Codesystem-consent-category.xml

Definition for Code System Consent Category Codes

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  <id value="consent-category"/> 
  <meta> 
    <lastUpdated value="2019-10-24T11:53:00+11:00"/> 
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      <h2> Consent Category Codes</h2> 
      <div> 
        <p> This value set includes sample Consent Directive Type codes, including several consent
           directive related LOINC codes; HL7 VALUE SET: ActConsentType(2.16.840.1.113883.1.11.19897);
           examples of US realm consent directive legal descriptions and references to online and/or
           downloadable forms such as the SSA-827 Authorization to Disclose Information to the Social
           Security Administration; and other anticipated consent directives related to participation
           in a clinical trial, medical procedures, reproductive procedures; health care directive
           (Living Will); advance directive, do not resuscitate (DNR); Physician Orders for Life-Sustaining
           Treatment (POLST)</p> 

      </div> 
      <p> 
        <b> Copyright Statement:</b>  This value set includes content from LOINC® which is copyright © 1995 Regenstrief Institute,
         Inc. and the LOINC Committee, and available at no cost under the license at http://loinc.org/terms-o
        f-use
      </p> 
      <p> This code system http://hl7.org/fhir/consentcategorycodes defines the following codes:</p> 
      <table class="codes">
        <tr> 
          <td> 
            <b> Code</b> 
          </td> 
          <td> 
            <b> Display</b> 
          </td> 
          <td> 
            <b> Definition</b> 
          </td> 
        </tr> 
        <tr> 
          <td> 42-CFR-2
            <a name="consent-category-42-CFR-2"> </a> 
          </td> 
          <td> 42 CFR Part 2 Form of written consent</td> 
          <td> Required elements in a written consent to a disclosure of information governed under 42
             CFR Part 2. http://www.ecfr.gov/cgi-bin/text-idx?SID=69c4339acd2df9fab9dcbed15181917b&amp;mc=true&am
            p;node=pt42.1.2&amp;rgn=div5</td> 
        </tr> 
        <tr> 
          <td> ACD
            <a name="consent-category-ACD"> </a> 
          </td> 
          <td> advance directive</td> 
          <td> Any instructions, written or given verbally by a patient to a health care provider in
             anticipation of potential need for medical treatment. [2005 Honor My Wishes]</td> 
        </tr> 
        <tr> 
          <td> CRIC
            <a name="consent-category-CRIC"> </a> 
          </td> 
          <td> common rule informed consent</td> 
          <td> 45 CFR part 46 §46.116 General requirements for informed consent; and §46.117 Documentation
             of informed consent. https://www.gpo.gov/fdsys/pkg/FR-2017-01-19/pdf/2017-01058.pdf</td> 
        </tr> 
        <tr> 
          <td> DNR
            <a name="consent-category-DNR"> </a> 
          </td> 
          <td> do not resuscitate</td> 
          <td> A legal document, signed by both the patient and their provider, stating a desire not
             to have CPR initiated in case of a cardiac event. Note: This form was replaced in 2003
             with the Physician Orders for Life-Sustaining Treatment [POLST].</td> 
        </tr> 
        <tr> 
          <td> EMRGONLY
            <a name="consent-category-EMRGONLY"> </a> 
          </td> 
          <td> emergency only</td> 
          <td> Opt-in to disclosure of health information for emergency only consent directive. Comment:
             This general consent directive specifically limits disclosure of health information for
             purpose of emergency treatment. Additional parameters may further limit the disclosure
             to specific users, roles, duration, types of information, and impose uses obligations.
             [ActConsentDirective (2.16.840.1.113883.1.11.20425)]</td> 
        </tr> 
        <tr> 
          <td> Illinois-Minor-Procedure
            <a name="consent-category-Illinois-Minor-Procedure"> </a> 
          </td> 
          <td> Illinois Consent by Minors to Medical Procedures</td> 
          <td> The consent to the performance of a medical or surgical procedure by a physician licensed
             to practice medicine and surgery, a licensed advanced practice nurse, or a licensed physician
             assistant executed by a married person who is a minor, by a parent who is a minor, by
             a pregnant woman who is a minor, or by any person 18 years of age or older, is not voidable
             because of such minority, and, for such purpose, a married person who is a minor, a parent
             who is a minor, a pregnant woman who is a minor, or any person 18 years of age or older,
             is deemed to have the same legal capacity to act and has the same powers and obligations
             as has a person of legal age. Consent by Minors to Medical Procedures Act. (410 ILCS 210/0.01)
             (from Ch. 111, par. 4500) Sec. 0.01. Short title. This Act may be cited as the Consent
             by Minors to Medical Procedures Act. (Source: P.A. 86-1324.) http://www.ilga.gov/legislation/ilcs/il
            cs3.asp?ActID=1539&amp;ChapterID=35</td> 
        </tr> 
        <tr> 
          <td> HCD
            <a name="consent-category-HCD"> </a> 
          </td> 
          <td> health care directive</td> 
          <td> Patient’s document telling patient’s health care provider what the patient wants or
             does not want if the patient is diagnosed as being terminally ill and in a persistent
             vegetative state or in a permanently unconscious condition.[2005 Honor My Wishes]</td> 
        </tr> 
        <tr> 
          <td> HIPAA-Auth
            <a name="consent-category-HIPAA-Auth"> </a> 
          </td> 
          <td> HIPAA Authorization</td> 
          <td> HIPAA 45 CFR Section 164.508 Uses and disclosures for which an authorization is required.
             (a) Standard: Authorizations for uses and disclosures. (1) Authorization required: General
             rule. Except as otherwise permitted or required by this subchapter, a covered entity may
             not use or disclose protected health information without an authorization that is valid
             under this section. When a covered entity obtains or receives a valid authorization for
             its use or disclosure of protected health information, such use or disclosure must be
             consistent with such authorization. Usage Note: Authorizations governed under this regulation
             meet the definition of an opt in class of consent directive.</td> 
        </tr> 
        <tr> 
          <td> HIPAA-NPP
            <a name="consent-category-HIPAA-NPP"> </a> 
          </td> 
          <td> HIPAA Notice of Privacy Practices</td> 
          <td> § 164.520 — Notice of privacy practices for protected health information. (1) Right
             to notice. Except as provided by paragraph (a)(2) or (3) of this section, an individual
             has a right to adequate notice of the uses and disclosures of protected health information
             that may be made by the covered entity, and of the individual's rights and the covered
             entity's legal duties with respect to protected health information. Usage Note: Restrictions
             governed under this regulation meet the definition of an implied with an opportunity to
             dissent class of consent directive.</td> 
        </tr> 
        <tr> 
          <td> HIPAA-Restrictions
            <a name="consent-category-HIPAA-Restrictions"> </a> 
          </td> 
          <td> HIPAA Restrictions</td> 
          <td> HIPAA 45 CFR § 164.510 - Uses and disclosures requiring an opportunity for the individual
             to agree or to object. A covered entity may use or disclose protected health information,
             provided that the individual is informed in advance of the use or disclosure and has the
             opportunity to agree to or prohibit or restrict the use or disclosure, in accordance with
             the applicable requirements of this section. The covered entity may orally inform the
             individual of and obtain the individual's oral agreement or objection to a use or disclosure
             permitted by this section. Usage Note: Restrictions governed under this regulation meet
             the definition of an opt out with exception class of consent directive.</td> 
        </tr> 
        <tr> 
          <td> HIPAA-Research
            <a name="consent-category-HIPAA-Research"> </a> 
          </td> 
          <td> HIPAA Research Authorization</td> 
          <td> HIPAA 45 CFR § 164.508 - Uses and disclosures for which an authorization is required.
             (a) Standard: Authorizations for uses and disclosures. (3) Compound authorizations. An
             authorization for use or disclosure of protected health information may not be combined
             with any other document to create a compound authorization, except as follows: (i) An
             authorization for the use or disclosure of protected health information for a research
             study may be combined with any other type of written permission for the same or another
             research study. This exception includes combining an authorization for the use or disclosure
             of protected health information for a research study with another authorization for the
             same research study, with an authorization for the creation or maintenance of a research
             database or repository, or with a consent to participate in research. Where a covered
             health care provider has conditioned the provision of research-related treatment on the
             provision of one of the authorizations, as permitted under paragraph (b)(4)(i) of this
             section, any compound authorization created under this paragraph must clearly differentiate
             between the conditioned and unconditioned components and provide the individual with an
             opportunity to opt in to the research activities described in the unconditioned authorization.
             Usage Notes: See HHS http://www.hhs.gov/hipaa/for-professionals/special-topics/research/index.html
             and OCR http://www.hhs.gov/hipaa/for-professionals/special-topics/research/index.html</td> 
        </tr> 
        <tr> 
          <td> HIPAA-Self-Pay
            <a name="consent-category-HIPAA-Self-Pay"> </a> 
          </td> 
          <td> HIPAA Self-Pay Restriction</td> 
          <td> HIPAA 45 CFR § 164.522(a)—Right To Request a Restriction of Uses and Disclosures. (vi)
             A covered entity must agree to the request of an individual to restrict disclosure of
             protected health information about the individual to a health plan if: (A) The disclosure
             is for the purpose of carrying out payment or health care operations and is not otherwise
             required by law; and (B) The protected health information pertains solely to a health
             care item or service for which the individual, or person other than the health plan on
             behalf of the individual, has paid the covered entity in full. Usage Note: Restrictions
             governed under this regulation meet the definition of an opt out with exception class
             of consent directive. Opt out is limited to disclosures to a payer for payment and operations
             purpose of use. See HL7 HIPAA Self-Pay code in ActPrivacyLaw (2.16.840.1.113883.1.11.20426).</td> 
        </tr> 
        <tr> 
          <td> MDHHS-5515
            <a name="consent-category-MDHHS-5515"> </a> 
          </td> 
          <td> Michigan MDHHS-5515 Consent to Share Behavioral Health Information for Care Coordination
             Purposes</td> 
          <td> On January 1, 2015, the Michigan Department of Health and Human Services (MDHHS) released
             a standard consent form for the sharing of health information specific to behavioral health
             and substance use treatment in accordance with Public Act 129 of 2014. In Michigan, while
             providers are not required to use this new standard form (MDHHS-5515), they are required
             to accept it. Note: Form is available at http://www.michigan.gov/documents/mdhhs/Consent_to_Share_Be
            havioral_Health_Information_for_Care_Coordination_Purposes_548835_7.docx For more information
             see http://www.michigan.gov/documents/mdhhs/Behavioral_Health_Consent_Form_Background_Information_54
            8864_7.pdf</td> 
        </tr> 
        <tr> 
          <td> NYSSIPP
            <a name="consent-category-NYSSIPP"> </a> 
          </td> 
          <td> New York State Surgical and Invasive Procedure Protocol</td> 
          <td> The New York State Surgical and Invasive Procedure Protocol (NYSSIPP) applies to all operative
             and invasive procedures including endoscopy, general surgery or interventional radiology.
             Other procedures that involve puncture or incision of the skin, or insertion of an instrument
             or foreign material into the body are within the scope of the protocol. This protocol
             also applies to those anesthesia procedures either prior to a surgical procedure or independent
             of a surgical procedure such as spinal facet blocks. Example: Certain 'minor' procedures
             such as venipuncture, peripheral IV placement, insertion of nasogastric tube and foley
             catheter insertion are not within the scope of the protocol. From http://www.health.ny.gov/professio
            nals/protocols_and_guidelines/surgical_and_invasive_procedure/nyssipp_faq.htm Note: HHC
             100B-1 Form is available at http://www.downstate.edu/emergency_medicine/documents/Consent_CT_with_co
            ntrast.pdf</td> 
        </tr> 
        <tr> 
          <td> NPP
            <a name="consent-category-NPP"> </a> 
          </td> 
          <td> notice of privacy practices</td> 
          <td> Acknowledgement of custodian notice of privacy practices. Usage Notes: This type of consent
             directive acknowledges a custodian's notice of privacy practices including its permitted
             collection, access, use and disclosure of health information to users and for purposes
             of use specified. [ActConsentDirective (2.16.840.1.113883.1.11.20425)]</td> 
        </tr> 
        <tr> 
          <td> POLST
            <a name="consent-category-POLST"> </a> 
          </td> 
          <td> POLST</td> 
          <td> The Physician Order for Life-Sustaining Treatment form records a person’s health care
             wishes for end of life emergency treatment and translates them into an order by the physician.
             It must be reviewed and signed by both the patient and the physician, Advanced Registered
             Nurse Practitioner or Physician Assistant. [2005 Honor My Wishes] Comment: Opt-in Consent
             Directive with restrictions.</td> 
        </tr> 
        <tr> 
          <td> RESEARCH
            <a name="consent-category-RESEARCH"> </a> 
          </td> 
          <td> research information access</td> 
          <td> Consent to have healthcare information in an electronic health record accessed for research
             purposes. [VALUE SET: ActConsentType (2.16.840.1.113883.1.11.19897)]</td> 
        </tr> 
        <tr> 
          <td> RSDID
            <a name="consent-category-RSDID"> </a> 
          </td> 
          <td> de-identified information access</td> 
          <td> Consent to have de-identified healthcare information in an electronic health record that
             is accessed for research purposes, but without consent to re-identify the information
             under any circumstance. [VALUE SET: ActConsentType (2.16.840.1.113883.1.11.19897)</td> 
        </tr> 
        <tr> 
          <td> RSREID
            <a name="consent-category-RSREID"> </a> 
          </td> 
          <td> re-identifiable information access</td> 
          <td> Consent to have de-identified healthcare information in an electronic health record that
             is accessed for research purposes re-identified under specific circumstances outlined
             in the consent. [VALUE SET: ActConsentType (2.16.840.1.113883.1.11.19897)]</td> 
        </tr> 
        <tr> 
          <td> SSA-827
            <a name="consent-category-SSA-827"> </a> 
          </td> 
          <td> Form SSA-827</td> 
          <td> SSA Form SSA-827 (Authorization to Disclose Information to the Social Security Administration
             (SSA))and its affiliated State disability determination services use Form SSA-827, Authorization
             to Disclose Information to the Social Security Administration (SSA) to obtain medical
             and other information needed to determine whether or not a claimant is disabled. Comment:
             Opt-in Consent Directive. Note: Form is available at https://www.socialsecurity.gov/forms/ssa-827-in
            st-sp.pdf </td> 
        </tr> 
        <tr> 
          <td> VA-10-0484
            <a name="consent-category-VA-10-0484"> </a> 
          </td> 
          <td> VA Form 10-0484</td> 
          <td> VA Form 10-0484 Revocation for Release of Individually-Identifiable Health Information
             enables a veteran to revoke authorization for the VA to release specified copies of individually-ide
            ntifiable health information with the non-VA health care provider organizations participating
             in the eHealth Exchange and partnering with VA. Comment: Opt-in Consent Directive with
             status = rescinded (aka 'revoked'). Note: Form is available at http://www.va.gov/vaforms/medical/pdf
            /vha-10-0484-fill.pdf</td> 
        </tr> 
        <tr> 
          <td> VA-10-0485
            <a name="consent-category-VA-10-0485"> </a> 
          </td> 
          <td> VA Form 10-0485</td> 
          <td> VA Form 10-0485 Request for and Authorization to Release Protected Health Information
             to eHealth Exchange enables a veteran to request and authorize a VA health care facility
             to release protected health information (PHI) for treatment purposes only to the communities
             that are participating in the eHealth Exchange, VLER Directive, and other Health Information
             Exchanges with who VA has an agreement. This information may consist of the diagnosis
             of Sickle Cell Anemia, the treatment of or referral for Drug Abuse, treatment of or referral
             for Alcohol Abuse or the treatment of or testing for infection with Human Immunodeficiency
             Virus. This authorization covers the diagnoses that I may have upon signing of the authorization
             and the diagnoses that I may acquire in the future including those protected by 38 U.S.C.
             7332. Comment: Opt-in Consent Directive. Note: Form is available at http://www.va.gov/vaforms/medica
            l/pdf/10-0485-fill.pdf</td> 
        </tr> 
        <tr> 
          <td> VA-10-5345
            <a name="consent-category-VA-10-5345"> </a> 
          </td> 
          <td> VA Form 10-5345</td> 
          <td> VA Form 10-5345 Request for and Authorization to Release Medical Records or Health Information
             enables a veteran to request and authorize the VA to release specified copies of protected
             health information (PHI), such as hospital summary or outpatient treatment notes, which
             may include information about conditions governed under Title 38 Section 7332 (drug abuse,
             alcoholism or alcohol abuse, testing for or infection with HIV, and sickle cell anemia).
             Comment: Opt-in Consent Directive. Note: Form is available at http://www.va.gov/vaforms/medical/pdf/
            vha-10-5345-fill.pdf</td> 
        </tr> 
        <tr> 
          <td> VA-10-5345a
            <a name="consent-category-VA-10-5345a"> </a> 
          </td> 
          <td> VA Form 10-5345a</td> 
          <td> VA Form 10-5345a Individuals' Request for a Copy of Their Own Health Information enables
             a veteran to request and authorize the VA to release specified copies of protected health
             information (PHI), such as hospital summary or outpatient treatment notes. Note: Form
             is available at http://www.va.gov/vaforms/medical/pdf/vha-10-5345a-fill.pdf</td> 
        </tr> 
        <tr> 
          <td> VA-10-5345a-MHV
            <a name="consent-category-VA-10-5345a-MHV"> </a> 
          </td> 
          <td> VA Form 10-5345a-MHV</td> 
          <td> VA Form 10-5345a-MHV Individual’s Request for a Copy of their own health information
             from MyHealtheVet enables a veteran to receive a copy of all available personal health
             information to be delivered through the veteran’s My HealtheVet account. Note: Form
             is available at http://www.va.gov/vaforms/medical/pdf/vha-10-5345a-MHV-fill.pdf</td> 
        </tr> 
        <tr> 
          <td> VA-10-10116
            <a name="consent-category-VA-10-10116"> </a> 
          </td> 
          <td> VA Form 10-10-10116</td> 
          <td> VA Form 10-10116 Revocation of Authorization for Use and Release of Individually Identifiable
             Health Information for Veterans Health Administration Research. Comment: Opt-in with Restriction
             Consent Directive with status = 'completed'. Note: Form is available at http://www.northerncaliforni
            a.va.gov/northerncalifornia/services/rnd/docs/vha-10-10116.pdf </td> 
        </tr> 
        <tr> 
          <td> VA-21-4142
            <a name="consent-category-VA-21-4142"> </a> 
          </td> 
          <td> VA Form 21-4142</td> 
          <td> VA Form 21-4142 (Authorization and Consent to Release Information to the Department of
             Veterans Affairs (VA) enables a veteran to authorize the US Veterans Administration [VA]
             to request veteran’s health information from non-VA providers. Aka VA Compensation Application
             Note: Form is available at http://www.vba.va.gov/pubs/forms/VBA-21-4142-ARE.pdf . For
             additional information regarding VA Form 21-4142, refer to the following website: www.benefits.va.go
            v/compensation/consent_privateproviders</td> 
        </tr> 
      </table> 
    </div> 
  </text> 
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    <valueInteger value="1"/> 
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  <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="cbcc"/> 
  </extension> 
  <url value="http://hl7.org/fhir/consentcategorycodes"/> 
  <identifier> 
    <system value="urn:ietf:rfc:3986"/> 
    <value value="urn:oid:2.16.840.1.113883.4.642.1.736"/> 
  </identifier> 
  <version value="3.0.2"/> 
  <name value="Consent Category Codes"/> 
  <status value="draft"/> 
  <experimental value="true"/> 
  <publisher value="FHIR Project (CBCC)"/> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://hl7.org/fhir"/> 
    </telecom> 
  </contact> 
  <description value="This value set includes sample Consent Directive Type codes, including several consent
   directive related LOINC codes; HL7 VALUE SET: ActConsentType(2.16.840.1.113883.1.11.19897);
   examples of US realm consent directive legal descriptions and references to online and/or
   downloadable forms such as the SSA-827 Authorization to Disclose Information to the Social
   Security Administration; and other anticipated consent directives related to participation
   in a clinical trial, medical procedures, reproductive procedures; health care directive
   (Living Will); advance directive, do not resuscitate (DNR); Physician Orders for Life-Sustaining
   Treatment (POLST)"/> 
  <copyright value="This value set includes content from LOINC® which is copyright © 1995 Regenstrief Institute,
   Inc. and the LOINC Committee, and available at no cost under the license at http://loinc.org/terms-o
  f-use"/> 
  <caseSensitive value="true"/> 
  <valueSet value="http://hl7.org/fhir/ValueSet/consent-category"/> 
  <hierarchyMeaning value="is-a"/> 
  <content value="complete"/> 
  <concept> 
    <code value="42-CFR-2"/> 
    <display value="42 CFR Part 2 Form of written consent"/> 
    <definition value="Required elements in a written consent to a disclosure of information governed under 42
     CFR Part 2. http://www.ecfr.gov/cgi-bin/text-idx?SID=69c4339acd2df9fab9dcbed15181917b&amp;mc=true&am
    p;node=pt42.1.2&amp;rgn=div5"/> 
  </concept> 
  <concept> 
    <code value="ACD"/> 
    <display value="advance directive"/> 
    <definition value="Any instructions, written or given verbally by a patient to a health care provider in
     anticipation of potential need for medical treatment. [2005 Honor My Wishes]"/> 
  </concept> 
  <concept> 
    <code value="CRIC"/> 
    <display value="common rule informed consent"/> 
    <definition value="45 CFR part 46 §46.116 General requirements for informed consent; and §46.117 Documentation
     of informed consent. https://www.gpo.gov/fdsys/pkg/FR-2017-01-19/pdf/2017-01058.pdf"/> 
  </concept> 
  <concept> 
    <code value="DNR"/> 
    <display value="do not resuscitate"/> 
    <definition value="A legal document, signed by both the patient and their provider, stating a desire not
     to have CPR initiated in case of a cardiac event. Note: This form was replaced in 2003
     with the Physician Orders for Life-Sustaining Treatment [POLST]."/> 
  </concept> 
  <concept> 
    <code value="EMRGONLY"/> 
    <display value="emergency only"/> 
    <definition value="Opt-in to disclosure of health information for emergency only consent directive. Comment:
     This general consent directive specifically limits disclosure of health information for
     purpose of emergency treatment. Additional parameters may further limit the disclosure
     to specific users, roles, duration, types of information, and impose uses obligations.
     [ActConsentDirective (2.16.840.1.113883.1.11.20425)]"/> 
  </concept> 
  <concept> 
    <code value="Illinois-Minor-Procedure"/> 
    <display value="Illinois Consent by Minors to Medical Procedures"/> 
    <definition value="The consent to the performance of a medical or surgical procedure by a physician licensed
     to practice medicine and surgery, a licensed advanced practice nurse, or a licensed physician
     assistant executed by a married person who is a minor, by a parent who is a minor, by
     a pregnant woman who is a minor, or by any person 18 years of age or older, is not voidable
     because of such minority, and, for such purpose, a married person who is a minor, a parent
     who is a minor, a pregnant woman who is a minor, or any person 18 years of age or older,
     is deemed to have the same legal capacity to act and has the same powers and obligations
     as has a person of legal age. Consent by Minors to Medical Procedures Act. (410 ILCS 210/0.01)
     (from Ch. 111, par. 4500) Sec. 0.01. Short title. This Act may be cited as the Consent
     by Minors to Medical Procedures Act. (Source: P.A. 86-1324.) http://www.ilga.gov/legislation/ilcs/il
    cs3.asp?ActID=1539&amp;ChapterID=35"/> 
  </concept> 
  <concept> 
    <code value="HCD"/> 
    <display value="health care directive"/> 
    <definition value="Patient’s document telling patient’s health care provider what the patient wants or
     does not want if the patient is diagnosed as being terminally ill and in a persistent
     vegetative state or in a permanently unconscious condition.[2005 Honor My Wishes]"/> 
  </concept> 
  <concept> 
    <code value="HIPAA-Auth"/> 
    <display value="HIPAA Authorization"/> 
    <definition value="HIPAA 45 CFR Section 164.508 Uses and disclosures for which an authorization is required.
     (a) Standard: Authorizations for uses and disclosures. (1) Authorization required: General
     rule. Except as otherwise permitted or required by this subchapter, a covered entity may
     not use or disclose protected health information without an authorization that is valid
     under this section. When a covered entity obtains or receives a valid authorization for
     its use or disclosure of protected health information, such use or disclosure must be
     consistent with such authorization. Usage Note: Authorizations governed under this regulation
     meet the definition of an opt in class of consent directive."/> 
  </concept> 
  <concept> 
    <code value="HIPAA-NPP"/> 
    <display value="HIPAA Notice of Privacy Practices"/> 
    <definition value="§ 164.520 — Notice of privacy practices for protected health information. (1) Right
     to notice. Except as provided by paragraph (a)(2) or (3) of this section, an individual
     has a right to adequate notice of the uses and disclosures of protected health information
     that may be made by the covered entity, and of the individual's rights and the covered
     entity's legal duties with respect to protected health information. Usage Note: Restrictions
     governed under this regulation meet the definition of an implied with an opportunity to
     dissent class of consent directive."/> 
  </concept> 
  <concept> 
    <code value="HIPAA-Restrictions"/> 
    <display value="HIPAA Restrictions"/> 
    <definition value="HIPAA 45 CFR § 164.510 - Uses and disclosures requiring an opportunity for the individual
     to agree or to object. A covered entity may use or disclose protected health information,
     provided that the individual is informed in advance of the use or disclosure and has the
     opportunity to agree to or prohibit or restrict the use or disclosure, in accordance with
     the applicable requirements of this section. The covered entity may orally inform the
     individual of and obtain the individual's oral agreement or objection to a use or disclosure
     permitted by this section. Usage Note: Restrictions governed under this regulation meet
     the definition of an opt out with exception class of consent directive."/> 
  </concept> 
  <concept> 
    <code value="HIPAA-Research"/> 
    <display value="HIPAA Research Authorization"/> 
    <definition value="HIPAA 45 CFR § 164.508 - Uses and disclosures for which an authorization is required.
     (a) Standard: Authorizations for uses and disclosures. (3) Compound authorizations. An
     authorization for use or disclosure of protected health information may not be combined
     with any other document to create a compound authorization, except as follows: (i) An
     authorization for the use or disclosure of protected health information for a research
     study may be combined with any other type of written permission for the same or another
     research study. This exception includes combining an authorization for the use or disclosure
     of protected health information for a research study with another authorization for the
     same research study, with an authorization for the creation or maintenance of a research
     database or repository, or with a consent to participate in research. Where a covered
     health care provider has conditioned the provision of research-related treatment on the
     provision of one of the authorizations, as permitted under paragraph (b)(4)(i) of this
     section, any compound authorization created under this paragraph must clearly differentiate
     between the conditioned and unconditioned components and provide the individual with an
     opportunity to opt in to the research activities described in the unconditioned authorization.
     Usage Notes: See HHS http://www.hhs.gov/hipaa/for-professionals/special-topics/research/index.html
     and OCR http://www.hhs.gov/hipaa/for-professionals/special-topics/research/index.html"/> 
  </concept> 
  <concept> 
    <code value="HIPAA-Self-Pay"/> 
    <display value="HIPAA Self-Pay Restriction"/> 
    <definition value="HIPAA 45 CFR § 164.522(a)—Right To Request a Restriction of Uses and Disclosures. (vi)
     A covered entity must agree to the request of an individual to restrict disclosure of
     protected health information about the individual to a health plan if: (A) The disclosure
     is for the purpose of carrying out payment or health care operations and is not otherwise
     required by law; and (B) The protected health information pertains solely to a health
     care item or service for which the individual, or person other than the health plan on
     behalf of the individual, has paid the covered entity in full. Usage Note: Restrictions
     governed under this regulation meet the definition of an opt out with exception class
     of consent directive. Opt out is limited to disclosures to a payer for payment and operations
     purpose of use. See HL7 HIPAA Self-Pay code in ActPrivacyLaw (2.16.840.1.113883.1.11.20426)."/> 
  </concept> 
  <concept> 
    <code value="MDHHS-5515"/> 
    <display value="Michigan MDHHS-5515 Consent to Share Behavioral Health Information for Care Coordination
     Purposes"/> 
    <definition value="On January 1, 2015, the Michigan Department of Health and Human Services (MDHHS) released
     a standard consent form for the sharing of health information specific to behavioral health
     and substance use treatment in accordance with Public Act 129 of 2014. In Michigan, while
     providers are not required to use this new standard form (MDHHS-5515), they are required
     to accept it. Note: Form is available at http://www.michigan.gov/documents/mdhhs/Consent_to_Share_Be
    havioral_Health_Information_for_Care_Coordination_Purposes_548835_7.docx For more information
     see http://www.michigan.gov/documents/mdhhs/Behavioral_Health_Consent_Form_Background_Information_54
    8864_7.pdf"/> 
  </concept> 
  <concept> 
    <code value="NYSSIPP"/> 
    <display value="New York State Surgical and Invasive Procedure Protocol"/> 
    <definition value="The New York State Surgical and Invasive Procedure Protocol (NYSSIPP) applies to all operative
     and invasive procedures including endoscopy, general surgery or interventional radiology.
     Other procedures that involve puncture or incision of the skin, or insertion of an instrument
     or foreign material into the body are within the scope of the protocol. This protocol
     also applies to those anesthesia procedures either prior to a surgical procedure or independent
     of a surgical procedure such as spinal facet blocks. Example: Certain 'minor' procedures
     such as venipuncture, peripheral IV placement, insertion of nasogastric tube and foley
     catheter insertion are not within the scope of the protocol. From http://www.health.ny.gov/professio
    nals/protocols_and_guidelines/surgical_and_invasive_procedure/nyssipp_faq.htm Note: HHC
     100B-1 Form is available at http://www.downstate.edu/emergency_medicine/documents/Consent_CT_with_co
    ntrast.pdf"/> 
  </concept> 
  <concept> 
    <code value="NPP"/> 
    <display value="notice of privacy practices"/> 
    <definition value="Acknowledgement of custodian notice of privacy practices. Usage Notes: This type of consent
     directive acknowledges a custodian's notice of privacy practices including its permitted
     collection, access, use and disclosure of health information to users and for purposes
     of use specified. [ActConsentDirective (2.16.840.1.113883.1.11.20425)]"/> 
  </concept> 
  <concept> 
    <code value="POLST"/> 
    <display value="POLST"/> 
    <definition value="The Physician Order for Life-Sustaining Treatment form records a person’s health care
     wishes for end of life emergency treatment and translates them into an order by the physician.
     It must be reviewed and signed by both the patient and the physician, Advanced Registered
     Nurse Practitioner or Physician Assistant. [2005 Honor My Wishes] Comment: Opt-in Consent
     Directive with restrictions."/> 
  </concept> 
  <concept> 
    <code value="RESEARCH"/> 
    <display value="research information access"/> 
    <definition value="Consent to have healthcare information in an electronic health record accessed for research
     purposes. [VALUE SET: ActConsentType (2.16.840.1.113883.1.11.19897)]"/> 
  </concept> 
  <concept> 
    <code value="RSDID"/> 
    <display value="de-identified information access"/> 
    <definition value="Consent to have de-identified healthcare information in an electronic health record that
     is accessed for research purposes, but without consent to re-identify the information
     under any circumstance. [VALUE SET: ActConsentType (2.16.840.1.113883.1.11.19897)"/> 
  </concept> 
  <concept> 
    <code value="RSREID"/> 
    <display value="re-identifiable information access"/> 
    <definition value="Consent to have de-identified healthcare information in an electronic health record that
     is accessed for research purposes re-identified under specific circumstances outlined
     in the consent. [VALUE SET: ActConsentType (2.16.840.1.113883.1.11.19897)]"/> 
  </concept> 
  <concept> 
    <code value="SSA-827"/> 
    <display value="Form SSA-827"/> 
    <definition value="SSA Form SSA-827 (Authorization to Disclose Information to the Social Security Administration
     (SSA))and its affiliated State disability determination services use Form SSA-827, Authorization
     to Disclose Information to the Social Security Administration (SSA) to obtain medical
     and other information needed to determine whether or not a claimant is disabled. Comment:
     Opt-in Consent Directive. Note: Form is available at https://www.socialsecurity.gov/forms/ssa-827-in
    st-sp.pdf "/> 
  </concept> 
  <concept> 
    <code value="VA-10-0484"/> 
    <display value="VA Form 10-0484"/> 
    <definition value="VA Form 10-0484 Revocation for Release of Individually-Identifiable Health Information
     enables a veteran to revoke authorization for the VA to release specified copies of individually-ide
    ntifiable health information with the non-VA health care provider organizations participating
     in the eHealth Exchange and partnering with VA. Comment: Opt-in Consent Directive with
     status = rescinded (aka 'revoked'). Note: Form is available at http://www.va.gov/vaforms/medical/pdf
    /vha-10-0484-fill.pdf"/> 
  </concept> 
  <concept> 
    <code value="VA-10-0485"/> 
    <display value="VA Form 10-0485"/> 
    <definition value="VA Form 10-0485 Request for and Authorization to Release Protected Health Information
     to eHealth Exchange enables a veteran to request and authorize a VA health care facility
     to release protected health information (PHI) for treatment purposes only to the communities
     that are participating in the eHealth Exchange, VLER Directive, and other Health Information
     Exchanges with who VA has an agreement. This information may consist of the diagnosis
     of Sickle Cell Anemia, the treatment of or referral for Drug Abuse, treatment of or referral
     for Alcohol Abuse or the treatment of or testing for infection with Human Immunodeficiency
     Virus. This authorization covers the diagnoses that I may have upon signing of the authorization
     and the diagnoses that I may acquire in the future including those protected by 38 U.S.C.
     7332. Comment: Opt-in Consent Directive. Note: Form is available at http://www.va.gov/vaforms/medica
    l/pdf/10-0485-fill.pdf"/> 
  </concept> 
  <concept> 
    <code value="VA-10-5345"/> 
    <display value="VA Form 10-5345"/> 
    <definition value="VA Form 10-5345 Request for and Authorization to Release Medical Records or Health Information
     enables a veteran to request and authorize the VA to release specified copies of protected
     health information (PHI), such as hospital summary or outpatient treatment notes, which
     may include information about conditions governed under Title 38 Section 7332 (drug abuse,
     alcoholism or alcohol abuse, testing for or infection with HIV, and sickle cell anemia).
     Comment: Opt-in Consent Directive. Note: Form is available at http://www.va.gov/vaforms/medical/pdf/
    vha-10-5345-fill.pdf"/> 
  </concept> 
  <concept> 
    <code value="VA-10-5345a"/> 
    <display value="VA Form 10-5345a"/> 
    <definition value="VA Form 10-5345a Individuals' Request for a Copy of Their Own Health Information enables
     a veteran to request and authorize the VA to release specified copies of protected health
     information (PHI), such as hospital summary or outpatient treatment notes. Note: Form
     is available at http://www.va.gov/vaforms/medical/pdf/vha-10-5345a-fill.pdf"/> 
  </concept> 
  <concept> 
    <code value="VA-10-5345a-MHV"/> 
    <display value="VA Form 10-5345a-MHV"/> 
    <definition value="VA Form 10-5345a-MHV Individual’s Request for a Copy of their own health information
     from MyHealtheVet enables a veteran to receive a copy of all available personal health
     information to be delivered through the veteran’s My HealtheVet account. Note: Form
     is available at http://www.va.gov/vaforms/medical/pdf/vha-10-5345a-MHV-fill.pdf"/> 
  </concept> 
  <concept> 
    <code value="VA-10-10116"/> 
    <display value="VA Form 10-10-10116"/> 
    <definition value="VA Form 10-10116 Revocation of Authorization for Use and Release of Individually Identifiable
     Health Information for Veterans Health Administration Research. Comment: Opt-in with Restriction
     Consent Directive with status = 'completed'. Note: Form is available at http://www.northerncaliforni
    a.va.gov/northerncalifornia/services/rnd/docs/vha-10-10116.pdf "/> 
  </concept> 
  <concept> 
    <code value="VA-21-4142"/> 
    <display value="VA Form 21-4142"/> 
    <definition value="VA Form 21-4142 (Authorization and Consent to Release Information to the Department of
     Veterans Affairs (VA) enables a veteran to authorize the US Veterans Administration [VA]
     to request veteran’s health information from non-VA providers. Aka VA Compensation Application
     Note: Form is available at http://www.vba.va.gov/pubs/forms/VBA-21-4142-ARE.pdf . For
     additional information regarding VA Form 21-4142, refer to the following website: www.benefits.va.go
    v/compensation/consent_privateproviders"/> 
  </concept> 
</CodeSystem>