This page is part of the FHIR Specification (v4.3.0-snapshot1: Release 4B Snapshot #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 BenefitCategoryCodes
<?xml version="1.0" encoding="UTF-8"?> <CodeSystem xmlns="http://hl7.org/fhir"> <id value="ex-benefitcategory"/> <meta> <lastUpdated value="2021-12-20T14:08:35.086+11:00"/> <profile value="http://hl7.org/fhir/StructureDefinition/shareablecodesystem"/> </meta> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> <p> This code system http://terminology.hl7.org/CodeSystem/ex-benefitcategory 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">1 <a name="ex-benefitcategory-1"> </a> </td> <td> Medical Care</td> <td> Medical Care.</td> </tr> <tr> <td style="white-space:nowrap">2 <a name="ex-benefitcategory-2"> </a> </td> <td> Surgical</td> <td> Surgical.</td> </tr> <tr> <td style="white-space:nowrap">3 <a name="ex-benefitcategory-3"> </a> </td> <td> Consultation</td> <td> Consultation.</td> </tr> <tr> <td style="white-space:nowrap">4 <a name="ex-benefitcategory-4"> </a> </td> <td> Diagnostic XRay</td> <td> Diagnostic XRay.</td> </tr> <tr> <td style="white-space:nowrap">5 <a name="ex-benefitcategory-5"> </a> </td> <td> Diagnostic Lab</td> <td> Diagnostic Lab.</td> </tr> <tr> <td style="white-space:nowrap">14 <a name="ex-benefitcategory-14"> </a> </td> <td> Renal Supplies</td> <td> Renal Supplies excluding Dialysis.</td> </tr> <tr> <td style="white-space:nowrap">23 <a name="ex-benefitcategory-23"> </a> </td> <td> Diagnostic Dental</td> <td> Diagnostic Dental.</td> </tr> <tr> <td style="white-space:nowrap">24 <a name="ex-benefitcategory-24"> </a> </td> <td> Periodontics</td> <td> Periodontics.</td> </tr> <tr> <td style="white-space:nowrap">25 <a name="ex-benefitcategory-25"> </a> </td> <td> Restorative</td> <td> Restorative.</td> </tr> <tr> <td style="white-space:nowrap">26 <a name="ex-benefitcategory-26"> </a> </td> <td> Endodontics</td> <td> Endodontics.</td> </tr> <tr> <td style="white-space:nowrap">27 <a name="ex-benefitcategory-27"> </a> </td> <td> Maxillofacial Prosthetics</td> <td> Maxillofacial Prosthetics.</td> </tr> <tr> <td style="white-space:nowrap">28 <a name="ex-benefitcategory-28"> </a> </td> <td> Adjunctive Dental Services</td> <td> Adjunctive Dental Services.</td> </tr> <tr> <td style="white-space:nowrap">30 <a name="ex-benefitcategory-30"> </a> </td> <td> Health Benefit Plan Coverage</td> <td> Health Benefit Plan Coverage.</td> </tr> <tr> <td style="white-space:nowrap">35 <a name="ex-benefitcategory-35"> </a> </td> <td> Dental Care</td> <td> Dental Care.</td> </tr> <tr> <td style="white-space:nowrap">36 <a name="ex-benefitcategory-36"> </a> </td> <td> Dental Crowns</td> <td> Dental Crowns.</td> </tr> <tr> <td style="white-space:nowrap">37 <a name="ex-benefitcategory-37"> </a> </td> <td> Dental Accident</td> <td> Dental Accident.</td> </tr> <tr> <td style="white-space:nowrap">49 <a name="ex-benefitcategory-49"> </a> </td> <td> Hospital Room and Board</td> <td> Hospital Room and Board.</td> </tr> <tr> <td style="white-space:nowrap">55 <a name="ex-benefitcategory-55"> </a> </td> <td> Major Medical</td> <td> Major Medical.</td> </tr> <tr> <td style="white-space:nowrap">56 <a name="ex-benefitcategory-56"> </a> </td> <td> Medically Related Transportation</td> <td> Medically Related Transportation.</td> </tr> <tr> <td style="white-space:nowrap">61 <a name="ex-benefitcategory-61"> </a> </td> <td> In-vitro Fertilization</td> <td> In-vitro Fertilization.</td> </tr> <tr> <td style="white-space:nowrap">62 <a name="ex-benefitcategory-62"> </a> </td> <td> MRI Scan</td> <td> MRI Scan.</td> </tr> <tr> <td style="white-space:nowrap">63 <a name="ex-benefitcategory-63"> </a> </td> <td> Donor Procedures</td> <td> Donor Procedures such as organ harvest.</td> </tr> <tr> <td style="white-space:nowrap">69 <a name="ex-benefitcategory-69"> </a> </td> <td> Maternity</td> <td> Maternity.</td> </tr> <tr> <td style="white-space:nowrap">76 <a name="ex-benefitcategory-76"> </a> </td> <td> Renal Dialysis</td> <td> Renal dialysis.</td> </tr> <tr> <td style="white-space:nowrap">F1 <a name="ex-benefitcategory-F1"> </a> </td> <td> Medical Coverage</td> <td> Medical Coverage.</td> </tr> <tr> <td style="white-space:nowrap">F3 <a name="ex-benefitcategory-F3"> </a> </td> <td> Dental Coverage</td> <td> Dental Coverage.</td> </tr> <tr> <td style="white-space:nowrap">F4 <a name="ex-benefitcategory-F4"> </a> </td> <td> Hearing Coverage</td> <td> Hearing Coverage.</td> </tr> <tr> <td style="white-space:nowrap">F6 <a name="ex-benefitcategory-F6"> </a> </td> <td> Vision Coverage</td> <td> Vision Coverage.</td> </tr> </table> </div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"> <valueCode value="fm"/> </extension> <url value="http://terminology.hl7.org/CodeSystem/ex-benefitcategory"/> <identifier> <system value="urn:ietf:rfc:3986"/> <value value="urn:oid:2.16.840.1.113883.4.642.1.1175"/> </identifier> <version value="4.3.0-snapshot1"/> <name value="BenefitCategoryCodes"/> <title value="Benefit Category Codes"/> <status value="draft"/> <experimental value="false"/> <description value="This value set includes a smattering of Benefit SubCategory codes."/> <copyright value="This is an example set."/> <caseSensitive value="true"/> <content value="complete"/> <concept> <code value="1"/> <display value="Medical Care"/> <definition value="Medical Care."/> </concept> <concept> <code value="2"/> <display value="Surgical"/> <definition value="Surgical."/> </concept> <concept> <code value="3"/> <display value="Consultation"/> <definition value="Consultation."/> </concept> <concept> <code value="4"/> <display value="Diagnostic XRay"/> <definition value="Diagnostic XRay."/> </concept> <concept> <code value="5"/> <display value="Diagnostic Lab"/> <definition value="Diagnostic Lab."/> </concept> <concept> <code value="14"/> <display value="Renal Supplies"/> <definition value="Renal Supplies excluding Dialysis."/> </concept> <concept> <code value="23"/> <display value="Diagnostic Dental"/> <definition value="Diagnostic Dental."/> </concept> <concept> <code value="24"/> <display value="Periodontics"/> <definition value="Periodontics."/> </concept> <concept> <code value="25"/> <display value="Restorative"/> <definition value="Restorative."/> </concept> <concept> <code value="26"/> <display value="Endodontics"/> <definition value="Endodontics."/> </concept> <concept> <code value="27"/> <display value="Maxillofacial Prosthetics"/> <definition value="Maxillofacial Prosthetics."/> </concept> <concept> <code value="28"/> <display value="Adjunctive Dental Services"/> <definition value="Adjunctive Dental Services."/> </concept> <concept> <code value="30"/> <display value="Health Benefit Plan Coverage"/> <definition value="Health Benefit Plan Coverage."/> </concept> <concept> <code value="35"/> <display value="Dental Care"/> <definition value="Dental Care."/> </concept> <concept> <code value="36"/> <display value="Dental Crowns"/> <definition value="Dental Crowns."/> </concept> <concept> <code value="37"/> <display value="Dental Accident"/> <definition value="Dental Accident."/> </concept> <concept> <code value="49"/> <display value="Hospital Room and Board"/> <definition value="Hospital Room and Board."/> </concept> <concept> <code value="55"/> <display value="Major Medical"/> <definition value="Major Medical."/> </concept> <concept> <code value="56"/> <display value="Medically Related Transportation"/> <definition value="Medically Related Transportation."/> </concept> <concept> <code value="61"/> <display value="In-vitro Fertilization"/> <definition value="In-vitro Fertilization."/> </concept> <concept> <code value="62"/> <display value="MRI Scan"/> <definition value="MRI Scan."/> </concept> <concept> <code value="63"/> <display value="Donor Procedures"/> <definition value="Donor Procedures such as organ harvest."/> </concept> <concept> <code value="69"/> <display value="Maternity"/> <definition value="Maternity."/> </concept> <concept> <code value="76"/> <display value="Renal Dialysis"/> <definition value="Renal dialysis."/> </concept> <concept> <code value="F1"/> <display value="Medical Coverage"/> <definition value="Medical Coverage."/> </concept> <concept> <code value="F3"/> <display value="Dental Coverage"/> <definition value="Dental Coverage."/> </concept> <concept> <code value="F4"/> <display value="Hearing Coverage"/> <definition value="Hearing Coverage."/> </concept> <concept> <code value="F6"/> <display value="Vision Coverage"/> <definition value="Vision Coverage."/> </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.