <display value="ethical/religious"/>
        <definition value="Definition:The dispenser has ethical, religious or moral objections to fulfilling the
           order/dispensing the product."/>
      </concept>
      <concept>
        <code value="FRR06"/>
        <abstract value="false"/>
        <display value="unable to provide care"/>
        <definition value="Definition:Fulfiller not able to provide appropriate care associated with fulfilling the
           order.                                                      Example:Therapy requires ongoing
           monitoring by fulfiller and fulfiller will be ending practice, leaving town, unable to
           schedule necessary time, etc."/>
      </concept>
    </concept>
    <concept>
      <code value="_ClinicalResearchEventReason"/>
      <abstract value="true"/>
      <display value="ClinicalResearchEventReason"/>
      <definition value="Definition:Specifies the reason that an event occurred in a clinical research study."/>
      <concept>
        <code value="RET"/>
        <abstract value="false"/>
        <display value="retest"/>
        <definition value="Definition:The event occurred so that a test or observation performed at a prior event
           could be performed again due to conditions set forth in the protocol."/>
      </concept>
      <concept>
        <code value="SCH"/>
        <abstract value="false"/>
        <display value="scheduled"/>
        <definition value="Definition:The event occurred due to it being scheduled in the research protocol."/>
      </concept>
      <concept>
        <code value="TRM"/>
        <abstract value="false"/>
        <display value="termination"/>
        <definition value="Definition:The event occurred in order to terminate the subject's participation in the
           study."/>
      </concept>
      <concept>
        <code value="UNS"/>
        <abstract value="false"/>
        <display value="unscheduled"/>
        <definition value="Definition:The event that occurred was initiated by a study participant (e.g. the subject
           or the investigator), and did not occur for protocol reasons."/>
      </concept>
    </concept>
    <concept>
      <code value="_ClinicalResearchObservationReason"/>
      <abstract value="true"/>
      <display value="ClinicalResearchObservationReason"/>
      <definition value="Definition:SSpecifies the reason that a test was performed or observation collected in
         a clinical research study.                                                      Note:This
         set of codes are not strictly reasons, but are used in the currently Normative standard.
          Future revisions of the specification will model these as ActRelationships and thes codes
         may subsequently be retired.  Thus, these codes should not be used for new specifications."/>
      <concept>
        <code value="NPT"/>
        <abstract value="false"/>
        <display value="non-protocol"/>
        <definition value="Definition:The observation or test was neither defined or scheduled in the study protocol."/>
      </concept>
      <concept>
        <code value="PPT"/>
        <abstract value="false"/>
        <display value="per protocol"/>
        <definition value="Definition:The observation or test occurred due to it being defined in the research protocol,
           and during an activity or event that was scheduled in the protocol."/>
      </concept>
      <concept>
        <code value="UPT"/>
        <abstract value="false"/>
        <display value="per definition"/>
        <definition value=":The observation or test occurred as defined in the research protocol, but at a point
           in time not specified in the study protocol."/>
      </concept>
    </concept>
    <concept>
      <code value="_CombinedPharmacyOrderSuspendReasonCode"/>
      <abstract value="true"/>
      <display value="CombinedPharmacyOrderSuspendReasonCode"/>
      <definition value="Description:Indicates why the prescription should be suspended."/>
      <concept>
        <code value="ALTCHOICE"/>
        <abstract value="false"/>
        <display value="try another treatment first"/>
        <definition value="Description:This therapy has been ordered as a backup to a preferred therapy.  This order
           will be released when and if the preferred therapy is unsuccessful."/>
      </concept>
      <concept>
        <code value="CLARIF"/>
        <abstract value="false"/>
        <display value="prescription requires clarification"/>
        <definition value="Description:Clarification is required before the order can be acted upon."/>
      </concept>
      <concept>
        <code value="DRUGHIGH"/>
        <abstract value="false"/>
        <display value="drug level too high"/>
        <definition value="Description:The current level of the medication in the patient's system is too high. 
           The medication is suspended to allow the level to subside to a safer level."/>
      </concept>
      <concept>
        <code value="HOSPADM"/>
        <abstract value="false"/>
        <display value="admission to hospital"/>
        <definition value="Description:The patient has been admitted to a care facility and their community medications
           are suspended until hospital discharge."/>
      </concept>
      <concept>
        <code value="LABINT"/>
        <abstract value="false"/>
        <display value="lab interference issues"/>
        <definition value="Description:The therapy would interfere with a planned lab test and the therapy is being
           withdrawn until the test is completed."/>
      </concept>
      <concept>
        <code value="NON-AVAIL"/>
        <abstract value="false"/>
        <display value="patient not-available"/>
        <definition value="Description:Patient not available for a period of time due to a scheduled therapy, leave
           of absence or other reason."/>
      </concept>
      <concept>
        <code value="PREG"/>
        <abstract value="false"/>
        <display value="parent is pregnant/breast feeding"/>
        <definition value="Description:The patient is pregnant or breast feeding.  The therapy will be resumed when
           the pregnancy is complete and the patient is no longer breastfeeding."/>
      </concept>
      <concept>
        <code value="SALG"/>
        <abstract value="false"/>
        <display value="allergy"/>
        <definition value="Description:The patient is believed to be allergic to a substance that is part of the
           therapy and the therapy is being temporarily withdrawn to confirm."/>
      </concept>
      <concept>
        <code value="SDDI"/>
        <abstract value="false"/>
        <display value="drug interacts with another drug"/>
        <definition value="Description:The drug interacts with a short-term treatment that is more urgently required.
            This order will be resumed when the short-term treatment is complete."/>
      </concept>
      <concept>
        <code value="SDUPTHER"/>
        <abstract value="false"/>
        <display value="duplicate therapy"/>
        <definition value="Description:Another short-term co-occurring therapy fulfills the same purpose as this
           therapy.  This therapy will be resumed when the co-occuring therapy is complete."/>
      </concept>
      <concept>
        <code value="SINTOL"/>
        <abstract value="false"/>
        <display value="suspected intolerance"/>
        <definition value="Description:The patient is believed to have an intolerance to a substance that is part
           of the therapy and the therapy is being temporarily withdrawn to confirm."/>
      </concept>
      <concept>
        <code value="SURG"/>
        <abstract value="false"/>
        <display value="patient scheduled for surgery"/>
        <definition value="Description:The drug is contraindicated for patients receiving surgery and the patient
           is scheduled to be admitted for surgery in the near future.  The drug will be resumed
           when the patient has sufficiently recovered from the surgery."/>
      </concept>
      <concept>
        <code value="WASHOUT"/>
        <abstract value="false"/>
        <display value="waiting for old drug to wash out"/>
        <definition value="Description:The patient was previously receiving a medication contraindicated with the
           current medication.  The current medication will remain on hold until the prior medication
           has been cleansed from their system."/>
      </concept>
    </concept>
    <concept>
      <code value="_ControlActNullificationReasonCode"/>
      <abstract value="false"/>
      <display value="ControlActNullificationReasonCode"/>
      <definition value="Description:Identifies reasons for nullifying (retracting) a particular control act."/>
      <concept>
        <code value="ALTD"/>
        <abstract value="false"/>
        <display value="altered decision"/>
        <definition value="Description:The decision on which the recorded information was based was changed before
           the decision had an effect.                                                      Example:Aborted
           prescription before patient left office, released prescription before suspend took effect."/>
      </concept>
      <concept>
        <code value="EIE"/>
        <abstract value="false"/>
        <display value="entered in error"/>
        <definition value="Description:The information was recorded incorrectly or was recorded in the wrong record."/>
      </concept>
      <concept>
        <code value="NORECMTCH"/>
        <abstract value="false"/>
        <display value="no record match"/>
        <definition value="Description: There is no match for the record in the database."/>
      </concept>
    </concept>
    <concept>
      <code value="_ControlActNullificationRefusalReasonType"/>
      <abstract value="true"/>
      <display value="ControlActNullificationRefusalReasonType"/>
      <definition value="Description: Reasons to refuse a transaction to be undone."/>
      <concept>
        <code value="INRQSTATE"/>
        <abstract value="false"/>
        <display value="in requested state"/>
        <definition value="The record is already in the requested state."/>
      </concept>
      <concept>
        <modifierExtension url="http://hl7.org/fhir/StructureDefinition/valueset-subsumes">
          <valueCode value="NORECMTCH"/>
        </modifierExtension>
        <code value="NOMATCH"/>
        <abstract value="false"/>
        <display value="no match"/>
        <definition value="Description: There is no match."/>
        <concept>
          <code value="NOPRODMTCH"/>
          <abstract value="false"/>
          <display value="no product match"/>
          <definition value="Description: There is no match for the product in the master file repository."/>
        </concept>
        <concept>
          <code value="NOSERMTCH"/>
          <abstract value="false"/>
          <display value="no service match"/>
          <definition value="Description: There is no match for the service in the master file repository."/>
        </concept>
        <concept>
          <code value="NOVERMTCH"/>
          <abstract value="false"/>
          <display value="no version match"/>
          <definition value="Description: There is no match for the record and version."/>
        </concept>
      </concept>
      <concept>
        <code value="NOPERM"/>
        <abstract value="false"/>
        <display value="no permission"/>
        <definition value="Description: There is no permission."/>
        <concept>
          <code value="NOUSERPERM"/>
          <abstract value="false"/>
          <display value="no user permission"/>
          <definition value="Definition:The user does not have permission"/>
        </concept>
        <concept>
          <code value="NOAGNTPERM"/>
          <abstract value="false"/>
          <display value="no agent permission"/>
          <definition value="Description: The agent does not have permission."/>
        </concept>
      </concept>
      <concept>
        <code value="WRNGVER"/>
        <abstract value="false"/>
        <display value="wrong version"/>
        <definition value="Description: The record and version requested to update is not the current version."/>
      </concept>
    </concept>
    <concept>
      <code value="_ControlActReason"/>
      <abstract value="true"/>
      <display value="ControlActReason"/>
      <definition value="Identifies why a specific query, request, or other trigger event occurred."/>
      <concept>
        <code value="_MedicationOrderAbortReasonCode"/>
        <abstract value="true"/>
        <display value="medication order abort reason"/>
        <definition value="Description:Indicates the reason the medication order should be aborted."/>
        <concept>
          <code value="DISCONT"/>
          <abstract value="false"/>
          <display value="product discontinued"/>
          <definition value="Description:The medication is no longer being manufactured or is otherwise no longer available."/>
        </concept>
        <concept>
          <code value="INEFFECT"/>
          <abstract value="false"/>
          <display value="ineffective"/>
          <definition value="Description:The therapy has been found to not have the desired therapeutic benefit on
             the patient."/>
        </concept>
        <concept>
          <code value="MONIT"/>
          <abstract value="false"/>
          <display value="response to monitoring"/>
          <definition value="Description:Monitoring the patient while taking the medication, the decision has been
             made that the therapy is no longer appropriate."/>
        </concept>
        <concept>
          <code value="NOREQ"/>
          <abstract value="false"/>
          <display value="no longer required for treatment"/>
          <definition value="Description:The underlying condition has been resolved or has evolved such that a different
             treatment is no longer needed."/>
        </concept>
        <concept>
          <code value="NOTCOVER"/>
          <abstract value="false"/>
          <display value="not covered"/>
          <definition value="Description:The product does not have (or no longer has) coverage under the patientaTMs
             insurance policy."/>
        </concept>
        <concept>
          <code value="PREFUS"/>
          <abstract value="false"/>
          <display value="patient refuse"/>
          <definition value="Description:The patient refused to take the product."/>
        </concept>
        <concept>
          <code value="RECALL"/>
          <abstract value="false"/>
          <display value="product recalled"/>
          <definition value="Description:The manufacturer or other agency has requested that stocks of a medication
             be removed from circulation."/>
        </concept>
        <concept>
          <code value="REPLACE"/>
          <abstract value="false"/>
          <display value="change in order"/>
          <definition value="Description:Item in current order is no longer in use as requested and a new one has/will
             be created to replace it."/>
          <concept>
            <code value="DOSECHG"/>
            <abstract value="false"/>
            <display value="change in medication/dose"/>
            <definition value="Description:The medication is being re-prescribed at a different dosage."/>
          </concept>
        </concept>
        <concept>
          <code value="REPLACEFIX"/>
          <abstract value="false"/>
          <display value="error in order"/>
          <definition value="Description:Current order was issued with incorrect data and a new order has/will be created
             to replace it."/>
        </concept>
        <concept>
          <code value="UNABLE"/>
          <abstract value="false"/>
          <display value="unable to use"/>
          <definition value="Description:&lt;The patient is not (or is no longer) able to use the medication in a manner
             prescribed.                                                      Example:CanaTMt swallow."/>
        </concept>
      </concept>
      <concept>
        <code value="_MedicationOrderReleaseReasonCode"/>
        <abstract value="true"/>
        <display value="medication order release reason"/>
        <definition value="Definition:A collection of concepts that indicate why the prescription should be released
           from suspended state."/>
        <concept>
          <code value="HOLDDONE"/>
          <abstract value="false"/>
          <display value="suspend reason no longer applies"/>
          <definition value="Definition:The original reason for suspending the medication has ended."/>
        </concept>
        <concept>
          <code value="HOLDINAP"/>
          <abstract value="false"/>
          <display value="suspend reason inappropriate"/>
          <definition value="Definition:"/>
        </concept>
      </concept>
      <concept>
        <code value="_ModifyPrescriptionReasonType"/>
        <abstract value="true"/>
        <display value="ModifyPrescriptionReasonType"/>
        <definition value="Types of reason why a prescription is being changed."/>
        <concept>
          <code value="ADMINERROR"/>
          <abstract value="false"/>
          <display value="administrative error in order"/>
          <definition value="Order was created with incorrect data and is changed to reflect the intended accuracy
             of the order."/>
        </concept>
        <concept>
          <code value="CLINMOD"/>
          <abstract value="false"/>
          <display value="clinical modification"/>
          <definition value="Order is changed based on a clinical reason."/>
        </concept>
      </concept>
      <concept>
        <code value="_PharmacySupplyEventAbortReason"/>
        <abstract value="false"/>
        <display value="PharmacySupplyEventAbortReason"/>
        <definition value="Definition:Identifies why the dispense event was not completed."/>
        <concept>
          <code value="CONTRA"/>
          <abstract value="false"/>
          <display value="contraindication"/>
          <definition value="Definition:Contraindication identified"/>
        </concept>
        <concept>
          <code value="FOABORT"/>
          <abstract value="false"/>
          <display value="order aborted"/>
          <definition value="Definition:Order to be fulfilled was aborted"/>
        </concept>
        <concept>
          <code value="FOSUSP"/>
          <abstract value="false"/>
          <display value="order suspended"/>
          <definition value="Definition:Order to be fulfilled was suspended"/>
        </concept>
        <concept>
          <code value="NOPICK"/>
          <abstract value="false"/>
          <display value="not picked up"/>
          <definition value="Definition:Patient did not come to get medication"/>
        </concept>
        <concept>
          <code value="PATDEC"/>
          <abstract value="false"/>
          <display value="patient changed mind"/>
          <definition value="Definition:Patient changed their mind regarding obtaining medication"/>
        </concept>
        <concept>
          <code value="QUANTCHG"/>
          <abstract value="false"/>
          <display value="change supply quantity"/>
          <definition value="Definition:Patient requested a revised quantity of medication"/>
        </concept>
      </concept>
      <concept>
        <code value="_PharmacySupplyEventStockReasonCode"/>
        <abstract value="true"/>
        <display value="pharmacy supply event stock reason"/>
        <definition value="Definition:A collection of concepts that indicates the reason for a &quot;bulk supply&quot;
           of medication."/>
        <concept>
          <code value="FLRSTCK"/>
          <abstract value="false"/>
          <display value="floor stock"/>
          <definition value="Definition:The bulk supply is issued to replenish a ward for local dispensing.  (Includes
             both mobile and fixed-location ward stocks.)"/>
        </concept>
        <concept>
          <code value="LTC"/>
          <abstract value="false"/>
          <display value="long term care use"/>
          <definition value="Definition:The bulk supply will be administered within a long term care facility."/>
        </concept>
        <concept>
          <code value="OFFICE"/>
          <abstract value="false"/>
          <display value="office use"/>
          <definition value="Definition:The bulk supply is intended for general clinician office use."/>
        </concept>
        <concept>
          <code value="PHARM"/>
          <abstract value="false"/>
          <display value="pharmacy transfer"/>
          <definition value="Definition:The bulk supply is being transferred to another dispensing facility to.   
                                                               Example:Alleviate a temporary shortage."/>
        </concept>
        <concept>
          <code value="PROG"/>
          <abstract value="false"/>
          <display value="program use"/>
          <definition value="Definition:The bulk supply is intended for dispensing according to a specific program.
                                                                  Example:Mass immunization."/>
        </concept>
      </concept>
      <concept>
        <modifierExtension url="http://hl7.org/fhir/StructureDefinition/valueset-subsumes">
          <valueCode value="DISCONT"/>
        </modifierExtension>
        <code value="_PharmacySupplyRequestRenewalRefusalReasonCode"/>
        <abstract value="true"/>
        <display value="pharmacy supply request renewal refusal reason"/>
        <definition value="Definition:A collection of concepts that identifies why a renewal prescription has been
           refused."/>
        <concept>
          <code value="ALREADYRX"/>
          <abstract value="false"/>
          <display value="new prescription exists"/>
          <definition value="Definition:Patient has already been given a new (renewal) prescription."/>
        </concept>
        <concept>
          <code value="FAMPHYS"/>
          <abstract value="false"/>
          <display value="family physician must authorize further fills"/>
          <definition value="Definition:Request for further authorization must be done through patient's family physician."/>
        </concept>
        <concept>
          <code value="MODIFY"/>
          <abstract value="false"/>
          <display value="modified prescription exists"/>
          <definition value="Definition:Therapy has been changed and new prescription issued"/>
        </concept>
        <concept>
          <code value="NEEDAPMT"/>
          <abstract value="false"/>
          <display value="patient must make appointment"/>
          <definition value="Definition:Patient must see prescriber prior to further fills."/>
        </concept>
        <concept>
          <code value="NOTAVAIL"/>
          <abstract value="false"/>
          <display value="prescriber not available"/>
          <definition value="Definition:Original prescriber is no longer available to prescribe and no other prescriber
             has taken responsibility for the patient."/>
        </concept>
        <concept>
          <code value="NOTPAT"/>
          <abstract value="false"/>
          <display value="patient no longer in this practice"/>
          <definition value="Definition:Patient no longer or has never been under this prescribers care."/>
        </concept>
        <concept>
          <code value="ONHOLD"/>
          <abstract value="false"/>
          <display value="medication on hold"/>
          <definition value="Definition:This medication is on hold."/>
        </concept>
        <concept>
          <code value="PRNA"/>
          <abstract value="false"/>
          <display value="product not available"/>
          <definition value="Description:This product is not available or manufactured."/>
        </concept>
        <concept>
          <code value="STOPMED"/>
          <abstract value="false"/>
          <display value="prescriber stopped medication for patient"/>
          <definition value="Renewing or original prescriber informed patient to stop using the medication."/>
        </concept>
        <concept>
          <code value="TOOEARLY"/>
          <abstract value="false"/>
          <display value="too early"/>
          <definition value="Definition:The patient should have medication remaining."/>
        </concept>
      </concept>
      <concept>
        <code value="_SupplyOrderAbortReasonCode"/>
        <abstract value="true"/>
        <display value="supply order abort reason"/>
        <definition value="Definition:A collection of concepts that indicates why the prescription should no longer
           be allowed to be dispensed (but can still administer what is already being dispensed)."/>
        <concept>
          <code value="IMPROV"/>
          <abstract value="false"/>
          <display value="condition improved"/>
          <definition value="Definition:The patient's medical condition has nearly abated."/>
        </concept>
        <concept>
          <code value="INTOL"/>
          <abstract value="false"/>
          <display value="intolerance"/>
          <definition value="Description:The patient has an intolerance to the medication."/>
        </concept>
        <concept>
          <code value="NEWSTR"/>
          <abstract value="false"/>
          <display value="new strength"/>
          <definition value="Definition:The current medication will be replaced by a new strength of the same medication."/>
        </concept>
        <concept>
          <code value="NEWTHER"/>
          <abstract value="false"/>
          <display value="new therapy"/>
          <definition value="Definition:A new therapy will be commenced when current supply exhausted."/>
        </concept>
      </concept>
    </concept>
    <concept>
      <code value="_GenericUpdateReasonCode"/>
      <abstract value="true"/>
      <display value="GenericUpdateReasonCode"/>
      <definition value="Description:Identifies why a change is being made to a  record."/>
      <concept>
        <code value="CHGDATA"/>
        <abstract value="false"/>
        <display value="information change"/>
        <definition value="Description:Information has changed since the record was created."/>
      </concept>
      <concept>
        <code value="FIXDATA"/>
        <abstract value="false"/>
        <display value="error correction"/>
        <definition value="Description:Previously recorded information was erroneous and is being corrected."/>
      </concept>
      <concept>
        <code value="MDATA"/>
        <abstract value="false"/>
        <display value="merge data"/>
        <definition value="Information is combined into the record."/>
      </concept>
      <concept>
        <code value="NEWDATA"/>
        <abstract value="false"/>
        <display value="new information"/>
        <definition value="Description:New information has become available to supplement the record."/>
      </concept>
      <concept>
        <code value="UMDATA"/>
        <abstract value="false"/>
        <display value="unmerge data"/>
        <definition value="Information is separated from the record."/>
      </concept>
    </concept>
    <concept>
      <modifierExtension url="http://hl7.org/fhir/StructureDefinition/valueset-subsumes">
        <valueCode value="LEGAL"/>
      </modifierExtension>
      <code value="_PatientProfileQueryReasonCode"/>
      <abstract value="true"/>
      <display value="patient profile query reason"/>
      <definition value="Definition:A collection of concepts identifying why the patient's profile is being queried."/>
      <concept>
        <code value="ADMREV"/>
        <abstract value="false"/>
        <display value="administrative review"/>
        <definition value="Definition: To evaluate for service authorization, payment, reporting, or performance/outcome
           measures."/>
      </concept>
      <concept>
        <code value="PATCAR"/>
        <abstract value="false"/>
        <display value="patient care"/>
        <definition value="Definition:To obtain records as part of patient care."/>
      </concept>
      <concept>
        <code value="PATREQ"/>
        <abstract value="false"/>
        <display value="patient request query"/>
        <definition value="Definition:Patient requests information from their profile."/>
      </concept>
      <concept>
        <code value="PRCREV"/>
        <abstract value="false"/>
        <display value="practice review"/>
        <definition value="Definition:To evaluate the provider's current practice for professional-improvement reasons."/>
      </concept>
      <concept>
        <code value="REGUL"/>
        <abstract value="false"/>
        <display value="regulatory review"/>
        <definition value="Description:Review for the purpose of regulatory compliance."/>
      </concept>
      <concept>
        <code value="RSRCH"/>
        <abstract value="false"/>
        <display value="research"/>
        <definition value="Definition:To provide research data, as authorized by the patient."/>
      </concept>
      <concept>
        <code value="VALIDATION"/>
        <abstract value="false"/>
        <display value="validation review"/>
        <definition value="Description:To validate the patient's record.                                        
                        Example:Merging or unmerging records."/>
      </concept>
    </concept>
    <concept>
      <modifierExtension url="http://hl7.org/fhir/StructureDefinition/valueset-subsumes">
        <valueCode value="NOUSERPERM"/>
      </modifierExtension>
      <code value="_PharmacySupplyRequestFulfillerRevisionRefusalReasonCode"/>
      <abstract value="false"/>
      <display value="PharmacySupplyRequestFulfillerRevisionRefusalReasonCode"/>
      <definition value="Definition:Indicates why the request to transfer a prescription from one dispensing facility
         to another has been refused."/>
      <concept>
        <code value="LOCKED"/>
        <abstract value="false"/>
        <display value="locked"/>
        <definition value="Definition:The prescription may not be reassigned from the original pharmacy."/>
      </concept>
      <concept>
        <code value="UNKWNTARGET"/>
        <abstract value="false"/>
        <display value="unknown target"/>
        <definition value="Definition:The target facility does not recognize the dispensing facility."/>
      </concept>
    </concept>
    <concept>
      <modifierExtension url="http://hl7.org/fhir/StructureDefinition/valueset-subsumes">
        <valueCode value="NOMATCH"/>
      </modifierExtension>
      <modifierExtension url="http://hl7.org/fhir/StructureDefinition/valueset-subsumes">
        <valueCode value="NOPERM"/>
      </modifierExtension>
      <code value="_RefusalReasonCode"/>
      <abstract value="true"/>
      <display value="RefusalReasonCode"/>
      <definition value="Description: Identifies why a request to add (or activate) a record is being refused.
          Examples include the receiving system not able to match the identifier and find that
         record in the receiving system, having no permission, or a detected issue exists which
         precludes the requested action."/>
    </concept>
    <concept>
      <modifierExtension url="http://hl7.org/fhir/StructureDefinition/valueset-subsumes">
        <valueCode value="PAT"/>
      </modifierExtension>
      <code value="_SchedulingActReason"/>
      <abstract value="true"/>
      <display value="SchedulingActReason"/>
      <definition value="Reasons for cancelling or rescheduling an Appointment"/>
      <concept>
        <code value="BLK"/>
        <abstract value="false"/>
        <display value="Unexpected Block (of Schedule)"/>
        <definition value="The time slots previously allocated are now blocked and no longer available for booking
           Appointments"/>
      </concept>
      <concept>
        <code value="DEC"/>
        <abstract value="false"/>
        <display value="Patient Deceased"/>
        <definition value="The Patient is deceased"/>
      </concept>
      <concept>
        <code value="FIN"/>
        <abstract value="false"/>
        <display value="No Financial Backing"/>
        <definition value="Patient unable to pay and not covered by insurance"/>
      </concept>
      <concept>
        <code value="MED"/>
        <abstract value="false"/>
        <display value="Medical Status Altered"/>
        <definition value="The medical condition of the Patient has changed"/>
      </concept>
      <concept>
        <code value="MTG"/>
        <abstract value="false"/>
        <display value="In an outside meeting"/>
        <definition value="The Physician is in a meeting.  For example, he/she may request administrative time to
           talk to family after appointment"/>
      </concept>
      <concept>
        <code value="PHY"/>
        <abstract value="false"/>
        <display value="Physician request"/>
        <definition value="The Physician requested the action"/>
      </concept>
    </concept>
    <concept>
      <modifierExtension url="http://hl7.org/fhir/StructureDefinition/valueset-subsumes">
        <valueCode value="NORECMTCH"/>
      </modifierExtension>
      <modifierExtension url="http://hl7.org/fhir/StructureDefinition/valueset-subsumes">
        <valueCode value="INRQSTATE"/>
      </modifierExtension>
      <modifierExtension url="http://hl7.org/fhir/StructureDefinition/valueset-subsumes">
        <valueCode value="NOUSERPERM"/>
      </modifierExtension>
      <code value="_StatusRevisionRefusalReasonCode"/>
      <abstract value="false"/>
      <display value="StatusRevisionRefusalReasonCode"/>
      <definition value="Indicates why the act revision (status update) is being refused."/>
      <concept>
        <code value="FILLED"/>
        <abstract value="false"/>
        <display value="fully filled"/>
        <definition value="Ordered quantity has already been completely fulfilled."/>
      </concept>
    </concept>
    <concept>
      <modifierExtension url="http://hl7.org/fhir/StructureDefinition/valueset-subsumes">
        <valueCode value="NOUSERPERM"/>
      </modifierExtension>
      <code value="_SubstanceAdministrationPermissionRefusalReasonCode"/>
      <abstract value="false"/>
      <display value="SubstanceAdministrationPermissionRefusalReasonCode"/>
      <definition value="Definition:Indicates why the requested authorization to prescribe or dispense a medication
         has been refused."/>
      <concept>
        <code value="PATINELIG"/>
        <abstract value="false"/>
        <display value="patient not eligible"/>
        <definition value="Definition:Patient not eligible for drug"/>
      </concept>
      <concept>
        <code value="PROTUNMET"/>
        <abstract value="false"/>
        <display value="protocol not met"/>
        <definition value="Definition:Patient does not meet required protocol"/>
      </concept>
      <concept>
        <code value="PROVUNAUTH"/>
        <abstract value="false"/>
        <display value="provider not authorized"/>
        <definition value="Definition:Provider is not authorized to prescribe or dispense"/>
      </concept>
    </concept>
    <concept>
      <modifierExtension url="http://hl7.org/fhir/StructureDefinition/valueset-subsumes">
        <valueCode value="PAT"/>
      </modifierExtension>
      <code value="_SubstanceAdminSubstitutionNotAllowedReason"/>
      <abstract value="true"/>
      <display value="SubstanceAdminSubstitutionNotAllowedReason"/>
      <definition value="Reasons why substitution of a substance administration request is not permitted."/>
      <concept>
        <code value="ALGINT"/>
        <abstract value="false"/>
        <display value="allergy intolerance"/>
        <definition value="Definition: Patient has had a prior allergic intolerance response to alternate product
           or one of its components."/>
      </concept>
      <concept>
        <code value="COMPCON"/>
        <abstract value="false"/>
        <display value="compliance concern"/>
        <definition value="Definition: Patient has compliance issues with medication such as differing appearance,
           flavor, size, shape or consistency."/>
      </concept>
      <concept>
        <code value="THERCHAR"/>
        <abstract value="false"/>
        <display value="therapeutic characteristics"/>
        <definition value="The prescribed product has specific clinical release or other therapeutic characteristics
           not shared by other substitutable medications."/>
      </concept>
      <concept>
        <code value="TRIAL"/>
        <abstract value="false"/>
        <display value="clinical trial drug"/>
        <definition value="Definition: The specific manufactured drug is part of a clinical trial."/>
      </concept>
    </concept>
    <concept>
      <code value="_SubstanceAdminSubstitutionReason"/>
      <abstract value="true"/>
      <display value="SubstanceAdminSubstitutionReason"/>
      <definition value="SubstanceAdminSubstitutionReason"/>
      <concept>
        <code value="CT"/>
        <abstract value="false"/>
        <display value="continuing therapy"/>
        <definition value="Indicates that the decision to substitute or to not substitute was driven by a desire
           to maintain consistency with a pre-existing therapy.  I.e. The performer provided the
           same item/service as had been previously provided rather than providing exactly what was
           ordered, or rather than substituting with a lower-cost equivalent."/>
      </concept>
      <concept>
        <code value="FP"/>
        <abstract value="false"/>
        <display value="formulary policy"/>
        <definition value="Indicates that the decision to substitute or to not substitute was driven by a policy
           expressed within the formulary."/>
      </concept>
      <concept>
        <code value="OS"/>
        <abstract value="false"/>
        <display value="out of stock"/>
        <definition value="In the case of 'substitution', indicates that the substitution occurred because the ordered
           item was not in stock.  In the case of 'no substitution', indicates that a cheaper equivalent
           was not substituted because it was not in stock."/>
      </concept>
      <concept>
        <code value="RR"/>
        <abstract value="false"/>
        <display value="regulatory requirement"/>
        <definition value="Indicates that the decision to substitute or to not substitute was driven by a jurisdictional
           regulatory requirement mandating or prohibiting substitution."/>
      </concept>
    </concept>
    <concept>
      <code value="_TransferActReason"/>
      <abstract value="true"/>
      <display value="TransferActReason"/>
      <definition value="The explanation for why a patient is moved from one location to another within the organization"/>
      <concept>
        <code value="ER"/>
        <abstract value="false"/>
        <display value="Error"/>
        <definition value="Moved to an error in placing the patient in the original location."/>
      </concept>
      <concept>
        <code value="RQ"/>
        <abstract value="false"/>
        <display value="Request"/>
        <definition value="Moved at the request of the patient."/>
      </concept>
    </concept>
  </define>
</ValueSet>

Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.