FHIR Release 3 (STU)

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4.3.2.88 HL7 v3 Code System ParticipationFunction

Vocabulary Work Group Maturity Level: N/AExternalUse Context: Any

This code system (http://hl7.org/fhir/v3/ParticipationFunction) is defined as part of HL7 v3.

Summary

Defining URL:http://hl7.org/fhir/v3/ParticipationFunction
Name:v3 Code System ParticipationFunction
Definition: This code is used to specify the exact function an actor had in a service in all necessary detail. This domain may include local extensions (CWE).
OID:2.16.840.1.113883.5.88 (for OID based terminology systems)
Source ResourceXML / JSON

This Code system is used in the following value sets:

  • v3 Code System ParticipationFunction ( This code is used to specify the exact function an actor had in a service in all necessary detail. This domain may include local extensions (CWE).)

Release Date: 2016-11-11

LevelCodeDisplayDefinition
1(_AuthorizedParticipationFunction) Abstract  This code is used to specify the exact function an actor is authorized to have in a service in all necessary detail.
2  (_AuthorizedReceiverParticipationFunction) Abstract  This code is used to specify the exact function an actor is authorized to have as a receiver of information that is the subject of a consent directive or consent override.
3    AUCG caregiver information receiver Description:Caregiver authorized to receive patient health information.
3    AULR legitimate relationship information receiver Description:Provider with legitimate relationship authorized to receive patient health information.
3    AUTM care team information receiver Description:Member of care team authorized to receive patient health information.
3    AUWA work area information receiver Description:Entities within specified work area authorized to receive patient health information.
2  (_ConsenterParticipationFunction) Abstract  This code is used to specify the exact function an actor is authorized to have in authoring a consent directive.
3    GRDCON legal guardian consent author Description:Legal guardian of the subject of consent authorized to author a consent directive for the subject of consent.
3    POACON healthcare power of attorney consent author Description:Person authorized with healthcare power of attorney to author a consent directive for the subject of consent.
3    PRCON personal representative consent author Description:Personal representative of the subject of consent authorized to author a consent directive for the subject of consent.
3    PROMSK authorized provider masking author Definition:Provider authorized to mask information to protect the patient, a third party, or to ensure that the provider has consulted with the patient prior to release of this information.
3    SUBCON subject of consent author Description:Subject of consent authorized to author a consent directive.
2  (_OverriderParticipationFunction) Abstract  This code is used to specify the exact function an actor is authorized to have in authoring a consent override.
3    AUCOV consent overrider Description:Entity authorized to override a consent directive.
3    AUEMROV emergency overrider Description:Entity authorized to override a consent directive or privacy policy in an emergency.
1(_CoverageParticipationFunction) Abstract  Definition: Set of codes indicating the manner in which sponsors, underwriters, and payers participate in a policy or program.
2  (_PayorParticipationFunction) Abstract  Definition: Set of codes indicating the manner in which payors participate in a policy or program.</
3    CLMADJ claims adjudication Definition: Manages all operations required to adjudicate fee for service claims or managed care encounter reports.
3    ENROLL enrollment broker Definition: Managing the enrollment of covered parties.
3    FFSMGT ffs management Definition: Managing all operations required to administer a fee for service or indemnity health plan including enrolling covered parties and providing customer service, provider contracting, claims payment, care management and utilization review.
3    MCMGT managed care management Definition: Managing all operations required to administer a managed care plan including enrolling covered parties and providing customer service,, provider contracting, claims payment, care management and utilization review.
3    PROVMGT provider management Definition: Managing provider contracting, provider services, credentialing, profiling, performance measures, and ensuring network adequacy.
3    UMGT utilization management Definition: Managing utilization of services by ensuring that providers adhere to, e.g., payeraTMs clinical protocols for medical appropriateness and standards of medical necessity. May include management of authorizations for services and referrals.
2  (_SponsorParticipationFunction) Abstract  Definition: Set of codes indicating the manner in which sponsors participate in a policy or program. NOTE: use only when the Sponsor is not further specified with a SponsorRoleType as being either a fully insured sponsor or a self insured sponsor.
3    FULINRD fully insured Definition: Responsibility taken by a sponsor to contract with one or more underwriters for the assumption of full responsibility for the risk and administration of a policy or program.
3    SELFINRD self insured Definition: Responsibility taken by a sponsor to organize the underwriting of risk and administration of a policy or program.
2  (_UnderwriterParticipationFunction) Abstract  Definition: Set of codes indicating the manner in which underwriters participate in a policy or program.
3    PAYORCNTR payor contracting Definition: Contracting for the provision and administration of health services to payors while retaining the risk for coverage. Contracting may be for all provision and administration; or for provision of certain types of services; for provision of services by region; and by types of administration, e.g., claims adjudication, enrollment, provider management, and utilization management. Typically done by underwriters for sponsors who need coverage provided to covered parties in multiple regions. The underwriter may act as the payor in some, but not all of the regions in which coverage is provided.
3    REINS reinsures Definition: Underwriting reinsurance for another underwriter for the policy or program.
3    RETROCES retrocessionaires Definition: Underwriting reinsurance for another reinsurer.
3    SUBCTRT subcontracting risk Definition: Delegating risk for a policy or program to one or more subcontracting underwriters, e.g., a major health insurer may delegate risk for provision of coverage under a national health plan to other underwriters by region .
3    UNDERWRTNG underwriting Definition: Provision of underwriting analysis for another underwriter without assumption of risk.
1ADMPHYS admitting physician A physician who admitted a patient to a hospital or other care unit that is the context of this service.
1ANEST anesthesist In a typical anesthesia setting an anesthesiologist or anesthesia resident in charge of the anesthesia and life support, but only a witness to the surgical procedure itself. To clarify responsibilities anesthesia should always be represented as a separate service related to the surgery.
1ANRS anesthesia nurse In a typical anesthesia setting the nurse principally assisting the anesthesiologist during the critical periods.
1ASSEMBLER assembly softwareA device that operates independently of an author on custodian's algorithms for data extraction of existing information for purpose of generating a new artifact. UsageConstraint: ASSEMBLER ParticipationFunction should be used with DEV (device) ParticipationType.
1ATTPHYS attending physician A physician who is primarily responsible for a patient during the hospitalization, which is the context of the service.
1COMPOSER composer softwareA device used by an author to record new information, which may also be used by the author to select existing information for aggregation with newly recorded information for the purpose of generating a new artifact. UsageConstraint: COMPOSER ParticipationFunction should be used with DEV (device) ParticipationType.
Usage Note: This code will enable implementers to more specifically represent the manner in which a Device participated in and facilitated the generation of a CDA Clinical Document or a CDA Entry by the responsible Author, which is comprised of the Author's newly entered content, and may include the pre-existing content selected by the Author, for the purpose of establishing the provenance and accountability for these acts.
1DISPHYS discharging physician A physician who discharged a patient from a hospital or other care unit that is the context of this service.
1FASST first assistant surgeon In a typical surgery setting the assistant facing the primary surgeon. The first assistant performs parts of the operation and assists in others (e.g., incision, approach, electrocoutering, ligatures, sutures).
1MDWF midwife A person (usually female) helping a woman deliver a baby. Responsibilities vary locally, ranging from a mere optional assistant to a full required participant, responsible for (normal) births and pre- and post-natal care for both mother and baby.
1NASST nurse assistant In a typical surgery setting the non-sterile nurse handles material supply from the stock, forwards specimen to pathology, and helps with other non-sterile tasks (e.g., phone calls, etc.).
1PCP primary care physician The healthcare provider that holds primary responsibility for the overall care of a patient.
1PRISURG primary surgeon In a typical surgery setting the primary performing surgeon.
1REVIEWER reviewer A verifier who is accountable for reviewing and asserting that the verification of an Act complies with jurisdictional or organizational policy.
UsageConstraint: UsageConstraint: Specifies the exact function that an actor is authorized to have as a verifier of an Act. Connotes that a specialized verifier asserts compliance for veracity of the review per jurisdictional or organizational policy. E.g., The Provider who takes responsibility for authenticity of a record submitted to a payer.
REVIEW ParticipationFunction should be used with VFR (verifier)
1RNDPHYS rounding physician A physician who made rounds on a patient in a hospital or other care center.
1SASST second assistant surgeon In a typical surgery setting the assistant who primarily holds the hooks.
1SNRS scrub nurse In a typical surgery setting the nurse in charge of the instrumentation.
1TASST third assistant In a typical surgery setting there is rarely a third assistant (e.g., in some Hip operations the third assistant postures the affected leg).