Connectathon 11 Snapshot

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1.25.4.1.111 HL7 v3 Code System RoleCode

This code system (http://hl7.org/fhir/v3/RoleCode) is defined as part of HL7 v3.

Summary

Defining URL:http://hl7.org/fhir/ValueSet/v3-RoleCode
Name:v3 Code System RoleCode
Definition: A set of codes further specifying the kind of Role; specific classification codes for further qualifying RoleClass codes.
OID: (for OID based terminology systems)
System URL:http://hl7.org/fhir/v3/RoleCode
System OID:2.16.840.1.113883.5.111
Source ResourceXML / JSON

This value set is not currently used

1.25.4.1.111.1 Content Logical Definition


This value set has an inline code system http://hl7.org/fhir/v3/RoleCode, which defines the following codes:

LvlCodeDisplayDefinition
1_AffiliationRoleType AffiliationRoleTypeConcepts characterizing the type of association formed by player and scoper when there is a recognized Affiliate role by which the two parties are related.
Examples: Business Partner, Business Associate, Colleague
2  _CoverageSponsorRoleType CoverageSponsorRoleTypeDescription:Codes that indicate a specific type of sponsor. Used when the sponsor's role is only either as a fully insured sponsor or only as a self-insured sponsor. NOTE: Where a sponsor may be either, use the SponsorParticipationFunction.code (fully insured or self insured) to indicate the type of responsibility. (CO6-0057)
3    FULLINS Fully insured coverage sponsorDescription:An employer or organization that contracts with an underwriter to assumes the financial risk and administrative responsibility for coverage of health services for covered parties.
3    SELFINS Self insured coverage sponsorDescription:An employer or organization that assumes the financial risk and administrative responsibility for coverage of health services for covered parties.
2  _PayorRoleType PayorRoleTypeDescription:PayorRoleType for a particular type of policy or program benefit package or plan where more detail about the coverage administration role of the Payor is required. The functions performed by a Payor qualified by a PayorRoleType may be specified by the PayorParticpationFunction value set.
Examples:A Payor that is a TPA may administer a managed care plan without underwriting the risk.
3    ENROLBKR Enrollment BrokerDescription:A payor that is responsible for functions related to the enrollment of covered parties.
3    TPA Third party administratorDescription:Third party administrator (TPA) is a payor organization that processes health care claims without carrying insurance risk. Third party administrators are prominent players in the managed care industry and have the expertise and capability to administer all or a portion of the claims process. They are normally contracted by a health insurer or self-insuring companies to administer services, including claims administration, premium collection, enrollment and other administrative activities.
Self-insured employers often contract with third party administrator to handle their insurance functions. Insurance companies oftentimes outsource the claims, utilization review or membership functions to a TPA. Sometimes TPAs only manage provider networks, only claims or only utilization review.
While some third-party administrators may operate as units of insurance companies, they are often independent. However, hospitals or provider organizations desiring to set up their own health plans will often outsource certain responsibilities to TPAs. TPAs may perform one or several payor functions, specified by the PayorParticipationFunction value set, such as provider management, enrollment, utilization management, and fee for service claims adjudication management.
3    UMO Utilization management organizationDescription:A payor that is responsible for review and case management of health services covered under a policy or program.
2  RESPRSN responsible partyThe role played by a party who has legal responsibility for another party.
3    EXCEST executor of estateThe role played by a person acting as the estate executor for a deceased subscriber or policyholder who was the responsible party
3    GUADLTM guardian ad lidemThe role played by a person appointed by the court to look out for the best interests of a minor child during the course of legal proceedings.
3    GUARD guardianThe role played by a person or institution legally empowered with responsibility for the care of a ward.
3    POWATT power of attorneyA relationship between two people in which one person authorizes another to act for him in a manner which is a legally binding upon the person giving such authority as if he or she personally were to do the acts.
4      DPOWATT durable power of attorneyA relationship between two people in which one person authorizes another, usually a family member or relative, to act for him or her in a manner which is a legally binding upon the person giving such authority as if he or she personally were to do the acts that is often limited in the kinds of powers that can be assigned. Unlike ordinary powers of attorney, durable powers can survive for long periods of time, and again, unlike standard powers of attorney, durable powers can continue after incompetency.
4      HPOWATT healthcare power of attorneyA relationship between two people in which one person authorizes another to act for him or her in a manner which is a legally binding upon the person giving such authority as if he or she personally were to do the acts that continues (by its terms) to be effective even though the grantor has become mentally incompetent after signing the document.
4      SPOWATT special power of attorneyA relationship between two people in which one person authorizes another to act for him or her in a manner which is a legally binding upon the person giving such authority as if he or she personally were to do the acts that is often limited in the kinds of powers that can be assigned.
1_AssignedRoleType AssignedRoleTypeAssignedRoleType
2  _AssignedNonPersonLivingSubjectRoleType AssignedNonPersonLivingSubjectRoleTypeDescription:A role type that is used to further qualify a non-person subject playing a role where the role class attribute is set to RoleClass AssignedEntity
3    ASSIST Assistive non-person living subjectDescription:Dogs trained to assist the ill or physically challenged.
3    BIOTH Biotherapeutic non-person living subjectDescription:Animals, including fish and insects, and microorganisms which may participate as assigned entities in biotherapies.
4      ANTIBIOT AntibioticDescription:Non-person living subject used as antibiotic.
Examples:Bacteriophage, is a virus that infects bacteria.
4      DEBR DebridementDescription:Maggots raised for biodebridement.
Discussion: Maggot Debridement Therapy is the medical use of live maggots for cleaning non-healing wounds.
Examples:Removal of burnt skin.
3    CCO Clinical CompanionDescription:Companion animals, such as dogs, cats, and rabbits, which may be provided to patients to improve general mood, decrease depression and loneliness, and distract from stress-inducing concerns to improve quality of life.
3    SEE SeeingDescription:Dogs trained to assist persons who are seeing impaired or blind.
3    SNIFF SniffingDescription:Dogs trained or having the ability to detect imminent seizures or cancers in humans, probably as a result of volatile chemical (odors) given off by the malignancy of the host.
1_CertifiedEntityType CertifiedEntityTypeDefines types of certifications for all entities
1_CitizenRoleType CitizenRoleTypeA role type used to qualify a person's legal status within a country or nation.
2  CAS asylum seekerA person who has fled his or her home country to find a safe place elsewhere.
3    CASM single minor asylum seekerA person who is someone of below legal age who has fled his or her home country, without his or her parents, to find a safe place elsewhere at time of categorization.
2  CN nationalA person who is legally recognized as a member of a nation or country, with associated rights and obligations.
2  CNRP non-country member without residence permitA foreigner who is present in a country (which is foreign to him/her) unlawfully or without the country's authorization (may be called an illegal alien).
3    CNRPM non-country member minor without residence permitA person who is below legal age present in a country, without his or her parents, (which is foreign to him/her) unlawfully or without the country's authorization.
2  CPCA permit card applicantA non-country member admitted to the territory of a nation or country as a non-resident for an explicit purpose.
2  CRP non-country member with residence permitA foreigner who is a resident of the country but does not have citizenship.
3    CRPM non-country member minor with residence permitA person who is a resident below legal age of the country without his or her parents and does not have citizenship.
1_ContactRoleType ContactRoleTypeTypes of contact for Role code "CON"
2  _AdministrativeContactRoleType AdministrativeContactRoleTypeA contact role used for business and/or administrative purposes.
3    BILL Billing ContactA contact role used to identify a person within a Provider organization that can be contacted for billing purposes (e.g. about the content of the Invoice).
3    ORG organizational contactA contact for an organization for administrative purposes. Contact role specifies a person acting as a liason for the organization.
Example: HR Department representative.
3    PAYOR Payor ContactA contact role used to identify a person within a Payor organization to whom this communication is addressed.
2  ECON emergency contactA contact designated for contact in emergent situations.
2  NOK next of kinPlayed by an individual who is designated as the next of kin for another individual which scopes the role.
1_IdentifiedEntityType IdentifiedEntityTypeDefinition: A code representing the type of identifier that has been assigned to the identified entity (IDENT).
Examples: Example values include Social Insurance Number, Product Catalog ID, Product Model Number.
2  _LocationIdentifiedEntityRoleCode LocationIdentifiedEntityRoleCodeDescription:Describes types of identifiers other than the primary location registry identifier for a service delivery location. Identifiers may be assigned by a local service delivery organization, a formal body capable of accrediting the location for the capability to provide specific services or the identifier may be assigned at a jurisdictional level.
3    ACHFID accreditation location identifierDescription:Identifier assigned to a location by the organization responsible for accrediting the location.
3    JURID jurisdiction location identifierDescription:Identifier assigned to a location by a jurisdiction.
3    LOCHFID local location identifierDescription:Identifier assigned to a location by a local party (which could be the facility itself or organization overseeing a group of facilities).
1_LivingSubjectProductionClass LivingSubjectProductionClassCode indicating the primary use for which a living subject is bred or grown
2  BF BeefCattle used for meat production
2  BL BroilerChickens raised for meat
2  BR BreederBreeding/genetic stock
2  CO CompanionCompanion animals
2  DA DairyMilk production
2  DR DraftDraft animals
2  DU DualDual purpose. Defined purposes based on species and breed
2  FI FiberAnimals raised for their fur, hair or skins
2  LY LayerChickens raised for egg production
2  MT MeatAnimals raised for meat production
2  MU MultiplierPoultry flocks used for chick/poult production
2  PL PleasureAnimals rasied for recreation
2  RC RacingAnimals raised for racing perfomance
2  SH ShowAnimals raised for shows
2  VL VealCattle raised for veal meat production. Implicit is the husbandry method.
2  WL WoolSheep, goats and other mammals raised for their fiber
2  WO WorkingAnimals used to perform work
1_MedicationGeneralizationRoleType MedicationGeneralizationRoleTypeIdentifies the specific hierarchical relationship between the playing and scoping medications.
Examples: Generic, Generic Formulation, Therapeutic Class, etc.
2  DC therapeutic classDescription:A categorization of medicinal products by their therapeutic properties and/or main therapeutic use.
2  GD generic drugRelates a manufactured drug product to the non-proprietary (generic) representation of its ingredients independent of strength, and form.
The scoping entity identifies a unique combination of medicine ingredients; sometimes referred to as "ingredient set".
3    GDF generic drug formRelates a manufactured drug product to the non-proprietary (generic) representation of its ingredients and dose form, independent of strength of the ingredients. The scoping entity identifies a unique combination of medicine ingredients in a specific dose form.
3    GDS generic drug strengthRelates a manufactured drug product to the non-proprietary (generic) representation of is ingredients with their strength. The scoping entity identifies a unique combination of medicine ingredients with their strength.
3    GDSF generic drug strength formRelates a manufactured drug product to the non-proprietary (generic) representation of its ingredients with their strength in a specific dose form. The scoping entity identifies a unique combination of medicine ingredients with their strength in a single dose form.
2  MGDSF manufactured drug strength formRelates a manufactured drug product to the non-proprietary (generic) representation of its ingredients with their strength in a specific dose form. The scoping entity identifies a unique combination of medicine ingredients with their strength in a single dose form.
1_MemberRoleType MemberRoleTypeTypes of membership for Role code "MBR"
2  TRB Tribal MemberA person who is a member of a tribe.
1_PersonalRelationshipRoleType PersonalRelationshipRoleTypePersonalRelationshipRoleType
2  FAMMEMB family memberA relationship between two people characterizing their "familial" relationship
3    CHILD childThe player of the role is a child of the scoping entity.
4      CHLDADOPT adopted childThe player of the role is a child taken into a family through legal means and raised by the scoping person (parent) as his or her own child.
5        DAUADOPT adopted daughterThe player of the role is a female child taken into a family through legal means and raised by the scoping person (parent) as his or her own child.
5        SONADOPT adopted sonThe player of the role is a male child taken into a family through legal means and raised by the scoping person (parent) as his or her own child.
4      CHLDFOST foster childThe player of the role is a child receiving parental care and nurture from the scoping person (parent) but not related to him or her through legal or blood ties.
5        DAUFOST foster daughterThe player of the role is a female child receiving parental care and nurture from the scoping person (parent) but not related to him or her through legal or blood ties.
5        SONFOST foster sonThe player of the role is a male child receiving parental care and nurture from the scoping person (parent) but not related to him or her through legal or blood ties.
4      DAUC daughterDescription: The player of the role is a female child (of any type) of scoping entity (parent)
5        DAU natural daughterThe player of the role is a female offspring of the scoping entity (parent).
5        STPDAU stepdaughterThe player of the role is a daughter of the scoping person's spouse by a previous union.
4      NCHILD natural childThe player of the role is an offspring of the scoping entity as determined by birth.
5        SON natural sonThe player of the role is a male offspring of the scoping entity (parent).
4      SONC sonDescription: The player of the role is a male child (of any type) of scoping entity (parent)
5        STPSON stepsonThe player of the role is a son of the scoping person's spouse by a previous union.
4      STPCHLD step childThe player of the role is a child of the scoping person's spouse by a previous union.
3    EXT extended family memberDescription: A family member not having an immediate genetic or legal relationship e.g. Aunt, cousin, great grandparent, grandchild, grandparent, niece, nephew or uncle.
4      AUNT auntThe player of the role is a sister of the scoping person's mother or father.
5        MAUNT maternal auntDescription:The player of the role is a biological sister of the scoping person's biological mother.
5        PAUNT paternal auntDescription:The player of the role is a biological sister of the scoping person's biological father.
4      COUSN cousinThe player of the role is a relative of the scoping person descended from a common ancestor, such as a grandparent, by two or more steps in a diverging line.
5        MCOUSN maternal cousinDescription:The player of the role is a biological relative of the scoping person descended from a common ancestor on the player's mother's side, such as a grandparent, by two or more steps in a diverging line.
5        PCOUSN paternal cousinDescription:The player of the role is a biological relative of the scoping person descended from a common ancestor on the player's father's side, such as a grandparent, by two or more steps in a diverging line.
4      GGRPRN great grandparentThe player of the role is a parent of the scoping person's grandparent.
5        GGRFTH great grandfatherThe player of the role is the father of the scoping person's grandparent.
6          MGGRFTH maternal great-grandfatherDescription:The player of the role is the biological father of the scoping person's biological mother's parent.
6          PGGRFTH paternal great-grandfatherDescription:The player of the role is the biological father of the scoping person's biological father's parent.
5        GGRMTH great grandmotherThe player of the role is the mother of the scoping person's grandparent.
6          MGGRMTH maternal great-grandmotherDescription:The player of the role is the biological mother of the scoping person's biological mother's parent.
6          PGGRMTH paternal great-grandmotherDescription:The player of the role is the biological mother of the scoping person's biological father's parent.
5        MGGRPRN maternal great-grandparentDescription:The player of the role is a biological parent of the scoping person's biological mother's parent.
5        PGGRPRN paternal great-grandparentDescription:The player of the role is a biological parent of the scoping person's biological father's parent.
4      GRNDCHILD grandchildThe player of the role is a child of the scoping person's son or daughter.
5        GRNDDAU granddaughterThe player of the role is a daughter of the scoping person's son or daughter.
5        GRNDSON grandsonThe player of the role is a son of the scoping person's son or daughter.
4      GRPRN grandparentThe player of the role is a parent of the scoping person's mother or father.
5        GRFTH grandfatherThe player of the role is the father of the scoping person's mother or father.
6          MGRFTH maternal grandfatherDescription:The player of the role is the biological father of the scoping person's biological mother.
6          PGRFTH paternal grandfatherDescription:The player of the role is the biological father of the scoping person's biological father.
5        GRMTH grandmotherThe player of the role is the mother of the scoping person's mother or father.
6          MGRMTH maternal grandmotherDescription:The player of the role is the biological mother of the scoping person's biological mother.
6          PGRMTH paternal grandmotherDescription:The player of the role is the biological mother of the scoping person's biological father.
5        MGRPRN maternal grandparentDescription:The player of the role is the biological parent of the scoping person's biological mother.
5        PGRPRN paternal grandparentDescription:The player of the role is the biological parent of the scoping person's biological father.
4      INLAW inlawA relationship between an individual and a member of their spousal partner's immediate family.
5        CHLDINLAW child-in-lawThe player of the role is the spouse of scoping person's child.
6          DAUINLAW daughter in-lawThe player of the role is the wife of scoping person's son.
6          SONINLAW son in-lawThe player of the role is the husband of scoping person's daughter.
5        PRNINLAW parent in-lawThe player of the role is the parent of scoping person's husband or wife.
6          FTHINLAW father-in-lawThe player of the role is the father of the scoping person's husband or wife.
6          MTHINLAW mother-in-lawThe player of the role is the mother of the scoping person's husband or wife.
5        SIBINLAW sibling in-lawThe player of the role is: (1) a sibling of the scoping person's spouse, or (2) the spouse of the scoping person's sibling, or (3) the spouse of a sibling of the scoping person's spouse.
6          BROINLAW brother-in-lawThe player of the role is: (1) a brother of the scoping person's spouse, or (2) the husband of the scoping person's sister, or (3) the husband of a sister of the scoping person's spouse.
6          SISINLAW sister-in-lawThe player of the role is: (1) a sister of the scoping person's spouse, or (2) the wife of the scoping person's brother, or (3) the wife of a brother of the scoping person's spouse.
4      NIENEPH niece/nephewThe player of the role is a child of scoping person's brother or sister or of the brother or sister of the scoping person's spouse.
5        NEPHEW nephewThe player of the role is a son of the scoping person's brother or sister or of the brother or sister of the scoping person's spouse.
5        NIECE nieceThe player of the role is a daughter of the scoping person's brother or sister or of the brother or sister of the scoping person's spouse.
4      UNCLE uncleThe player of the role is a brother of the scoping person's mother or father.
5        MUNCLE maternal uncleDescription:The player of the role is a biological brother of the scoping person's biological mother.
5        PUNCLE paternal uncleDescription:The player of the role is a biological brother of the scoping person's biological father.
3    PRN parentThe player of the role is one who begets, gives birth to, or nurtures and raises the scoping entity (child).
4      ADOPTP adoptive parentThe player of the role (parent) has taken the scoper (child) into their family through legal means and raises them as his or her own child.
5        ADOPTF adoptive fatherThe player of the role (father) is a male who has taken the scoper (child) into their family through legal means and raises them as his own child.
5        ADOPTM adoptive motherThe player of the role (father) is a female who has taken the scoper (child) into their family through legal means and raises them as her own child.
4      FTH fatherThe player of the role is a male who begets or raises or nurtures the scoping entity (child).
5        FTHFOST foster fatherThe player of the role (parent) who is a male state-certified caregiver responsible for the scoper (child) who has been placed in the parent's care. The placement of the child is usually arranged through the government or a social-service agency, and temporary.
The state, via a jurisdiction recognized child protection agency, stands as in loco parentis to the child, making all legal decisions while the foster parent is responsible for the day-to-day care of the specified child.
5        NFTH natural fatherThe player of the role is a male who begets the scoping entity (child).
6          NFTHF natural father of fetusIndicates the biologic male parent of a fetus.
5        STPFTH stepfatherThe player of the role is the husband of scoping person's mother and not the scoping person's natural father.
4      MTH motherThe player of the role is a female who conceives, gives birth to, or raises and nurtures the scoping entity (child).
5        GESTM gestational motherThe player is a female whose womb carries the fetus of the scoper. Generally used when the gestational mother and natural mother are not the same.
5        MTHFOST foster motherThe player of the role (parent) who is a female state-certified caregiver responsible for the scoper (child) who has been placed in the parent's care. The placement of the child is usually arranged through the government or a social-service agency, and temporary.
The state, via a jurisdiction recognized child protection agency, stands as in loco parentis to the child, making all legal decisions while the foster parent is responsible for the day-to-day care of the specified child.
5        NMTH natural motherThe player of the role is a female who conceives or gives birth to the scoping entity (child).
6          NMTHF natural mother of fetusThe player is the biologic female parent of the scoping fetus.
5        STPMTH stepmotherThe player of the role is the wife of scoping person's father and not the scoping person's natural mother.
4      NPRN natural parentnatural parent
4      PRNFOST foster parentThe player of the role (parent) who is a state-certified caregiver responsible for the scoper (child) who has been placed in the parent's care. The placement of the child is usually arranged through the government or a social-service agency, and temporary.
The state, via a jurisdiction recognized child protection agency, stands as in loco parentis to the child, making all legal decisions while the foster parent is responsible for the day-to-day care of the specified child.
4      STPPRN step parentThe player of the role is the spouse of the scoping person's parent and not the scoping person's natural parent.
3    SIB siblingThe player of the role shares one or both parents in common with the scoping entity.
4      BRO brotherThe player of the role is a male sharing one or both parents in common with the scoping entity.
5        HBRO half-brotherThe player of the role is a male related to the scoping entity by sharing only one biological parent.
5        NBRO natural brotherThe player of the role is a male having the same biological parents as the scoping entity.
6          TWINBRO twin brotherThe scoper was carried in the same womb as the male player and shares common biological parents.
7            FTWINBRO fraternal twin brotherThe scoper was carried in the same womb as the male player and shares common biological parents but is the product of a distinct egg/sperm pair.
7            ITWINBRO identical twin brotherThe male scoper is an offspring of the same egg-sperm pair as the male player.
5        STPBRO stepbrotherThe player of the role is a son of the scoping person's stepparent.
4      HSIB half-siblingThe player of the role is related to the scoping entity by sharing only one biological parent.
5        HSIS half-sisterThe player of the role is a female related to the scoping entity by sharing only one biological parent.
4      NSIB natural siblingThe player of the role has both biological parents in common with the scoping entity.
5        NSIS natural sisterThe player of the role is a female having the same biological parents as the scoping entity.
6          TWINSIS twin sisterThe scoper was carried in the same womb as the female player and shares common biological parents.
7            FTWINSIS fraternal twin sisterThe scoper was carried in the same womb as the female player and shares common biological parents but is the product of a distinct egg/sperm pair.
7            ITWINSIS identical twin sisterThe female scoper is an offspring of the same egg-sperm pair as the female player.
5        TWIN twinThe scoper and player were carried in the same womb and shared common biological parents.
6          FTWIN fraternal twinThe scoper and player were carried in the same womb and share common biological parents but are the product of distinct egg/sperm pairs.
6          ITWIN identical twinThe scoper and player are offspring of the same egg-sperm pair.
4      SIS sisterThe player of the role is a female sharing one or both parents in common with the scoping entity.
5        STPSIS stepsisterThe player of the role is a daughter of the scoping person's stepparent.
4      STPSIB step siblingThe player of the role is a child of the scoping person's stepparent.
3    SIGOTHR significant otherA person who is important to one's well being; especially a spouse or one in a similar relationship. (The player is the one who is important)
4      DOMPART domestic partnerThe player of the role cohabits with the scoping person but is not the scoping person's spouse.
4      FMRSPS former spousePlayer of the role was previously joined to the scoping person in marriage and this marriage is now dissolved and inactive.
Usage Note: This is significant to indicate as some jurisdictions have different legal requirements for former spouse to access the patient's record, from a general friend.
4      SPS spouseThe player of the role is a marriage partner of the scoping person.
5        HUSB husbandThe player of the role is a man joined to a woman (scoping person) in marriage.
5        WIFE wifeThe player of the role is a woman joined to a man (scoping person) in marriage.
2  FRND unrelated friendThe player of the role is a person who is known, liked, and trusted by the scoping person.
2  NBOR neighborThe player of the role lives near or next to the scoping person.
2  ONESELF selfThe relationship that a person has with his or her self.
2  ROOM RoommateOne who shares living quarters with the subject.
1_PolicyOrProgramCoverageRoleType PolicyOrProgramCoverageRoleTypeDescription: A role recognized through the eligibility of an identified party for benefits covered under an insurance policy or a program based on meeting eligibility criteria.
Eligibility as a covered party may be conditioned on the party meeting criteria to qualify for coverage under a policy or program, which may be mandated by law. These criteria may be:
The sole basis for coverage, e.g., being differently abled may qualify a person for disability coverage
May more fully qualify a covered party role e.g, being differently abled may qualify an adult child as a dependent
May impact the level of coverage for a covered party under a policy or program, e.g., being differently abled may qualify a program eligible for additional benefits.
Discussion: The Abstract Value Set "CoverageRoleType", which was developed for use in the Canadian realm "pre-coordinate" coverage roles with other roles that a covered party must play in order to be eligible for coverage, e.g., "handicapped dependent". These role.codes may only be used with COVPTY to avoid overlapping concepts that would result from using them to specify the specializations of COVPTY, e.g., the role.class DEPEN should not be used with the role.code family dependent because that relationship has overlapping concepts due to the role.code precoodination and is conveyed in FICO with the personal relationship role that has a PART role link to the covered party role. For the same reasons, the role.class DEPEN should not be used with the role.code HANDIC (handicapped dependent); the role.code DIFFABLE (differently abled) should be used instead.
In summary, the coded concepts in the Abstract Value Set "CoveredPartyRoleType" can be "post-coordinated" with the "RoleClassCoveredParty" Abstract Value Set. Decoupling these concepts is intended to support an expansive range of covered party concepts and their semantic comparability.
2  _CoverageRoleType CoverageRoleTypeRole recognized through the issuance of insurance coverage to an identified covered party who has this relationship with the policy holder such as the policy holder themselves (self), spouse, child, etc
3    FAMDEP family dependentThe player of the role is dependent of the scoping entity.
3    HANDIC handicapped dependentCovered party is a dependent of the policy holder with a physical or mental disability causing a disadvantage that makes independent achievement unusually difficult.
3    INJ injured plaintiffCovered party is an injured party with a legal claim for compensation against a policy holder under an insurance policy.
3    SELF selfCovered party is the policy holder. Also known as the subscriber.
3    SPON sponsored dependentCovered party is an individual that the policy holder has assumed responsibility for, such as foster child or legal ward.
3    STUD studentCovered party to an insurance policy has coverage through full-time or part-time attendance at a recognized educational institution as defined by a particular insurance policy.
4      FSTUD full-time studentCovered party to an insurance policy has coverage through full-time attendance at a recognized educational institution as defined by a particular insurance policy.
4      PSTUD part-time studentCovered party to an insurance policy has coverage through part-time attendance at a recognized educational institution as defined by a particular insurance policy.
3    ADOPT adopted childA child taken into one's family through legal means and raised as one's own child.
3    GCHILD grandchildA child of one's son or daughter.
3    GPARNT grandparentparent of a parent of the subject.
3    NAT natural childA child as determined by birth.
3    NIENE niece/nephewA child of one's brother or sister or of the brother or sister of one's spouse.
3    PARNT parentOne that begets or brings forth offspring or a person who brings up and cares for for another (Webster's Collegiate Dictionary)
3    SPSE spouseA marriage partner; a husband or wife.
3    STEP step childA child receiving parental care and nurture from a person who is related to them through marriage to their parent.
2  _CoveredPartyRoleType covered party role typeA role recognized through the eligibility of an identified living subject for benefits covered under an insurance policy or a program. Eligibility as a covered party may be conditioned on a relationship with (1) the policy holder such as the policy holder who is covered as an individual under a poliy or as a party sponsored for coverage by the policy holder.
Example:An employee as a subscriber; or (2) on being scoped another covered party such as the subscriber, as in the case of a dependent.
Discussion: The Abstract Value Set "CoverageRoleType", which was developed for use in the Canadian realm "pre-coordinate" coverage roles with other roles that a covered party must play in order to be eligible for coverage, e.g., "handicapped dependent". Other codes in the Abstract Value Set CoveredPartyRoleType domain can be "post-coordinated" with the EligiblePartyRoleType codes to denote comparable concepts. Decoupling the concepts is intended to support a wider range of concepts and semantic comparability of coded concepts.
3    _ClaimantCoveredPartyRoleType ClaimantCoveredPartyRoleTypeDescriptionA role recognized through the eligibility of a party play a claimant for benefits covered or provided under an insurance policy.
4      CRIMEVIC crime victimDescription: A person playing the role of program eligible under a program based on allegations of being the victim of a crime.
Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is "program eligible" and the person's status as a crime victim meets jurisdictional or program criteria.
4      INJWKR injured workerDescription: A person playing the role of program eligible under a workers compensation program based on the filing of work-related injury claim.
Discussion: This CoveredPartyRoleType.code is used when the CoveredPartyRole class code is either "program eligible", a "named insured", and "individual insured", or "dependent", and the person's status as differently abled or "handicapped" meets jurisdictional, policy, or program criteria.
3    _DependentCoveredPartyRoleType DependentCoveredPartyRoleTypeDescription: A role recognized through the eligibility of a party to play a dependent for benefits covered or provided under a health insurance policy because of an association with the subscriber that is recognized by the policy underwriter.
4      COCBEN continuity of coverage beneficiaryDescription: A person playing the role of an individual insured with continuity of coverage under a policy which is being terminated based on loss of original status that was the basis for coverage. Criteria for qualifying for continuity of coverage may be set by law.
Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the person's status as a continuity of coverage beneficiary meets jurisdictional or policy criteria.
4      DIFFABL differently abledDescription: A person playing the role of program eligible under a program based on meeting criteria for health or functional limitation set by law or by the program.
Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible", "named insured", "individual insured", or "dependent", and the person's status as differently abled meets jurisdictional, policy, or program criteria.
4      WARD wardDescription: A person, who is a minor or is deemed incompetent, who plays the role of a program eligible where eligibility for coverage is based on meeting program eligibility criteria for status as a ward of a court or jurisdiction.
Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is a "claimant", "program eligible", a "named insured", an "individual Insured" or a "dependent", and the person's status as a ward meets program or policy criteria. In the case of a ward covered under a program providing financial or health benefits, a governmental agency may take temporary custody of a minor or incompetent for his/her protection and care, e.g., if the ward is suffering from neglect or abuse, or has been in trouble with the law.
3    _IndividualInsuredPartyRoleType IndividualInsuredPartyRoleTypeA role recognized through the eligibility of a party to play an individual insured for benefits covered or provided under an insurance policy where the party is also the policy holder.
4      RETIREE retireeDescription: A person playing the role of an individual insured under a policy based on meeting criteria for the employment status of retired set by law or the policy.
Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the person's status as a retiree meets jurisdictional or policy criteria.
3    _ProgramEligiblePartyRoleType ProgramEligiblePartyRoleTypeDescription:A role recognized through the eligibility of a party to play a program eligible for benefits covered or provided under a program.
4      INDIG member of an indigenous peopleDescription: A person playing the role of program eligible under a program based on aboriginal ancestry or as a member of an aboriginal community.
Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is "program eligible" and the person's status as a member of an indigenous people meets jurisdictional or program criteria.
4      MIL militaryDefinition: A person playing the role of program eligible under a program based on military status.
Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the person's status as a member of the military meets jurisdictional or program criteria
5        ACTMIL active duty militaryDescription: A person playing the role of program eligible under a program based on active military status.
Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the persons status as active duty military meets jurisdictional or program criteria.
5        RETMIL retired militaryDescription: A person playing the role of program eligible under a program based on retired military status.
Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the persons status as retired military meets jurisdictional or program criteria.
5        VET veteranDescription: A person playing the role of program eligible under a program based on status as a military veteran.
Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the persons status as a veteran meets jurisdictional or program criteria.
3    _SubscriberCoveredPartyRoleType SubscriberCoveredPartyRoleTypeDescription: A role recognized through the eligibility of a party to play a subscriber for benefits covered or provided under a health insurance policy.
1_ResearchSubjectRoleBasis ResearchSubjectRoleBasisSpecifies the administrative functionality within a formal experimental design for which the ResearchSubject role was established. Examples: screening - role is used for pre-enrollment evaluation portion of the design; enrolled - role is used for subjects admitted to the active treatment portion of the design.
2  ERL enrollmentDefinition:The specific role being played by a research subject participating in the active treatment or primary data collection portion of a research study.
2  SCN screeningDefinition:The specific role being played by a research subject participating in the pre-enrollment evaluation portion of a research study.
1_ServiceDeliveryLocationRoleType ServiceDeliveryLocationRoleTypeA role of a place that further classifies the setting (e.g., accident site, road side, work site, community location) in which services are delivered.
2  _DedicatedServiceDeliveryLocationRoleType DedicatedServiceDeliveryLocationRoleTypeA role of a place that further classifies a setting that is intended to house the provision of services.
3    _DedicatedClinicalLocationRoleType DedicatedClinicalLocationRoleTypeA role of a place that further classifies the clinical setting (e.g., cardiology clinic, primary care clinic, rehabilitation hospital, skilled nursing facility) in which care is delivered during an encounter.
4      DX Diagnostics or therapeutics unitA practice setting where diagnostic procedures or therapeutic interventions are performed
5        CVDX Cardiovascular diagnostics or therapeutics unitA practice setting where cardiovascular diagnostic procedures or therapeutic interventions are performed (e.g., cardiac catheterization lab, echocardiography suite)
6          CATH Cardiac catheterization labCardiac catheterization lab
6          ECHO Echocardiography labEchocardiography lab
5        GIDX Gastroenterology diagnostics or therapeutics labA practice setting where GI procedures (such as endoscopies) are performed
6          ENDOS Endoscopy lab(X12N 261QD0000N)
5        RADDX Radiology diagnostics or therapeutics unitA practice setting where radiology services (diagnostic or therapeutic) are provided (X12N 261QR0200N)
6          RADO Radiation oncology unit(X12N 261QX0203N)
6          RNEU Neuroradiology unitNeuroradiology unit
4      HOSP HospitalAn acute care institution that provides medical, surgical, or psychiatric care and treatment for the sick or the injured.
5        CHR Chronic Care Facility(1) A hospital including a physical plant and personnel that provides multidisciplinary diagnosis and treatment for diseases that have one or more of the following characteristics: is permanent; leaves residual disability; is caused by nonreversible pathological alteration; requires special training of the patient for rehabilitation; and/or may be expected to require a long period of supervision or care. In addition, patients require the safety, security, and shelter of these specialized inpatient or partial hospitalization settings. (2) A hospital that provides medical and skilled nursing services to patients with long-term illnesses who are not in an acute phase but who require an intensity of services not available in nursing homes
5        GACH Hospitals; General Acute Care Hospital(X12N 282N00000N)
5        MHSP Military HospitalA health care facility operated by the Department of Defense or other military operation.
5        PSYCHF Psychatric Care FacilityHealthcare facility that cares for patients with psychiatric illness(s).
5        RH Rehabilitation hospital(X12N 283X00000N)
6          RHAT addiction treatment centerDescription: A location that plays the role of delivering services which may include life training and/or social support to people with addictions.
6          RHII intellectual impairment centerDescription: A location that plays the role of delivering services which may include adaptation, rehabilitation and social integration services for people with intellectual and/or pervasive development disorders such as autism or severe behaviour disorder.
6          RHMAD parents with adjustment difficulties centerDescription: A location that plays the role of delivering services which may social support services for adolescents who are pregnant or have child and are experiencing adaptation issues/difficulties in their current or eventual parenting role.
6          RHPI physical impairment centerDescription: A location that plays the role of delivering services which may include adaptation, rehabilitation and social integration services for people with physical impairments.
7            RHPIH physical impairment - hearing centerDescription: A location that plays the role of delivering services for people with hearing impairments.
7            RHPIMS physical impairment - motor skills centerDescription: A location that plays the role of delivering services for people with motor skill impairments.
7            RHPIVS physical impairment - visual skills centerDescription: A location that plays the role of delivering services for people with visual skill impairments.
6          RHYAD youths with adjustment difficulties centerDescription: A location that plays the role of delivering services which may include life training and/or social support services for the adaption, rehabilitation and social integration of youths with adjustment difficulties.
4      HU Hospital unitHospital unit
5        BMTU Bone marrow transplant unitBone marrow transplant unit
5        CCU Coronary care unitCoronary care unit
5        CHEST Chest unitA specialty unit in hospital that focuses on chronic respirator patients and pulmonary failure
5        EPIL Epilepsy unitEpilepsy unit
5        ER Emergency roomThe section of a health care facility for providing rapid treatment to victims of sudden illness or trauma.
6          ETU Emergency trauma unitEmergency trauma unit
5        HD Hemodialysis unitHemodialysis unit
5        HLAB hospital laboratoryDescription: A location that plays the role of delivering services which may include tests done based on clinical specimens to get health information about a patient as pertaining to the diagnosis, treatment and prevention of disease. Hospital laboratories may be further divided into specialized units such as Anatomic Pathology, Microbiology, and Biochemistry.
6          INLAB inpatient laboratoryDescription: A location that plays the role of delivering services which may include tests are done on clinical specimens to get health information about a patient pertaining to the diagnosis, treatment, and prevention of disease for a hospital visit longer than one day.
6          OUTLAB outpatient laboratoryDescription: A location that plays the role of delivering services which may include tests are done on clinical specimens to get health information about a patient pertaining to the diagnosis, treatment, and prevention of disease for same day visits.
5        HRAD radiology unitDescription: A location that plays the role of delivering services which may include the branch of medicine that uses ionizing and non-ionizing radiation to diagnose and treat diseases. The radiology unit may be further divided into subspecialties such as Imaging, Cardiovascular, Thoracic, and Ultrasound.
5        HUSCS specimen collection siteDescription: A location that plays the role of delivering services which may include collecting specimens and/or samples from patients for laboratory testing purposes, but does not perform any tests or analysis functions.
5        ICU Intensive care unitIntensive care unit
6          PEDICU Pediatric intensive care unitPediatric intensive care unit
7            PEDNICU Pediatric neonatal intensive care unitPediatric neonatal intensive care unit
5        INPHARM inpatient pharmacyDescription: A location that plays the role of delivering services which may include providing judicious, safe, efficacious, appropriate and cost effective use of medicines for treatment of patients for visits longer than one day. The distinction between inpatient pharmacies and retail (or outpatient) pharmacies is that they are part of a patient's continuity of care while staying in the hospital.
5        MBL medical laboratoryDescription: A location that plays the role of delivering services which include biochemistry, hematology, microbiology, immunochemistry, and toxicology.
5        NCCS Neurology critical care and stroke unitNeurology critical care and stroke unit
5        NS Neurosurgery unitNeurosurgery unit
5        OUTPHARM outpatient pharmacyDescription: A location that plays the role of delivering services which may include providing judicious, safe, efficacious, appropriate and cost effective use of medicines for treatment of patients for outpatient visits and may also be used for discharge prescriptions.
5        PEDU Pediatric unitPediatric unit
5        PHU Psychiatric hospital unit(X12N 273R00000N)
5        RHU Rehabilitation hospital unitRehabilitation hospital unit
5        SLEEP Sleep disorders unit(X12N 261QA1200N)
4      NCCF Nursing or custodial care facilityNursing or custodial care facility
5        SNF Skilled nursing facility(X12N 314000000N)
4      OF Outpatient facilityOutpatient facility
5        ALL Allergy clinicAllergy clinic
5        AMPUT Amputee clinicAmputee clinic
5        BMTC Bone marrow transplant clinicBone marrow transplant clinic
5        BREAST Breast clinicBreast clinic
5        CANC Child and adolescent neurology clinicChild and adolescent neurology clinic
5        CAPC Child and adolescent psychiatry clinicChild and adolescent psychiatry clinic
5        CARD Ambulatory Health Care Facilities; Clinic/Center; Rehabilitation: Cardiac FacilitiesAmbulatory Health Care Facilities; Clinic/Center; Rehabilitation: Cardiac Facilities
6          PEDCARD Pediatric cardiology clinicPediatric cardiology clinic
5        COAG Coagulation clinicCoagulation clinic
5        CRS Colon and rectal surgery clinicColon and rectal surgery clinic
5        DERM Dermatology clinicDermatology clinic
5        ENDO Endocrinology clinicEndocrinology clinic
6          PEDE Pediatric endocrinology clinicPediatric endocrinology clinic
5        ENT Otorhinolaryngology clinicOtorhinolaryngology clinic
5        FMC Family medicine clinicFamily medicine clinic
5        GI Gastroenterology clinicGastroenterology clinic
6          PEDGI Pediatric gastroenterology clinicPediatric gastroenterology clinic
5        GIM General internal medicine clinicGeneral internal medicine clinic
5        GYN Gynecology clinicGynecology clinic
5        HEM Hematology clinicHematology clinic
6          PEDHEM Pediatric hematology clinicPediatric hematology clinic
5        HTN Hypertension clinicHypertension clinic
5        IEC Impairment evaluation centerFocuses on assessing disability
5        INFD Infectious disease clinicInfectious disease clinic
6          PEDID Pediatric infectious disease clinicPediatric infectious disease clinic
5        INV Infertility clinicInfertility clinic
5        LYMPH Lympedema clinicLympedema clinic
5        MGEN Medical genetics clinicMedical genetics clinic
5        NEPH Nephrology clinicNephrology clinic
6          PEDNEPH Pediatric nephrology clinicPediatric nephrology clinic
5        NEUR Neurology clinicNeurology clinic
5        OB Obstetrics clinicObstetrics clinic
5        OMS Oral and maxillofacial surgery clinicOral and maxillofacial surgery clinic
5        ONCL Medical oncology clinicMedical oncology clinic
6          PEDHO Pediatric oncology clinicPediatric oncology clinic
5        OPH Opthalmology clinicOpthalmology clinic
5        OPTC optometry clinicDescription: A location that plays the role of delivering services which may include examination, diagnosis, treatment, management, and prevention of diseases and disorders of the eye as well as prescribing and fitting appropriate corrective lenses (glasses or contact lenses) as needed. Optometry clinics may also provide tests for visual field screening, measuring intra-ocular pressure and ophthalmoscopy, as and when required.
5        ORTHO Orthopedics clinicOrthopedics clinic
6          HAND Hand clinicHand clinic
5        PAINCL Pain clinic(X12N 261QP3300N)
5        PC Primary care clinic(X12N 261QP2300N)
5        PEDC Pediatrics clinicPediatrics clinic
6          PEDRHEUM Pediatric rheumatology clinicPediatric rheumatology clinic
5        POD Podiatry clinic(X12N 261QP1100N)
5        PREV Preventive medicine clinicPreventive medicine clinic
5        PROCTO Proctology clinicProctology clinic
5        PROFF Provider's OfficeLocation where healthcare service was delivered, identified as the healthcare provider's practice office.
5        PROS Prosthodontics clinicProsthodontics clinic
5        PSI Psychology clinicPsychology clinic
5        PSY Psychiatry clinicPsychiatry clinic
5        RHEUM Rheumatology clinicRheumatology clinic
5        SPMED Sports medicine clinicSports medicine clinic
5        SU Surgery clinicSurgery clinic
6          PLS Plastic surgery clinicPlastic surgery clinic
6          URO Urology clinicUrology clinic
5        TR Transplant clinicTransplant clinic
5        TRAVEL Travel and geographic medicine clinicTravel and geographic medicine clinic
5        WND Wound clinicWound clinic
4      RTF Residential treatment facilityResidential treatment facility
5        PRC Pain rehabilitation centerPain rehabilitation center
5        SURF Substance use rehabilitation facility(X12N 324500000N)
3    _DedicatedNonClinicalLocationRoleType DedicatedNonClinicalLocationRoleTypeA role of a place that further classifies a setting that is intended to house the provision of non-clinical services.
4      DADDR Delivery AddressLocation address where medical supplies were transported to for use.
4      MOBL Mobile UnitLocation (mobile) where healthcare service was delivered.
5        AMB AmbulanceLocation (mobile) where healthcare service was delivered, identified specifically as an ambulance.
4      PHARM PharmacyLocation where healthcare service was delivered, identified as a pharmacy.
2  _IncidentalServiceDeliveryLocationRoleType IncidentalServiceDeliveryLocationRoleTypeIncidentalServiceDeliveryLocationRoleType
3    ACC accident siteLocation of an accident where healthcare service was delivered, such as a roadside.
3    COMM Community LocationCommunity location where healthcare is delivered.
4      CSC community service centerDescription: A location that plays the role of delivering services which may include providing front-line services to the population of a defined geographic area such as: healthcare services and social services, preventive or curative, rehabilitation or reintegration.
3    PTRES Patient's Residencelocation where healthcare was delivered which is the residence of the Patient.
3    SCHOOL schoolLocation where healthcare service was delivered, identified as a school or educational facility.
3    UPC underage protection centerDescription: A location that plays the role of delivering services which may include: social emergency services required for a young person as required under any jurisdictional youth laws, child placement, and family mediation in the defined geographical area the SDL is responsible for. It may provide expertise in a judiciary setting on child custody, adoption and biological history research.
3    WORK work siteLocation where healthcare service was delivered, identified as a work place.
1_SpecimenRoleType SpecimenRoleTypeSpecimenRoleType
2  C CalibratorA specimen used for initial calibration settings of an instrument
2  G GroupA set of patient samples in which the individuals of the group may or may not be identified.
2  L PoolAliquots of individual specimens combined to form a single specimen representing all of the included individuals.
2  P PatientA specimen that has been collected from a patient.
2  Q Quality ControlA specimen specifically used to verify the sensitivity, specificity, accuracy or other perfomance parameter of a diagnostic test.
3    B BlindQuality Control specimen submitted to the lab whose identity and composition is not known to the lab.
3    E Electronic QCAn electronically simulated QC specimen
3    F Filler ProficiencySpecimen used for testing proficiency of an organization performing testing (how does this differ from O?)
3    O Operator ProficiencyA specimen used for evaluation of operator proficiency (operator in what context?)
3    V VerifyingA specimen used for periodic calibration checks of instruments
2  R ReplicateA portion of an original patent sample that is tested at the same time as the original sample
1CLAIM claimantA party that makes a claim for coverage under a policy.
1communityLaboratory Community LaboratoryCommunity Laboratory
1GT GuarantorAn individual or organization that makes or gives a promise, assurance, pledge to pay or has paid the healthcare service provider.
1homeHealth Home HealthHome Health
1laboratory LaboratoryLaboratory
1pathologist PathologistPathologist
1PH Policy HolderPolicy holder for the insurance policy.
1phlebotomist PhlebotomistPhlebotomist
1PROG program eligibleA party that meets the eligibility criteria for coverage under a program.
1PT PatientThe recipient for the service(s) and/or product(s) when they are not the covered party.
1subject SelfSelf
1thirdParty Third PartyThird Party
1DEP
1DEPEN dependentA party covered under a policy based on association with a subscriber.
1FM Family MemberA member of the covered party's family. This could be the spouse, a parent, a grand parent, a sibling, etc.
1INDIV individualA party covered under a policy as the policyholder.
1NAMED named insuredA party to an insurance policy to whom the insurer agrees to indemnify for losses, provides benefits for, or renders services.
1PSYCHCF
1SUBSCR subscriberA party covered under a policy based on association with a sponsor who is the policy holder, and whose association may provide for the eligibility of dependents for coverage