Release 4B

This page is part of the FHIR Specification (v4.3.0: R4B - STU). 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

Codesystem-ex-benefitcategory.xml

Financial Management Work GroupMaturity Level: N/AStandards Status: Informative

Raw XML (canonical form + also see XML Format Specification)

Definition for Code SystemBenefitCategoryCodes

<?xml version="1.0" encoding="UTF-8"?>

<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="ex-benefitcategory"/> 
  <meta> 
    <lastUpdated value="2022-05-28T12:47:40.239+10:00"/> 
    <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"/> 
  <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.