This page is part of the FHIR Specification (v4.2.0: R5 Preview #1). 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
Financial Management Work Group | Maturity Level: N/A | Standards Status: Informative |
Raw XML (canonical form + also see XML Format Specification)
Definition for Code System CoverageClassCodes
<?xml version="1.0" encoding="UTF-8"?> <CodeSystem xmlns="http://hl7.org/fhir"> <id value="coverage-class"/> <meta> <lastUpdated value="2019-12-31T21:03:40.621+11:00"/> <profile value="http://hl7.org/fhir/StructureDefinition/shareablecodesystem"/> </meta> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> <h2> Coverage Class Codes</h2> <div> <p> This value set includes Coverage Class codes.</p> </div> <p> <b> Copyright Statement:</b> HL7 Inc. </p> <p> This code system http://terminology.hl7.org/CodeSystem/coverage-class defines the following codes:</p> <table class="codes"> <tr> <td style="white-space:nowrap"> <b> Code</b> </td> <td> <b> Display</b> </td> <td> <b> Definition</b> </td> </tr> <tr> <td style="white-space:nowrap">group <a name="coverage-class-group"> </a> </td> <td> Group</td> <td> An employee group</td> </tr> <tr> <td style="white-space:nowrap">subgroup <a name="coverage-class-subgroup"> </a> </td> <td> SubGroup</td> <td> A sub-group of an employee group</td> </tr> <tr> <td style="white-space:nowrap">plan <a name="coverage-class-plan"> </a> </td> <td> Plan</td> <td> A specific suite of benefits.</td> </tr> <tr> <td style="white-space:nowrap">subplan <a name="coverage-class-subplan"> </a> </td> <td> SubPlan</td> <td> A subset of a specific suite of benefits.</td> </tr> <tr> <td style="white-space:nowrap">class <a name="coverage-class-class"> </a> </td> <td> Class</td> <td> A class of benefits.</td> </tr> <tr> <td style="white-space:nowrap">subclass <a name="coverage-class-subclass"> </a> </td> <td> SubClass</td> <td> A subset of a class of benefits.</td> </tr> <tr> <td style="white-space:nowrap">sequence <a name="coverage-class-sequence"> </a> </td> <td> Sequence</td> <td> A sequence number associated with a short-term continuance of the coverage.</td> </tr> <tr> <td style="white-space:nowrap">rxbin <a name="coverage-class-rxbin"> </a> </td> <td> RX BIN</td> <td> Pharmacy benefit manager's Business Identification Number.</td> </tr> <tr> <td style="white-space:nowrap">rxpcn <a name="coverage-class-rxpcn"> </a> </td> <td> RX PCN</td> <td> A Pharmacy Benefit Manager specified Processor Control Number.</td> </tr> <tr> <td style="white-space:nowrap">rxid <a name="coverage-class-rxid"> </a> </td> <td> RX Id</td> <td> A Pharmacy Benefit Manager specified Member ID.</td> </tr> <tr> <td style="white-space:nowrap">rxgroup <a name="coverage-class-rxgroup"> </a> </td> <td> RX Group</td> <td> A Pharmacy Benefit Manager specified Group number.</td> </tr> </table> </div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"> <valueCode value="fm"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"> <valueCode value="trial-use"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"> <valueInteger value="2"/> </extension> <url value="http://terminology.hl7.org/CodeSystem/coverage-class"/> <identifier> <system value="urn:ietf:rfc:3986"/> <value value="urn:oid:2.16.840.1.113883.4.642.1.1147"/> </identifier> <version value="4.2.0"/> <name value="CoverageClassCodes"/> <title value="Coverage Class Codes"/> <status value="draft"/> <experimental value="false"/> <publisher value="Financial Management"/> <contact> <telecom> <system value="url"/> <value value="http://hl7.org/fhir"/> </telecom> </contact> <contact> <telecom> <system value="url"/> <value value="http://hl7.org/fhir"/> </telecom> </contact> <description value="This value set includes Coverage Class codes."/> <copyright value="HL7 Inc."/> <caseSensitive value="true"/> <valueSet value="http://hl7.org/fhir/ValueSet/coverage-class"/> <content value="complete"/> <concept> <code value="group"/> <display value="Group"/> <definition value="An employee group"/> </concept> <concept> <code value="subgroup"/> <display value="SubGroup"/> <definition value="A sub-group of an employee group"/> </concept> <concept> <code value="plan"/> <display value="Plan"/> <definition value="A specific suite of benefits."/> </concept> <concept> <code value="subplan"/> <display value="SubPlan"/> <definition value="A subset of a specific suite of benefits."/> </concept> <concept> <code value="class"/> <display value="Class"/> <definition value="A class of benefits."/> </concept> <concept> <code value="subclass"/> <display value="SubClass"/> <definition value="A subset of a class of benefits."/> </concept> <concept> <code value="sequence"/> <display value="Sequence"/> <definition value="A sequence number associated with a short-term continuance of the coverage."/> </concept> <concept> <code value="rxbin"/> <display value="RX BIN"/> <definition value="Pharmacy benefit manager's Business Identification Number."/> </concept> <concept> <code value="rxpcn"/> <display value="RX PCN"/> <definition value="A Pharmacy Benefit Manager specified Processor Control Number."/> </concept> <concept> <code value="rxid"/> <display value="RX Id"/> <definition value="A Pharmacy Benefit Manager specified Member ID."/> </concept> <concept> <code value="rxgroup"/> <display value="RX Group"/> <definition value="A Pharmacy Benefit Manager specified Group number."/> </concept> </CodeSystem>
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.