R4 Ballot #2 (Mixed Normative/Trial use)

This page is part of the FHIR Specification (v3.5.0: R4 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: R4B R4

4.3.13.112 Code System http://terminology.hl7.org/CodeSystem/applicability

Patient Administration

Work Group

Maturity Level: 0

Trial Use

Use Context: Not yet ready for Production use

This is a code system defined by the FHIR project.

Summary

Defining URL:

http://terminology.hl7.org/CodeSystem/applicability

Version:

3.5.0

Name:

BenefitCostApplicability

Title:

Benefit cost applicability

Definition:

Whether the cost applies to in-network or out-of-network providers.

Committee:

Patient Administration

Work Group

OID:

2.16.840.1.113883.4.642.1.0 (for OID based terminology systems)

Source Resource

XML / JSON

This Code system is used in the following value sets:

ValueSet: Benefit cost applicability (Whether the cost applies to in-network or out-of-network providers.)

4.3.13.112.1 Content

4.3.13.112.2 Benefit cost applicability

Whether the cost applies to in-network or out-of-network providers.

This code system http://terminology.hl7.org/CodeSystem/applicability defines the following codes:

Code	Display	Definition
in-network	In Network	Provider is contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates
out-of-network	Out of Network	Provider is not contracted with the health insurance company to provide services to plan members for specific pre-negotiated rates
other	Other	Other applicability

See the full registry of code systems defined as part of FHIR.

Explanation of the columns that may appear on this page:

Lvl

A few code lists that FHIR defines are hierarchical - each code is assigned a level. See Code System for further information.

Source

The source of the definition of the code (when the value set draws in codes defined elsewhere)

Code

The code (used as the code in the resource instance). If the code is in italics, this indicates that the code is not selectable ('Abstract')

Display

The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application

Definition

An explanation of the meaning of the concept

Comments

Additional notes about how to use the code