Generated Narrative: CodeSystem v3-ActCode Properties This code system defines the following properties for its concepts Name Code URI Type status status http://hl7.org/fhir/concept-properties#status code Inactive inactive http://hl7.org/fhir/concept-properties#inactive boolean effectiveDate effectiveDate http://hl7.org/fhir/concept-properties#effectiveDate dateTime deprecationDate deprecationDate http://hl7.org/fhir/concept-properties#deprecationDate dateTime retirementDate retirementDate http://hl7.org/fhir/concept-properties#retirementDate dateTime Not Selectable notSelectable http://hl7.org/fhir/concept-properties#notSelectable boolean Parent parent http://hl7.org/fhir/concept-properties#parent code Child child http://hl7.org/fhir/concept-properties#child code partOf partOf http://hl7.org/fhir/concept-properties#partOf code synonym synonym http://hl7.org/fhir/concept-properties#synonym code comment comment http://hl7.org/fhir/concept-properties#comment string itemWeight itemWeight http://hl7.org/fhir/concept-properties#itemWeight decimal Concepts This case-sensitive code system http://hl7.org/fhir/v3/ActCode defines the following codes in an undefined hierarchy: Lvl Code Display Definition Not Selectable 1 _ActAccountCode ActAccountCode An account represents a grouping of financial transactions that are tracked and reported together with a single balance. Examples of account codes (types) are Patient billing accounts (collection of charges), Cost centers; Cash. true 2 ACCTRECEIVABLE account receivable An account for collecting charges, reversals, adjustments and payments, including deductibles, copayments, coinsurance (financial transactions) credited or debited to the account receivable account for a patient's encounter. false 2 CASH Cash Cash false 2 CC credit card Description: Types of advance payment to be made on a plastic card usually issued by a financial institution used of purchasing services and/or products. false 3 AE American Express American Express false 3 DN Diner's Club Diner's Club false 3 DV Discover Card Discover Card false 3 MC Master Card Master Card false 3 V Visa Visa false 2 PBILLACCT patient billing account An account representing charges and credits (financial transactions) for a patient's encounter. false 1 _ActAdjudicationCode ActAdjudicationCode Includes coded responses that will occur as a result of the adjudication of an electronic invoice at a summary level and provides guidance on interpretation of the referenced adjudication results. true 2 _ActAdjudicationGroupCode ActAdjudicationGroupCode Catagorization of grouping criteria for the associated transactions and/or summary (totals, subtotals). true 3 CONT contract Transaction counts and value totals by Contract Identifier. false 3 DAY day Transaction counts and value totals for each calendar day within the date range specified. false 3 LOC location Transaction counts and value totals by service location (e.g. clinic). false 3 MONTH month Transaction counts and value totals for each calendar month within the date range specified. false 3 PERIOD period Transaction counts and value totals for the date range specified. false 3 PROV provider Transaction counts and value totals by Provider Identifier. false 3 WEEK week Transaction counts and value totals for each calendar week within the date range specified. false 3 YEAR year Transaction counts and value totals for each calendar year within the date range specified. false 2 AA adjudicated with adjustments The invoice element has been accepted for payment but one or more adjustment(s) have been made to one or more invoice element line items (component charges). Also includes the concept 'Adjudicate as zero' and items not covered under a particular Policy. Invoice element can be reversed (nullified). Recommend that the invoice element is saved for DUR (Drug Utilization Reporting). false 3 ANF adjudicated with adjustments and no financial impact The invoice element has been accepted for payment but one or more adjustment(s) have been made to one or more invoice element line items (component charges) without changing the amount. Invoice element can be reversed (nullified). Recommend that the invoice element is saved for DUR (Drug Utilization Reporting). false 2 AR adjudicated as refused The invoice element has passed through the adjudication process but payment is refused due to one or more reasons. Includes items such as patient not covered, or invoice element is not constructed according to payer rules (e.g. 'invoice submitted too late'). If one invoice element line item in the invoice element structure is rejected, the remaining line items may not be adjudicated and the complete group is treated as rejected. A refused invoice element can be forwarded to the next payer (for Coordination of Benefits) or modified and resubmitted to refusing payer. Invoice element cannot be reversed (nullified) as there is nothing to reverse. Recommend that the invoice element is not saved for DUR (Drug Utilization Reporting). false 2 AS adjudicated as submitted The invoice element was/will be paid exactly as submitted, without financial adjustment(s). If the dollar amount stays the same, but the billing codes have been amended or financial adjustments have been applied through the adjudication process, the invoice element is treated as "Adjudicated with Adjustment". If information items are included in the adjudication results that do not affect the monetary amounts paid, then this is still Adjudicated as Submitted (e.g. 'reached Plan Maximum on this Claim'). Invoice element can be reversed (nullified). Recommend that the invoice element is saved for DUR (Drug Utilization Reporting). false 1 _ActAdjudicationResultActionCode ActAdjudicationResultActionCode Actions to be carried out by the recipient of the Adjudication Result information. true 2 DISPLAY Display The adjudication result associated is to be displayed to the receiver of the adjudication result. false 2 FORM Print on Form The adjudication result associated is to be printed on the specified form, which is then provided to the covered party. false 1 _ActBillableModifierCode ActBillableModifierCode Definition:An identifying modifier code for healthcare interventions or procedures. true 2 CPTM CPT modifier codes Description:CPT modifier codes are found in Appendix A of CPT 2000 Standard Edition. false 2 HCPCSA HCPCS Level II and Carrier-assigned Description:HCPCS Level II (HCFA-assigned) and Carrier-assigned (Level III) modifiers are reported in Appendix A of CPT 2000 Standard Edition and in the Medicare Bulletin. false 1 _ActBillingArrangementCode ActBillingArrangementCode The type of provision(s) made for reimbursing for the deliver of healthcare services and/or goods provided by a Provider, over a specified period. true 2 BLK block funding A billing arrangement where a Provider charges a lump sum to provide a prescribed group (volume) of services to a single patient which occur over a period of time. Services included in the block may vary. This billing arrangement is also known as Program of Care for some specific Payors and Program Fees for other Payors. false 2 CAP capitation funding A billing arrangement where the payment made to a Provider is determined by analyzing one or more demographic attributes about the persons/patients who are enrolled with the Provider (in their practice). false 2 CONTF contract funding A billing arrangement where a Provider charges a lump sum to provide a particular volume of one or more interventions/procedures or groups of interventions/procedures. false 2 FINBILL financial A billing arrangement where a Provider charges for non-clinical items. This includes interest in arrears, mileage, etc. Clinical content is not included in Invoices submitted with this type of billing arrangement. false 2 ROST roster funding A billing arrangement where funding is based on a list of individuals registered as patients of the Provider. false 2 SESS sessional funding A billing arrangement where a Provider charges a sum to provide a group (volume) of interventions/procedures to one or more patients within a defined period of time, typically on the same date. Interventions/procedures included in the session may vary. false 2 FFS fee for service A billing arrangement where a Provider charges a separate fee for each intervention/procedure/event or product. Fee for Service is used when an individual intervention/procedure/event is used for billing purposes. In other words, fees are associated with the intervention/procedure/event. For example, a specific CCI (Canadian Classification of Interventions) code has an associated fee and is used for billing purposes. false 3 FFPS first fill, part fill, partial strength A first fill where the quantity supplied is less than one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.) and also where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets) false 3 FFCS first fill complete, partial strength A first fill where the quantity supplied is equal to one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets) and also where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets). false 3 TFS trial fill partial strength A fill where a small portion is provided to allow for determination of the therapy effectiveness and patient tolerance and also where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets). false 1 _ActBoundedROICode ActBoundedROICode Type of bounded ROI. true 2 ROIFS fully specified ROI A fully specified bounded Region of Interest (ROI) delineates a ROI in which only those dimensions participate that are specified by boundary criteria, whereas all other dimensions are excluded. For example a ROI to mark an episode of "ST elevation" in a subset of the EKG leads V2, V3, and V4 would include 4 boundaries, one each for time, V2, V3, and V4. false 2 ROIPS partially specified ROI A partially specified bounded Region of Interest (ROI) specifies a ROI in which at least all values in the dimensions specified by the boundary criteria participate. For example, if an episode of ventricular fibrillations (VFib) is observed, it usually doesn't make sense to exclude any EKG leads from the observation and the partially specified ROI would contain only one boundary for time indicating the time interval where VFib was observed. false 1 _ActCareProvisionCode act care provision Description:The type and scope of responsibility taken-on by the performer of the Act for a specific subject of care. true 2 _ActCredentialedCareCode act credentialed care Description:The type and scope of legal and/or professional responsibility taken-on by the performer of the Act for a specific subject of care as described by a credentialing agency, i.e. government or non-government agency. Failure in executing this Act may result in loss of credential to the person or organization who participates as performer of the Act. Excludes employment agreements. Example:Hospital license; physician license; clinic accreditation. true 3 _ActCredentialedCareProvisionPersonCode act credentialed care provision peron Description:The type and scope of legal and/or professional responsibility taken-on by the performer of the Act for a specific subject of care as described by an agency for credentialing individuals. true 4 CACC certified anatomic pathology and clinical pathology care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CAIC certified allergy and immunology care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CAMC certified aerospace medicine care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CANC certified anesthesiology care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CAPC certified anatomic pathology care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CBGC certified clinical biochemical genetics care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CCCC certified clinical cytogenetics care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CCGC certified clinical genetics (M.D.) care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CCPC certified clinical pathology care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CCSC certified colon and rectal surgery care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CDEC certified dermatology care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CDRC certified diagnostic radiology care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CEMC certified emergency medicine care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CFPC certified family practice care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CIMC certified internal medicine care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CMGC certified clinical molecular genetics care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CNEC certified neurology care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board false 4 CNMC certified nuclear medicine care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CNQC certified neurology with special qualifications in child neurology care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CNSC certified neurological surgery care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 COGC certified obstetrics and gynecology care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 COMC certified occupational medicine care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 COPC certified ophthalmology care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 COSC certified orthopaedic surgery care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 COTC certified otolaryngology care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CPEC certified pediatrics care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CPGC certified Ph.D. medical genetics care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CPHC certified public health and general preventive medicine care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CPRC certified physical medicine and rehabilitation care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CPSC certified plastic surgery care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CPYC certified psychiatry care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CROC certified radiation oncology care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CRPC certified radiological physics care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CSUC certified surgery care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CTSC certified thoracic surgery care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CURC certified urology care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 CVSC certified vascular surgery care Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board. false 4 LGPC licensed general physician care Description:Scope of responsibility taken-on for physician care of a patient as defined by a governmental licensing agency. false 3 _ActCredentialedCareProvisionProgramCode act credentialed care provision program Description:The type and scope of legal and/or professional responsibility taken-on by the performer of the Act for a specific subject of care as described by an agency for credentialing programs within organizations. true 4 AALC accredited assisted living care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency. false 4 AAMC accredited ambulatory care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency. false 4 ABHC accredited behavioral health care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency. false 4 ACAC accredited critical access hospital care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency. false 4 ACHC accredited hospital care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency. false 4 AHOC accredited home care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency. false 4 ALTC accredited long term care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency. false 4 AOSC accredited office-based surgery care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency. false 4 CACS certified acute coronary syndrome care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CAMI certified acute myocardial infarction care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CAST certified asthma care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CBAR certified bariatric surgery care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CCAD certified coronary artery disease care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CCAR certified cardiac care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CDEP certified depression care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CDGD certified digestive/gastrointestinal disorders care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CDIA certified diabetes care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CEPI certified epilepsy care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CFEL certified frail elderly care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CHFC certified heart failure care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CHRO certified high risk obstetrics care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CHYP certified hyperlipidemia care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CMIH certified migraine headache care Description:. false 4 CMSC certified multiple sclerosis care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 COJR certified orthopedic joint replacement care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CONC certified oncology care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 COPD certified chronic obstructive pulmonary disease care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CORT certified organ transplant care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CPAD certified parkinsons disease care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CPND certified pneumonia disease care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CPST certified primary stroke center care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CSDM certified stroke disease management care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CSIC certified sickle cell care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CSLD certified sleep disorders care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CSPT certified spine treatment care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CTBU certified trauma/burn center care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CVDC certified vascular diseases care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CWMA certified wound management care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 4 CWOH certified women's health care Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency. false 2 _ActEncounterCode ActEncounterCode Domain provides codes that qualify the ActEncounterClass (ENC) true 3 AMB ambulatory A comprehensive term for health care provided in a healthcare facility (e.g. a practitioneraTMs office, clinic setting, or hospital) on a nonresident basis. The term ambulatory usually implies that the patient has come to the location and is not assigned to a bed. Sometimes referred to as an outpatient encounter. false 3 EMER emergency A patient encounter that takes place at a dedicated healthcare service delivery location where the patient receives immediate evaluation and treatment, provided until the patient can be discharged or responsibility for the patient's care is transferred elsewhere (for example, the patient could be admitted as an inpatient or transferred to another facility.) false 3 FLD field A patient encounter that takes place both outside a dedicated service delivery location and outside a patient's residence. Example locations might include an accident site and at a supermarket. false 3 HH home health Healthcare encounter that takes place in the residence of the patient or a designee false 3 IMP inpatient encounter A patient encounter where a patient is admitted by a hospital or equivalent facility, assigned to a location where patients generally stay at least overnight and provided with room, board, and continuous nursing service. false 4 ACUTE inpatient acute An acute inpatient encounter. false 4 NONAC inpatient non-acute Any category of inpatient encounter except 'acute' false 3 PRENC pre-admission A patient encounter where patient is scheduled or planned to receive service delivery in the future, and the patient is given a pre-admission account number. When the patient comes back for subsequent service, the pre-admission encounter is selected and is encapsulated into the service registration, and a new account number is generated. Usage Note: This is intended to be used in advance of encounter types such as ambulatory, inpatient encounter, virtual, etc. false 3 SS short stay An encounter where the patient is admitted to a health care facility for a predetermined length of time, usually less than 24 hours. false 3 VR virtual A patient encounter where the patient and the practitioner(s) are not in the same physical location. Examples include telephone conference, email exchange, robotic surgery, and televideo conference. false 2 _ActMedicalServiceCode ActMedicalServiceCode General category of medical service provided to the patient during their encounter. true 3 ALC Alternative Level of Care Provision of Alternate Level of Care to a patient in an acute bed. Patient is waiting for placement in a long-term care facility and is unable to return home. false 3 CARD Cardiology Provision of diagnosis and treatment of diseases and disorders affecting the heart false 3 CHR Chronic Provision of recurring care for chronic illness. false 3 DNTL Dental Provision of treatment for oral health and/or dental surgery. false 3 DRGRHB Drug Rehab Provision of treatment for drug abuse. false 3 GENRL General General care performed by a general practitioner or family doctor as a responsible provider for a patient. false 3 MED Medical Provision of diagnostic and/or therapeutic treatment. false 3 OBS Obstetrics Provision of care of women during pregnancy, childbirth and immediate postpartum period. Also known as Maternity. false 3 ONC Oncology Provision of treatment and/or diagnosis related to tumors and/or cancer. false 3 PALL Palliative Provision of care for patients who are living or dying from an advanced illness. false 3 PED Pediatrics Provision of diagnosis and treatment of diseases and disorders affecting children. false 3 PHAR Pharmaceutical Pharmaceutical care performed by a pharmacist. false 3 PHYRHB Physical Rehab Provision of treatment for physical injury. false 3 PSYCH Psychiatric Provision of treatment of psychiatric disorder relating to mental illness. false 3 SURG Surgical Provision of surgical treatment. false 1 _ActClaimAttachmentCategoryCode ActClaimAttachmentCategoryCode Description: Coded types of attachments included to support a healthcare claim. true 2 AUTOATTCH auto attachment Description: Automobile Information Attachment false 2 DOCUMENT document Description: Document Attachment false 2 HEALTHREC health record Description: Health Record Attachment false 2 IMG image attachment Description: Image Attachment false 2 LABRESULTS lab results Description: Lab Results Attachment false 2 MODEL model Description: Digital Model Attachment false 2 WIATTCH work injury report attachment Description: Work Injury related additional Information Attachment false 2 XRAY x-ray Description: Digital X-Ray Attachment false 1 _ActConsentType ActConsentType Definition: The type of consent directive, e.g. to consent or dissent to collect, access, or use in specific ways within an EHRS or for health information exchange; or to disclose health information for purposes such as research. true 2 ICOL information collection Definition: Consent to have healthcare information collected in an electronic health record. This entails that the information may be used in analysis, modified, updated. false 2 IDSCL information disclosure Definition: Consent to have collected healthcare information disclosed. false 2 INFA information access Definition: Consent to access healthcare information. false 3 INFAO access only Definition: Consent to access or "read" only, which entails that the information is not to be copied, screen printed, saved, emailed, stored, re-disclosed or altered in any way. This level ensures that data which is masked or to which access is restricted will not be. Example: Opened and then emailed or screen printed for use outside of the consent directive purpose. false 3 INFASO access and save only Definition: Consent to access and save only, which entails that access to the saved copy will remain locked. false 2 IRDSCL information redisclosure Definition: Information re-disclosed without the patient's consent. false 2 RESEARCH research information access Definition: Consent to have healthcare information in an electronic health record accessed for research purposes. false 3 RSDID de-identified information access Definition: 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. false 3 RSREID re-identifiable information access Definition: 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. Example:: Where there is a need to inform the subject of potential health issues. false 1 _ActContainerRegistrationCode ActContainerRegistrationCode Constrains the ActCode to the domain of Container Registration true 2 ID Identified Used by one system to inform another that it has received a container. false 2 IP In Position Used by one system to inform another that the container is in position for specimen transfer (e.g. container removal from track, pipetting, etc.). false 2 L Left Equipment Used by one system to inform another that the container has been released from that system. false 2 M Missing Used by one system to inform another that the container did not arrive at its next expected location. false 2 O In Process Used by one system to inform another that the specific container is being processed by the equipment. It is useful as a response to a query about Container Status, when the specific step of the process is not relevant. false 2 R Process Completed Status is used by one system to inform another that the processing has been completed, but the container has not been released from that system. false 2 X Container Unavailable Used by one system to inform another that the container is no longer available within the scope of the system (e.g. tube broken or discarded). false 1 _ActControlVariable ActControlVariable An observation form that determines parameters or attributes of an Act. Examples are the settings of a ventilator machine as parameters of a ventilator treatment act; the controls on dillution factors of a chemical analyzer as a parameter of a laboratory observation act; the settings of a physiologic measurement assembly (e.g. time skew) or the position of the body while measuring blood pressure. Control variables are forms of observations because just as with clinical observations, the Observation.code determines the parameter and the Observation.value assigns the value. While control variables sometimes can be observed (by noting the control settings or an actually measured feedback loop) they are not primary observations, in the sense that a control variable without a primary act is of no use (e.g. it makes no sense to record a blood pressure position without recording a blood pressure, whereas it does make sense to record a systolic blood pressure without a diastolic blood pressure). true 2 AUTO auto-repeat permission Specifies whether or not automatic repeat testing is to be initiated on specimens. false 2 ENDC endogenous content A baseline value for the measured test that is inherently contained in the diluent. In the calculation of the actual result for the measured test, this baseline value is normally considered. false 2 REFLEX reflex permission Specifies whether or not further testing may be automatically or manually initiated on specimens. false 1 _ActCoverageConfirmationCode ActCoverageConfirmationCode Response to an insurance coverage eligibility query or authorization request. true 2 _ActCoverageAuthorizationConfirmationCode ActCoverageAuthorizationConfirmationCode Indication of authorization for healthcare service(s) and/or product(s). If authorization is approved, funds are set aside. true 3 AUTH Authorized Authorization approved and funds have been set aside to pay for specified healthcare service(s) and/or product(s) within defined criteria for the authorization. false 3 NAUTH Not Authorized Authorization for specified healthcare service(s) and/or product(s) denied. false 2 _ActCoverageEligibilityConfirmationCode ActCoverageEligibilityConfirmationCode Indication of eligibility coverage for healthcare service(s) and/or product(s). true 3 ELG Eligible Insurance coverage is in effect for healthcare service(s) and/or product(s). false 3 NELG Not Eligible Insurance coverage is not in effect for healthcare service(s) and/or product(s). May optionally include reasons for the ineligibility. false 1 _ActCoverageLimitCode ActCoverageLimitCode Criteria that are applicable to the authorized coverage. true 2 _ActCoverageQuantityLimitCode ActCoverageQuantityLimitCode Maximum amount paid or maximum number of services/products covered; or maximum amount or number covered during a specified time period under the policy or program. true 3 COVPRD coverage period Codes representing the time period during which coverage is available; or financial participation requirements are in effect. false 3 LFEMX life time maximum Definition: Maximum amount paid by payer or covered party; or maximum number of services or products covered under the policy or program during a covered party's lifetime. false 3 NETAMT Net Amount Maximum net amount that will be covered for the product or service specified. false 3 PRDMX period maximum Definition: Maximum amount paid by payer or covered party; or maximum number of services/products covered under the policy or program by time period specified by the effective time on the act. false 3 UNITPRICE Unit Price Maximum unit price that will be covered for the authorized product or service. false 3 UNITQTY Unit Quantity Maximum number of items that will be covered of the product or service specified. false 2 COVMX coverage maximum Definition: Codes representing the maximum coverate or financial participation requirements. false 2 _ActCoveredPartyLimitCode ActCoveredPartyLimitCode Codes representing the types of covered parties that may receive covered benefits under a policy or program. true 1 _ActCoverageTypeCode ActCoverageTypeCode Definition: Set of codes indicating the type of insurance policy or program that pays for the cost of benefits provided to covered parties. true 2 _ActInsurancePolicyCode ActInsurancePolicyCode Set of codes indicating the type of insurance policy or other source of funds to cover healthcare costs. true 3 EHCPOL extended healthcare Private insurance policy that provides coverage in addition to other policies (e.g. in addition to a Public Healthcare insurance policy). false 3 HSAPOL health spending account Insurance policy that provides for an allotment of funds replenished on a periodic (e.g. annual) basis. The use of the funds under this policy is at the discretion of the covered party. false 3 AUTOPOL automobile Insurance policy for injuries sustained in an automobile accident. Will also typically covered non-named parties to the policy, such as pedestrians and passengers. false 4 COL collision coverage policy Definition: An automobile insurance policy under which the insurance company will cover the cost of damages to an automobile owned by the named insured that are caused by accident or intentionally by another party. false 4 UNINSMOT uninsured motorist policy Definition: An automobile insurance policy under which the insurance company will indemnify a loss for which another motorist is liable if that motorist is unable to pay because he or she is uninsured. Coverage under the policy applies to bodily injury damages only. Injuries to the covered party caused by a hit-and-run driver are also covered. false 3 PUBLICPOL public healthcare Insurance policy funded by a public health system such as a provincial or national health plan. Examples include BC MSP (British Columbia Medical Services Plan) OHIP (Ontario Health Insurance Plan), NHS (National Health Service). false 4 DENTPRG dental program Definition: A public or government health program that administers and funds coverage for dental care to assist program eligible who meet financial and health status criteria. false 4 DISEASEPRG public health program Definition: A public or government health program that administers and funds coverage for health and social services to assist program eligible who meet financial and health status criteria related to a particular disease. Example: Reproductive health, sexually transmitted disease, and end renal disease programs. false 5 CANPRG women's cancer detection program Definition: A program that provides low-income, uninsured, and underserved women access to timely, high-quality screening and diagnostic services, to detect breast and cervical cancer at the earliest stages. Example: To improve women's access to screening for breast and cervical cancers, Congress passed the Breast and Cervical Cancer Mortality Prevention Act of 1990, which guided CDC in creating the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), which provides access to critical breast and cervical cancer screening services for underserved women in the United States. An estimated 7 to 10% of U.S. women of screening age are eligible to receive NBCCEDP services. Federal guidelines establish an eligibility baseline to direct services to uninsured and underinsured women at or below 250% of federal poverty level; ages 18 to 64 for cervical screening; ages 40 to 64 for breast screening. false 5 ENDRENAL end renal program Definition: A public or government program that administers publicly funded coverage of kidney dialysis and kidney transplant services. Example: In the U.S., the Medicare End-stage Renal Disease program (ESRD), the National Kidney Foundation (NKF) American Kidney Fund (AKF) The Organ Transplant Fund. false 5 HIVAIDS HIV-AIDS program Definition: Government administered and funded HIV-AIDS program for beneficiaries meeting financial and health status criteria. Administration, funding levels, eligibility criteria, covered benefits, provider types, and financial participation are typically set by a regulatory process. Payer responsibilities for administering the program may be delegated to contractors. Example: In the U.S., the Ryan White program, which is administered by the Health Resources and Services Administration. false 4 MANDPOL mandatory health program mandatory health program false 4 MENTPRG mental health program Definition: Government administered and funded mental health program for beneficiaries meeting financial and mental health status criteria. Administration, funding levels, eligibility criteria, covered benefits, provider types, and financial participation are typically set by a regulatory process. Payer responsibilities for administering the program may be delegated to contractors. Example: In the U.S., states receive funding for substance use programs from the Substance Abuse Mental Health Administration (SAMHSA). false 4 SAFNET safety net clinic program Definition: Government administered and funded program to support provision of care to underserved populations through safety net clinics. Example: In the U.S., safety net providers such as federally qualified health centers (FQHC) receive funding under PHSA Section 330 grants administered by the Health Resources and Services Administration. false 4 SUBPRG substance use program Definition: Government administered and funded substance use program for beneficiaries meeting financial, substance use behavior, and health status criteria. Beneficiaries may be required to enroll as a result of legal proceedings. Administration, funding levels, eligibility criteria, covered benefits, provider types, and financial participation are typically set by a regulatory process. Payer responsibilities for administering the program may be delegated to contractors. Example: In the U.S., states receive funding for substance use programs from the Substance Abuse Mental Health Administration (SAMHSA). false 4 SUBSIDIZ subsidized health program Definition: A government health program that provides coverage for health services to persons meeting eligibility criteria such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds. false 5 SUBSIDMC subsidized managed care program Definition: A government health program that provides coverage through managed care contracts for health services to persons meeting eligibility criteria such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds. Discussion: The structure and business processes for underwriting and administering a subsidized managed care program is further specified by the Underwriter and Payer Role.class and Role.code. false 5 SUBSUPP subsidized supplemental health program Definition: A government health program that provides coverage for health services to persons meeting eligibility criteria for a supplemental health policy or program such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds. Example: Supplemental health coverage program may cover the cost of a health program or policy financial participations, such as the copays and the premiums, and may provide coverage for services in addition to those covered under the supplemented health program or policy. In the U.S., Medicaid programs may pay the premium for a covered party who is also covered under the Medicare program or a private health policy. Discussion: The structure and business processes for underwriting and administering a subsidized supplemental retiree health program is further specified by the Underwriter and Payer Role.class and Role.code. false 3 WCBPOL worker's compensation Insurance policy for injuries sustained in the work place or in the course of employment. false 2 _ActInsuranceTypeCode ActInsuranceTypeCode Definition: Set of codes indicating the type of insurance policy. Insurance, in law and economics, is a form of risk management primarily used to hedge against the risk of potential financial loss. Insurance is defined as the equitable transfer of the risk of a potential loss, from one entity to another, in exchange for a premium and duty of care. A policy holder is an individual or an organization enters into a contract with an underwriter which stipulates that, in exchange for payment of a sum of money (a premium), one or more covered parties (insureds) is guaranteed compensation for losses resulting from certain perils under specified conditions. The underwriter analyzes the risk of loss, makes a decision as to whether the risk is insurable, and prices the premium accordingly. A policy provides benefits that indemnify or cover the cost of a loss incurred by a covered party, and may include coverage for services required to remediate a loss. An insurance policy contains pertinent facts about the policy holder, the insurance coverage, the covered parties, and the insurer. A policy may include exemptions and provisions specifying the extent to which the indemnification clause cannot be enforced for intentional tortious conduct of a covered party, e.g. whether the covered parties are jointly or severably insured. Discussion: In contrast to programs, an insurance policy has one or more policy holders, who own the policy. The policy holder may be the covered party, a relative of the covered party, a partnership, or a corporation, e.g. an employer. A subscriber of a self-insured health insurance policy is a policy holder. A subscriber of an employer sponsored health insurance policy is holds a certificate of coverage, but is not a policy holder; the policy holder is the employer. See CoveredRoleType. true 3 _ActHealthInsuranceTypeCode ActHealthInsuranceTypeCode Definition: Set of codes indicating the type of health insurance policy that covers health services provided to covered parties. A health insurance policy is a written contract for insurance between the insurance company and the policyholder, and contains pertinent facts about the policy owner (the policy holder), the health insurance coverage, the insured subscribers and dependents, and the insurer. Health insurance is typically administered in accordance with a plan, which specifies (1) the type of health services and health conditions that will be covered under what circumstances (e.g. exclusion of a pre-existing condition, service must be deemed medically necessary; service must not be experimental; service must provided in accordance with a protocol; drug must be on a formulary; service must be prior authorized; or be a referral from a primary care provider); (2) the type and affiliation of providers (e.g. only allopathic physicians, only in network, only providers employed by an HMO); (3) financial participations required of covered parties (e.g. co-pays, coinsurance, deductibles, out-of-pocket); and (4) the manner in which services will be paid (e.g. under indemnity or fee-for-service health plans, the covered party typically pays out-of-pocket and then file a claim for reimbursement, while health plans that have contractual relationships with providers, i.e., network providers, typically do not allow the providers to bill the covered party for the cost of the service until after filing a claim with the payer and receiving reimbursement). true 4 DENTAL dental care policy Definition: A health insurance policy that that covers benefits for dental services. false 4 DISEASE disease specific policy Definition: A health insurance policy that covers benefits for healthcare services provided for named conditions under the policy, e.g. cancer, diabetes, or HIV-AIDS. false 4 DRUGPOL drug policy Definition: A health insurance policy that covers benefits for prescription drugs, pharmaceuticals, and supplies. false 4 HIP health insurance plan policy Definition: A health insurance policy that covers healthcare benefits by protecting covered parties from medical expenses arising from health conditions, sickness, or accidental injury as well as preventive care. Health insurance policies explicitly exclude coverage for losses insured under a disability policy, workers' compensation program, liability insurance (including automobile insurance); or for medical expenses, coverage for on-site medical clinics or for limited dental or vision benefits when these are provided under a separate policy. Discussion: Health insurance policies are offered by health insurance plans that typically reimburse providers for covered services on a fee-for-service basis, that is, a fee that is the allowable amount that a provider may charge. This is in contrast to managed care plans, which typically prepay providers a per-member/per-month amount or capitation as reimbursement for all covered services rendered. Health insurance plans include indemnity and healthcare services plans. false 4 LTC long term care policy Definition: An insurance policy that covers benefits for long-term care services people need when they no longer can care for themselves. This may be due to an accident, disability, prolonged illness or the simple process of aging. Long-term care services assist with activities of daily living including: Help at home with day-to-day activities, such as cooking, cleaning, bathing and dressing Care in the community, such as in an adult day care facility Supervised care provided in an assisted living facility Skilled care provided in a nursing home false 4 MCPOL managed care policy Definition: Government mandated program providing coverage, disability income, and vocational rehabilitation for injuries sustained in the work place or in the course of employment. Employers may either self-fund the program, purchase commercial coverage, or pay a premium to a government entity that administers the program. Employees may be required to pay premiums toward the cost of coverage as well. Managed care policies specifically exclude coverage for losses insured under a disability policy, workers' compensation program, liability insurance (including automobile insurance); or for medical expenses, coverage for on-site medical clinics or for limited dental or vision benefits when these are provided under a separate policy. Discussion: Managed care policies are offered by managed care plans that contract with selected providers or health care organizations to provide comprehensive health care at a discount to covered parties and coordinate the financing and delivery of health care. Managed care uses medical protocols and procedures agreed on by the medical profession to be cost effective, also known as medical practice guidelines. Providers are typically reimbursed for covered services by a capitated amount on a per member per month basis that may reflect difference in the health status and level of services anticipated to be needed by the member. false 5 POS point of service policy Definition: A policy for a health plan that has features of both an HMO and a FFS plan. Like an HMO, a POS plan encourages the use its HMO network to maintain discounted fees with participating providers, but recognizes that sometimes covered parties want to choose their own provider. The POS plan allows a covered party to use providers who are not part of the HMO network (non-participating providers). However, there is a greater cost associated with choosing these non-network providers. A covered party will usually pay deductibles and coinsurances that are substantially higher than the payments when he or she uses a plan provider. Use of non-participating providers often requires the covered party to pay the provider directly and then to file a claim for reimbursement, like in an FFS plan. false 5 HMO health maintenance organization policy Definition: A policy for a health plan that provides coverage for health care only through contracted or employed physicians and hospitals located in particular geographic or service areas. HMOs emphasize prevention and early detection of illness. Eligibility to enroll in an HMO is determined by where a covered party lives or works. false 5 PPO preferred provider organization policy Definition: A network-based, managed care plan that allows a covered party to choose any health care provider. However, if care is received from a "preferred" (participating in-network) provider, there are generally higher benefit coverage and lower deductibles. false 4 MENTPOL mental health policy Definition: A health insurance policy that covers benefits for mental health services and prescriptions. false 4 SUBPOL substance use policy Definition: A health insurance policy that covers benefits for substance use services. false 4 VISPOL vision care policy Definition: Set of codes for a policy that provides coverage for health care expenses arising from vision services. A health insurance policy that covers benefits for vision care services, prescriptions, and products. false 3 DIS disability insurance policy Definition: An insurance policy that provides a regular payment to compensate for income lost due to the covered party's inability to work because of illness or injury. false 3 EWB employee welfare benefit plan policy Definition: An insurance policy under a benefit plan run by an employer or employee organization for the purpose of providing benefits other than pension-related to employees and their families. Typically provides health-related benefits, benefits for disability, disease or unemployment, or day care and scholarship benefits, among others. An employer sponsored health policy includes coverage of health care expenses arising from sickness or accidental injury, coverage for on-site medical clinics or for dental or vision benefits, which are typically provided under a separate policy. Coverage excludes health care expenses covered by accident or disability, workers' compensation, liability or automobile insurance. false 3 FLEXP flexible benefit plan policy Definition: An insurance policy that covers qualified benefits under a Flexible Benefit plan such as group medical insurance, long and short term disability income insurance, group term life insurance for employees only up to $50,000 face amount, specified disease coverage such as a cancer policy, dental and/or vision insurance, hospital indemnity insurance, accidental death and dismemberment insurance, a medical expense reimbursement plan and a dependent care reimbursement plan. Discussion: See UnderwriterRoleTypeCode flexible benefit plan which is defined as a benefit plan that allows employees to choose from several life, health, disability, dental, and other insurance plans according to their individual needs. Also known as cafeteria plans. Authorized under Section 125 of the Revenue Act of 1978. false 3 LIFE life insurance policy Definition: A policy under which the insurer agrees to pay a sum of money upon the occurrence of the covered partys death. In return, the policyholder agrees to pay a stipulated amount called a premium at regular intervals. Life insurance indemnifies the beneficiary for the loss of the insurable interest that a beneficiary has in the life of a covered party. For persons related by blood, a substantial interest established through love and affection, and for all other persons, a lawful and substantial economic interest in having the life of the insured continue. An insurable interest is required when purchasing life insurance on another person. Specific exclusions are often written into the contract to limit the liability of the insurer; for example claims resulting from suicide or relating to war, riot and civil commotion. Discussion:A life insurance policy may be used by the covered party as a source of health care coverage in the case of a viatical settlement, which is the sale of a life insurance policy by the policy owner, before the policy matures. Such a sale, at a price discounted from the face amount of the policy but usually in excess of the premiums paid or current cash surrender value, provides the seller an immediate cash settlement. Generally, viatical settlements involve insured individuals with a life expectancy of less than two years. In countries without state-subsidized healthcare and high healthcare costs (e.g. United States), this is a practical way to pay extremely high health insurance premiums that severely ill people face. Some people are also familiar with life settlements, which are similar transactions but involve insureds with longer life expectancies (two to fifteen years). false 4 ANNU annuity policy Definition: A policy that, after an initial premium or premiums, pays out a sum at pre-determined intervals. For example, a policy holder may pay $10,000, and in return receive $150 each month until he dies; or $1,000 for each of 14 years or death benefits if he dies before the full term of the annuity has elapsed. false 4 TLIFE term life insurance policy Definition: Life insurance under which the benefit is payable only if the insured dies during a specified period. If an insured dies during that period, the beneficiary receives the death payments. If the insured survives, the policy ends and the beneficiary receives nothing. false 4 ULIFE universal life insurance policy Definition: Life insurance under which the benefit is payable upon the insuredaTMs death or diagnosis of a terminal illness. If an insured dies during that period, the beneficiary receives the death payments. If the insured survives, the policy ends and the beneficiary receives nothing false 3 PNC property and casualty insurance policy Definition: A type of insurance that covers damage to or loss of the policyholderaTMs property by providing payments for damages to property damage or the injury or death of living subjects. The terms "casualty" and "liability" insurance are often used interchangeably. Both cover the policyholder's legal liability for damages caused to other persons and/or their property. false 3 REI reinsurance policy Definition: An agreement between two or more insurance companies by which the risk of loss is proportioned. Thus the risk of loss is spread and a disproportionately large loss under a single policy does not fall on one insurance company. Acceptance by an insurer, called a reinsurer, of all or part of the risk of loss of another insurance company. Discussion: Reinsurance is a means by which an insurance company can protect itself against the risk of losses with other insurance companies. Individuals and corporations obtain insurance policies to provide protection for various risks (hurricanes, earthquakes, lawsuits, collisions, sickness and death, etc.). Reinsurers, in turn, provide insurance to insurance companies. For example, an HMO may purchase a reinsurance policy to protect itself from losing too much money from one insured's particularly expensive health care costs. An insurance company issuing an automobile liability policy, with a limit of $100,000 per accident may reinsure its liability in excess of $10,000. A fire insurance company which issues a large policy generally reinsures a portion of the risk with one or several other companies. Also called risk control insurance or stop-loss insurance. false 3 SURPL surplus line insurance policy Definition: A risk or part of a risk for which there is no normal insurance market available. Insurance written by unauthorized insurance companies. Surplus lines insurance is insurance placed with unauthorized insurance companies through licensed surplus lines agents or brokers. false 3 UMBRL umbrella liability insurance policy Definition: A form of insurance protection that provides additional liability coverage after the limits of your underlying policy are reached. An umbrella liability policy also protects you (the insured) in many situations not covered by the usual liability policies. false 2 _ActProgramTypeCode ActProgramTypeCode Definition: A set of codes used to indicate coverage under a program. A program is an organized structure for administering and funding coverage of a benefit package for covered parties meeting eligibility criteria, typically related to employment, health, financial, and demographic status. Programs are typically established or permitted by legislation with provisions for ongoing government oversight. Regulations may mandate the structure of the program, the manner in which it is funded and administered, covered benefits, provider types, eligibility criteria and financial participation. A government agency may be charged with implementing the program in accordance to the regulation. Risk of loss under a program in most cases would not meet what an underwriter would consider an insurable risk, i.e., the risk is not random in nature, not financially measurable, and likely requires subsidization with government funds. Discussion: Programs do not have policy holders or subscribers. Program eligibles are enrolled based on health status, statutory eligibility, financial status, or age. Program eligibles who are covered parties under the program may be referred to as members, beneficiaries, eligibles, or recipients. Programs risk are underwritten by not for profit organizations such as governmental entities, and the beneficiaries typically do not pay for any or some portion of the cost of coverage. See CoveredPartyRoleType. true 3 CHAR charity program Definition: A program that covers the cost of services provided directly to a beneficiary who typically has no other source of coverage without charge. false 3 CRIME crime victim program Definition: A program that covers the cost of services provided to crime victims for injuries or losses related to the occurrence of a crime. false 3 EAP employee assistance program Definition: An employee assistance program is run by an employer or employee organization for the purpose of providing benefits and covering all or part of the cost for employees to receive counseling, referrals, and advice in dealing with stressful issues in their lives. These may include substance abuse, bereavement, marital problems, weight issues, or general wellness issues. The services are usually provided by a third-party, rather than the company itself, and the company receives only summary statistical data from the service provider. Employee's names and services received are kept confidential. false 3 GOVEMP government employee health program Definition: A set of codes used to indicate a government program that is an organized structure for administering and funding coverage of a benefit package for covered parties meeting eligibility criteria, typically related to employment, health and financial status. Government programs are established or permitted by legislation with provisions for ongoing government oversight. Regulation mandates the structure of the program, the manner in which it is funded and administered, covered benefits, provider types, eligibility criteria and financial participation. A government agency is charged with implementing the program in accordance to the regulation Example: Federal employee health benefit program in the U.S. false 3 HIRISK high risk pool program Definition: A government program that provides health coverage to individuals who are considered medically uninsurable or high risk, and who have been denied health insurance due to a serious health condition. In certain cases, it also applies to those who have been quoted very high premiums a" again, due to a serious health condition. The pool charges premiums for coverage. Because the pool covers high-risk people, it incurs a higher level of claims than premiums can cover. The insurance industry pays into the pool to make up the difference and help it remain viable. false 3 IND indigenous peoples health program Definition: Services provided directly and through contracted and operated indigenous peoples health programs. Example: Indian Health Service in the U.S. false 3 MILITARY military health program Definition: A government program that provides coverage for health services to military personnel, retirees, and dependents. A covered party who is a subscriber can choose from among Fee-for-Service (FFS) plans, and their Preferred Provider Organizations (PPO), or Plans offering a Point of Service (POS) Product, or Health Maintenance Organizations. Example: In the U.S., TRICARE, CHAMPUS. false 3 RETIRE retiree health program Definition: A government mandated program with specific eligibility requirements based on premium contributions made during employment, length of employment, age, and employment status, e.g. being retired, disabled, or a dependent of a covered party under this program. Benefits typically include ambulatory, inpatient, and long-term care, such as hospice care, home health care and respite care. false 3 SOCIAL social service program Definition: A social service program funded by a public or governmental entity. Example: Programs providing habilitation, food, lodging, medicine, transportation, equipment, devices, products, education, training, counseling, alteration of living or work space, and other resources to persons meeting eligibility criteria. false 3 VET veteran health program Definition: Services provided directly and through contracted and operated veteran health programs. false 1 _ActDetectedIssueManagementCode ActDetectedIssueManagementCode Codes dealing with the management of Detected Issue observations true 2 _ActAdministrativeDetectedIssueManagementCode ActAdministrativeDetectedIssueManagementCode Codes dealing with the management of Detected Issue observations for the administrative and patient administrative acts domains. true 3 _AuthorizationIssueManagementCode Authorization Issue Management Code Authorization Issue Management Code true 4 EMAUTH emergency authorization override Used to temporarily override normal authorization rules to gain access to data in a case of emergency. Use of this override code will typically be monitored, and a procedure to verify its proper use may be triggered when used. false 5 21 authorization confirmed Description: Indicates that the permissions have been externally verified and the request should be processed. false 2 1 Therapy Appropriate Confirmed drug therapy appropriate false 3 19 Consulted Supplier Consulted other supplier/pharmacy, therapy confirmed false 3 2 Assessed Patient Assessed patient, therapy is appropriate false 3 22 appropriate indication or diagnosis Description: The patient has the appropriate indication or diagnosis for the action to be taken. false 3 23 prior therapy documented Description: It has been confirmed that the appropriate pre-requisite therapy has been tried. false 3 3 Patient Explanation Patient gave adequate explanation false 3 4 Consulted Other Source Consulted other supply source, therapy still appropriate false 3 5 Consulted Prescriber Consulted prescriber, therapy confirmed false 4 6 Prescriber Declined Change Consulted prescriber and recommended change, prescriber declined false 3 7 Interacting Therapy No Longer Active/Planned Concurrent therapy triggering alert is no longer on-going or planned false 2 14 Supply Appropriate Confirmed supply action appropriate false 3 15 Replacement Patient's existing supply was lost/wasted false 3 16 Vacation Supply Supply date is due to patient vacation false 3 17 Weekend Supply Supply date is intended to carry patient over weekend false 3 18 Leave of Absence Supply is intended for use during a leave of absence from an institution. false 3 20 additional quantity on separate dispense Description: Supply is different than expected as an additional quantity has been supplied in a separate dispense. false 2 8 Other Action Taken Order is performed as issued, but other action taken to mitigate potential adverse effects false 3 10 Provided Patient Education Provided education or training to the patient on appropriate therapy use false 3 11 Added Concurrent Therapy Instituted an additional therapy to mitigate potential negative effects false 3 12 Temporarily Suspended Concurrent Therapy Suspended existing therapy that triggered interaction for the duration of this therapy false 3 13 Stopped Concurrent Therapy Aborted existing therapy that triggered interaction. false 3 9 Instituted Ongoing Monitoring Program Arranged to monitor patient for adverse effects false 1 _ActExposureCode ActExposureCode Concepts that identify the type or nature of exposure interaction. Examples include "household", "care giver", "intimate partner", "common space", "common substance", etc. to further describe the nature of interaction. true 2 CHLDCARE Day care - Child care Interaction Description: Exposure participants' interaction occurred in a child care setting false 2 CONVEYNC Common Conveyance Interaction Description: An interaction where the exposure participants traveled in/on the same vehicle (not necessarily concurrently, e.g. both are passengers of the same plane, but on different flights of that plane). false 2 HLTHCARE Health Care Interaction - Not Patient Care Description: Exposure participants' interaction occurred during the course of health care delivery or in a health care delivery setting, but did not involve the direct provision of care (e.g. a janitor cleaning a patient's hospital room). false 2 HOMECARE Care Giver Interaction Description: Exposure interaction occurred in context of one providing care for the other, i.e. a babysitter providing care for a child, a home-care aide providing assistance to a paraplegic. false 2 HOSPPTNT Hospital Patient Interaction Description: Exposure participants' interaction occurred when both were patients being treated in the same (acute) health care delivery facility. false 2 HOSPVSTR Hospital Visitor Interaction Description: Exposure participants' interaction occurred when one visited the other who was a patient being treated in a health care delivery facility. false 2 HOUSEHLD Household Interaction Description: Exposure interaction occurred in context of domestic interaction, i.e. both participants reside in the same household. false 2 INMATE Inmate Interaction Description: Exposure participants' interaction occurred in the course of one or both participants being incarcerated at a correctional facility false 2 INTIMATE Intimate Interaction Description: Exposure interaction was intimate, i.e. participants are intimate companions (e.g. spouses, domestic partners). false 2 LTRMCARE Long Term Care Facility Interaction Description: Exposure participants' interaction occurred in the course of one or both participants being resident at a long term care facility (second participant may be a visitor, worker, resident or a physical place or object within the facility). false 2 PLACE Common Space Interaction Description: An interaction where the exposure participants were both present in the same location/place/space. false 2 PTNTCARE Health Care Interaction - Patient Care Description: Exposure participants' interaction occurred during the course of health care delivery by a provider (e.g. a physician treating a patient in her office). false 2 SCHOOL2 School Interaction Description: Exposure participants' interaction occurred in an academic setting (e.g. participants are fellow students, or student and teacher). false 2 SOCIAL2 Social/Extended Family Interaction Description: An interaction where the exposure participants are social associates or members of the same extended family false 2 SUBSTNCE Common Substance Interaction Description: An interaction where the exposure participants shared or co-used a common substance (e.g. drugs, needles, or common food item). false 2 TRAVINT Common Travel Interaction Description: An interaction where the exposure participants traveled together in/on the same vehicle/trip (e.g. concurrent co-passengers). false 2 WORK2 Work Interaction Description: Exposure interaction occurred in a work setting, i.e. participants are co-workers. false 1 _ActFinancialTransactionCode ActFinancialTransactionCode ActFinancialTransactionCode true 2 CHRG Standard Charge A type of transaction that represents a charge for a service or product. Expressed in monetary terms. false 2 REV Standard Charge Reversal A type of transaction that represents a reversal of a previous charge for a service or product. Expressed in monetary terms. It has the opposite effect of a standard charge. false 1 _ActIncidentCode ActIncidentCode Set of codes indicating the type of incident or accident. true 2 MVA Motor vehicle accident Incident or accident as the result of a motor vehicle accident false 2 SCHOOL School Accident Incident or accident is the result of a school place accident. false 2 SPT Sporting Accident Incident or accident is the result of a sporting accident. false 2 WPA Workplace accident Incident or accident is the result of a work place accident false 1 _ActInformationAccessCode ActInformationAccessCode Description: The type of health information to which the subject of the information or the subject's delegate consents or dissents. true 2 ACADR adverse drug reaction access Description: Provide consent to collect, use, disclose, or access adverse drug reaction information for a patient. false 2 ACALL all access Description: Provide consent to collect, use, disclose, or access all information for a patient. false 2 ACALLG allergy access Description: Provide consent to collect, use, disclose, or access allergy information for a patient. false 2 ACCONS informational consent access Description: Provide consent to collect, use, disclose, or access informational consent information for a patient. false 2 ACDEMO demographics access Description: Provide consent to collect, use, disclose, or access demographics information for a patient. false 2 ACDI diagnostic imaging access Description: Provide consent to collect, use, disclose, or access diagnostic imaging information for a patient. false 2 ACIMMUN immunization access Description: Provide consent to collect, use, disclose, or access immunization information for a patient. false 2 ACLAB lab test result access Description: Provide consent to collect, use, disclose, or access lab test result information for a patient. false 2 ACMED medication access Description: Provide consent to collect, use, disclose, or access medical condition information for a patient. false 2 ACMEDC medical condition access Definition: Provide consent to view or access medical condition information for a patient. false 2 ACMEN mental health access Description:Provide consent to collect, use, disclose, or access mental health information for a patient. false 2 ACOBS common observations access Description: Provide consent to collect, use, disclose, or access common observation information for a patient. false 2 ACPOLPRG policy or program information access Description: Provide consent to collect, use, disclose, or access coverage policy or program for a patient. false 2 ACPROV provider information access Description: Provide consent to collect, use, disclose, or access provider information for a patient. false 2 ACPSERV professional service access Description: Provide consent to collect, use, disclose, or access professional service information for a patient. false 2 ACSUBSTAB substance abuse access Description:Provide consent to collect, use, disclose, or access substance abuse information for a patient. false 1 _ActInformationAccessContextCode ActInformationAccessContextCode Concepts conveying the context in which consent to transfer specified patient health information for collection, access, use or disclosure applies. true 2 INFAUT authorized information transfer Description: Information transfer in accordance with subjectaTMs consent directive. false 2 INFCON after explicit consent Consent to collect, access, use, or disclose specified patient health information only after explicit consent. false 2 INFCRT only on court order Description: Information transfer in accordance with judicial system protocol. false 2 INFDNG only if danger to others Consent to collect, access, use, or disclose specified patient health information only if necessary to avert potential danger to other persons. false 2 INFEMER only in an emergency Description: Information transfer in accordance with emergency information transfer protocol. false 2 INFPWR only if public welfare risk Consent to collect, access, use, or disclose specified patient health information only if necessary to avert potential public welfare risk. false 2 INFREG regulatory information transfer Description: Information transfer in accordance with regulatory protocol, e.g. for public health, welfare, and safety. false 1 _ActInformationCategoryCode ActInformationCategoryCode Definition:Indicates the set of information types which may be manipulated or referenced, such as for recommending access restrictions. true 2 ALLCAT all categories Description: All patient information. false 2 ALLGCAT allergy category Definition:All information pertaining to a patient's allergy and intolerance records. false 2 ARCAT adverse drug reaction category Description: All information pertaining to a patient's adverse drug reactions. false 2 COBSCAT common observation category Definition:All information pertaining to a patient's common observation records (height, weight, blood pressure, temperature, etc.). false 2 DEMOCAT demographics category Definition:All information pertaining to a patient's demographics (such as name, date of birth, gender, address, etc.). false 2 DICAT diagnostic image category Definition:All information pertaining to a patient's diagnostic image records (orders & results). false 2 IMMUCAT immunization category Definition:All information pertaining to a patient's vaccination records. false 2 LABCAT lab test category Description: All information pertaining to a patient's lab test records (orders & results) false 2 MEDCCAT medical condition category Definition:All information pertaining to a patient's medical condition records. false 2 MENCAT mental health category Description: All information pertaining to a patient's mental health records. false 2 PSVCCAT professional service category Definition:All information pertaining to a patient's professional service records (such as smoking cessation, counseling, medication review, mental health). false 2 RXCAT medication category Definition:All information pertaining to a patient's medication records (orders, dispenses and other active medications). false 1 _ActInvoiceElementCode ActInvoiceElementCode Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results. true 2 _ActInvoiceAdjudicationPaymentCode ActInvoiceAdjudicationPaymentCode Codes representing a grouping of invoice elements (totals, sub-totals), reported through a Payment Advice or a Statement of Financial Activity (SOFA). The code can represent summaries by day, location, payee and other cost elements such as bonus, retroactive adjustment and transaction fees. true 3 _ActInvoiceAdjudicationPaymentGroupCode ActInvoiceAdjudicationPaymentGroupCode Codes representing adjustments to a Payment Advice such as retroactive, clawback, garnishee, etc. true 4 ALEC alternate electronic Payment initiated by the payor as the result of adjudicating a submitted invoice that arrived to the payor from an electronic source that did not provide a conformant set of HL7 messages (e.g. web claim submission). false 4 BONUS bonus Bonus payments based on performance, volume, etc. as agreed to by the payor. false 4 CFWD carry forward adjusment An amount still owing to the payor but the payment is 0$ and this cannot be settled until a future payment is made. false 4 EDU education fees Fees deducted on behalf of a payee for tuition and continuing education. false 4 EPYMT early payment fee Fees deducted on behalf of a payee for charges based on a shorter payment frequency (i.e. next day versus biweekly payments. false 4 GARN garnishee Fees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee. false 4 INVOICE submitted invoice Payment is based on a payment intent for a previously submitted Invoice, based on formal adjudication results.. false 4 PINV paper invoice Payment initiated by the payor as the result of adjudicating a paper (original, may have been faxed) invoice. false 4 PPRD prior period adjustment An amount that was owed to the payor as indicated, by a carry forward adjusment, in a previous payment advice false 4 PROA professional association deduction Professional association fee that is collected by the payor from the practitioner/provider on behalf of the association false 4 RECOV recovery Retroactive adjustment such as fee rate adjustment due to contract negotiations. false 4 RETRO retro adjustment Bonus payments based on performance, volume, etc. as agreed to by the payor. false 4 TRAN transaction fee Fees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee. false 3 _ActInvoiceAdjudicationPaymentSummaryCode ActInvoiceAdjudicationPaymentSummaryCode Codes representing a grouping of invoice elements (totals, sub-totals), reported through a Payment Advice or a Statement of Financial Activity (SOFA). The code can represent summaries by day, location, payee, etc. true 4 INVTYPE invoice type Transaction counts and value totals by invoice type (e.g. RXDINV - Pharmacy Dispense) false 4 PAYEE payee Transaction counts and value totals by each instance of an invoice payee. false 4 PAYOR payor Transaction counts and value totals by each instance of an invoice payor. false 4 SENDAPP sending application Transaction counts and value totals by each instance of a messaging application on a single processor. It is a registered identifier known to the receivers. false 2 _ActInvoiceDetailCode ActInvoiceDetailCode Codes representing a service or product that is being invoiced (billed). The code can represent such concepts as "office visit", "drug X", "wheelchair" and other billable items such as taxes, service charges and discounts. true 3 _ActInvoiceDetailClinicalProductCode ActInvoiceDetailClinicalProductCode An identifying data string for healthcare products. true 4 UNSPSC United Nations Standard Products and Services Classification Description:United Nations Standard Products and Services Classification, managed by Uniform Code Council (UCC): www.unspsc.org false 3 _ActInvoiceDetailDrugProductCode ActInvoiceDetailDrugProductCode An identifying data string for A substance used as a medication or in the preparation of medication. true 4 GTIN Global Trade Item Number Description:Global Trade Item Number is an identifier for trade items developed by GS1 (comprising the former EAN International and Uniform Code Council). false 4 UPC Universal Product Code Description:Universal Product Code is one of a wide variety of bar code languages widely used in the United States and Canada for items in stores. false 3 _ActInvoiceDetailGenericCode ActInvoiceDetailGenericCode The detail item codes to identify charges or changes to the total billing of a claim due to insurance rules and payments. true 4 _ActInvoiceDetailGenericAdjudicatorCode ActInvoiceDetailGenericAdjudicatorCode The billable item codes to identify adjudicator specified components to the total billing of a claim. true 5 COIN coinsurance That portion of the eligible charges which a covered party must pay for each service and/or product. It is a percentage of the eligible amount for the service/product that is typically charged after the covered party has met the policy deductible. This amount represents the covered party's coinsurance that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results. false 5 COPAYMENT patient co-pay That portion of the eligible charges which a covered party must pay for each service and/or product. It is a defined amount per service/product of the eligible amount for the service/product. This amount represents the covered party's copayment that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results. false 5 DEDUCTIBLE deductible That portion of the eligible charges which a covered party must pay in a particular period (e.g. annual) before the benefits are payable by the adjudicator. This amount represents the covered party's deductible that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results. false 5 PAY payment The guarantor, who may be the patient, pays the entire charge for a service. Reasons for such action may include: there is no insurance coverage for the service (e.g. cosmetic surgery); the patient wishes to self-pay for the service; or the insurer denies payment for the service due to contractual provisions such as the need for prior authorization. false 5 SPEND spend down That total amount of the eligible charges which a covered party must periodically pay for services and/or products prior to the Medicaid program providing any coverage. This amount represents the covered party's spend down that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results false 5 COINS co-insurance The covered party pays a percentage of the cost of covered services. false 4 _ActInvoiceDetailGenericModifierCode ActInvoiceDetailGenericModifierCode The billable item codes to identify modifications to a billable item charge. As for example after hours increase in the office visit fee. true 5 AFTHRS non-normal hours Premium paid on service fees in compensation for practicing outside of normal working hours. false 5 ISOL isolation allowance Premium paid on service fees in compensation for practicing in a remote location. false 5 OOO out of office Premium paid on service fees in compensation for practicing at a location other than normal working location. false 4 _ActInvoiceDetailGenericProviderCode ActInvoiceDetailGenericProviderCode The billable item codes to identify provider supplied charges or changes to the total billing of a claim. true 5 CANCAPT cancelled appointment A charge to compensate the provider when a patient cancels an appointment with insufficient time for the provider to make another appointment with another patient. false 5 DSC discount A reduction in the amount charged as a percentage of the amount. For example a 5% discount for volume purchase. false 5 ESA extraordinary service assessment A premium on a service fee is requested because, due to extenuating circumstances, the service took an extraordinary amount of time or supplies. false 5 FFSTOP fee for service top off Under agreement between the parties (payor and provider), a guaranteed level of income is established for the provider over a specific, pre-determined period of time. The normal course of business for the provider is submission of fee-for-service claims. Should the fee-for-service income during the specified period of time be less than the agreed to amount, a top-up amount is paid to the provider equal to the difference between the fee-for-service total and the guaranteed income amount for that period of time. The details of the agreement may specify (or not) a requirement for repayment to the payor in the event that the fee-for-service income exceeds the guaranteed amount. false 5 FNLFEE final fee Anticipated or actual final fee associated with treating a patient. false 5 FRSTFEE first fee Anticipated or actual initial fee associated with treating a patient. false 5 MARKUP markup or up-charge An increase in the amount charged as a percentage of the amount. For example, 12% markup on product cost. false 5 MISSAPT missed appointment A charge to compensate the provider when a patient does not show for an appointment. false 5 PERFEE periodic fee Anticipated or actual periodic fee associated with treating a patient. For example, expected billing cycle such as monthly, quarterly. The actual period (e.g. monthly, quarterly) is specified in the unit quantity of the Invoice Element. false 5 PERMBNS performance bonus The amount for a performance bonus that is being requested from a payor for the performance of certain services (childhood immunizations, influenza immunizations, mammograms, pap smears) on a sliding scale. That is, for 90% of childhood immunizations to a maximum of $2200/yr. An invoice is created at the end of the service period (one year) and a code is submitted indicating the percentage achieved and the dollar amount claimed. false 5 RESTOCK restocking fee A charge is requested because the patient failed to pick up the item and it took an amount of time to return it to stock for future use. false 5 TRAVEL travel A charge to cover the cost of travel time and/or cost in conjuction with providing a service or product. It may be charged per kilometer or per hour based on the effective agreement. false 5 URGENT urgent Premium paid on service fees in compensation for providing an expedited response to an urgent situation. false 4 _ActInvoiceDetailTaxCode ActInvoiceDetailTaxCode The billable item codes to identify modifications to a billable item charge by a tax factor applied to the amount. As for example 7% provincial sales tax. true 5 FST federal sales tax Federal tax on transactions such as the Goods and Services Tax (GST) false 5 HST harmonized sales Tax Joint Federal/Provincial Sales Tax false 5 PST provincial/state sales tax Tax levied by the provincial or state jurisdiction such as Provincial Sales Tax false 3 _ActInvoiceDetailPreferredAccommodationCode ActInvoiceDetailPreferredAccommodationCode An identifying data string for medical facility accommodations. true 4 _ActEncounterAccommodationCode ActEncounterAccommodationCode Accommodation type. In Intent mood, represents the accommodation type requested. In Event mood, represents accommodation assigned/used. In Definition mood, represents the available accommodation type. true 5 _HL7AccommodationCode HL7AccommodationCode Description:Accommodation type. In Intent mood, represents the accommodation type requested. In Event mood, represents accommodation assigned/used. In Definition mood, represents the available accommodation type. true 6 I Isolation Accommodations used in the care of diseases that are transmitted through casual contact or respiratory transmission. false 6 P Private Accommodations in which there is only 1 bed. false 6 S Suite Uniquely designed and elegantly decorated accommodations with many amenities available for an additional charge. false 6 SP Semi-private Accommodations in which there are 2 beds. false 6 W Ward Accommodations in which there are 3 or more beds. false 3 _ActInvoiceDetailClinicalServiceCode ActInvoiceDetailClinicalServiceCode An identifying data string for healthcare procedures. true 2 _ActInvoiceGroupCode ActInvoiceGroupCode Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results. Invoice elements of this type signify a grouping of one or more children (detail) invoice elements. They do not have intrinsic costing associated with them, but merely reflect the sum of all costing for it's immediate children invoice elements. true 3 _ActInvoiceInterGroupCode ActInvoiceInterGroupCode Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results. Invoice elements of this type signify a grouping of one or more children (detail) invoice elements. They do not have intrinsic costing associated with them, but merely reflect the sum of all costing for it's immediate children invoice elements. The domain is only specified for an intermediate invoice element group (non-root or non-top level) for an Invoice. true 4 CPNDDRGING compound drug invoice group A grouping of invoice element groups and details including the ones specifying the compound ingredients being invoiced. It may also contain generic detail items such as markup. false 4 CPNDINDING compound ingredient invoice group A grouping of invoice element details including the one specifying an ingredient drug being invoiced. It may also contain generic detail items such as tax or markup. false 4 CPNDSUPING compound supply invoice group A grouping of invoice element groups and details including the ones specifying the compound supplies being invoiced. It may also contain generic detail items such as markup. false 4 DRUGING drug invoice group A grouping of invoice element details including the one specifying the drug being invoiced. It may also contain generic detail items such as markup. false 4 FRAMEING frame invoice group A grouping of invoice element details including the ones specifying the frame fee and the frame dispensing cost that are being invoiced. false 4 LENSING lens invoice group A grouping of invoice element details including the ones specifying the lens fee and the lens dispensing cost that are being invoiced. false 4 PRDING product invoice group A grouping of invoice element details including the one specifying the product (good or supply) being invoiced. It may also contain generic detail items such as tax or discount. false 3 _ActInvoiceRootGroupCode ActInvoiceRootGroupCode Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results. Invoice elements of this type signify a grouping of one or more children (detail) invoice elements. They do not have intrinsic costing associated with them, but merely reflect the sum of all costing for it's immediate children invoice elements. Codes from this domain reflect the type of Invoice such as Pharmacy Dispense, Clinical Service and Clinical Product. The domain is only specified for the root (top level) invoice element group for an Invoice. true 4 CPINV clinical product invoice Clinical product invoice where the Invoice Grouping contains one or more billable item and is supported by clinical product(s). For example, a crutch or a wheelchair. false 4 CSINV clinical service invoice Clinical Services Invoice which can be used to describe a single service, multiple services or repeated services. [1] Single Clinical services invoice where the Invoice Grouping contains one billable item and is supported by one clinical service. For example, a single service for an office visit or simple clinical procedure (e.g. knee mobilization). [2] Multiple Clinical services invoice where the Invoice Grouping contains more than one billable item, supported by one or more clinical services. The services can be distinct and over multiple dates, but for the same patient. This type of invoice includes a series of treatments which must be adjudicated together. For example, an adjustment and ultrasound for a chiropractic session where fees are associated for each of the services and adjudicated (invoiced) together. [3] Repeated Clinical services invoice where the Invoice Grouping contains one or more billable item, supported by the same clinical service repeated over a period of time. For example, the same Chiropractic adjustment (service or treatment) delivered on 3 separate occasions over a period of time at the discretion of the provider (e.g. month). false 4 CSPINV clinical service and product A clinical Invoice Grouping consisting of one or more services and one or more product. Billing for these service(s) and product(s) are supported by multiple clinical billable events (acts). All items in the Invoice Grouping must be adjudicated together to be acceptable to the Adjudicator. For example , a brace (product) invoiced together with the fitting (service). false 4 FININV financial invoice Invoice Grouping without clinical justification. These will not require identification of participants and associations from a clinical context such as patient and provider. Examples are interest charges and mileage. false 4 OHSINV oral health service A clinical Invoice Grouping consisting of one or more oral health services. Billing for these service(s) are supported by multiple clinical billable events (acts). All items in the Invoice Grouping must be adjudicated together to be acceptable to the Adjudicator. false 4 PAINV preferred accommodation invoice HealthCare facility preferred accommodation invoice. false 4 RXCINV Rx compound invoice Pharmacy dispense invoice for a compound. false 4 RXDINV Rx dispense invoice Pharmacy dispense invoice not involving a compound false 4 SBFINV sessional or block fee invoice Clinical services invoice where the Invoice Group contains one billable item for multiple clinical services in one or more sessions. false 4 VRXINV vision dispense invoice Vision dispense invoice for up to 2 lens (left and right), frame and optional discount. Eye exams are invoiced as a clinical service invoice. false 1 _ActInvoiceElementSummaryCode ActInvoiceElementSummaryCode Identifies the different types of summary information that can be reported by queries dealing with Statement of Financial Activity (SOFA). The summary information is generally used to help resolve balance discrepancies between providers and payors. true 2 _InvoiceElementAdjudicated InvoiceElementAdjudicated Total counts and total net amounts adjudicated for all Invoice Groupings that were adjudicated within a time period based on the adjudication date of the Invoice Grouping. true 3 ADNFPPELAT adjud. nullified prior-period electronic amount Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically. false 3 ADNFPPELCT adjud. nullified prior-period electronic count Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically. false 3 ADNFPPMNAT adjud. nullified prior-period manual amount Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually. false 3 ADNFPPMNCT adjud. nullified prior-period manual count Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually. false 3 ADNFSPELAT adjud. nullified same-period electronic amount Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently nullified in the specified period and submitted electronically. false 3 ADNFSPELCT adjud. nullified same-period electronic count Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently nullified in the specified period and submitted electronically. false 3 ADNFSPMNAT adjud. nullified same-period manual amount Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually. false 3 ADNFSPMNCT adjud. nullified same-period manual count Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually. false 3 ADNPPPELAT adjud. non-payee payable prior-period electronic amount Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically. false 3 ADNPPPELCT adjud. non-payee payable prior-period electronic count Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically. false 3 ADNPPPMNAT adjud. non-payee payable prior-period manual amount Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually. false 3 ADNPPPMNCT adjud. non-payee payable prior-period manual count Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually. false 3 ADNPSPELAT adjud. non-payee payable same-period electronic amount Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically. false 3 ADNPSPELCT adjud. non-payee payable same-period electronic count Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically. false 3 ADNPSPMNAT adjud. non-payee payable same-period manual amount Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually. false 3 ADNPSPMNCT adjud. non-payee payable same-period manual count Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually. false 3 ADPPPPELAT adjud. payee payable prior-period electronic amount Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically. false 3 ADPPPPELCT adjud. payee payable prior-period electronic count Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically. false 3 ADPPPPMNAT adjud. payee payable prior-period manual amout Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually. false 3 ADPPPPMNCT adjud. payee payable prior-period manual count Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually. false 3 ADPPSPELAT adjud. payee payable same-period electronic amount Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically. false 3 ADPPSPELCT adjud. payee payable same-period electronic count Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically. false 3 ADPPSPMNAT adjud. payee payable same-period manual amount Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually. false 3 ADPPSPMNCT adjud. payee payable same-period manual count Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually. false 3 ADRFPPELAT adjud. refused prior-period electronic amount Identifies the total net amount of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted electronically. false 3 ADRFPPELCT adjud. refused prior-period electronic count Identifies the total number of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted electronically. false 3 ADRFPPMNAT adjud. refused prior-period manual amount Identifies the total net amount of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted manually. false 3 ADRFPPMNCT adjud. refused prior-period manual count Identifies the total number of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted manually. false 3 ADRFSPELAT adjud. refused same-period electronic amount Identifies the total net amount of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted electronically. false 3 ADRFSPELCT adjud. refused same-period electronic count Identifies the total number of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted electronically. false 3 ADRFSPMNAT adjud. refused same-period manual amount Identifies the total net amount of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted manually. false 3 ADRFSPMNCT adjud. refused same-period manual count Identifies the total number of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted manually. false 2 _InvoiceElementPaid InvoiceElementPaid Total counts and total net amounts paid for all Invoice Groupings that were paid within a time period based on the payment date. true 3 PDNFPPELAT paid nullified prior-period electronic amount Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently nullified in the specified period and submitted electronically. false 3 PDNFPPELCT paid nullified prior-period electronic count Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently nullified in the specified period and submitted electronically. false 3 PDNFPPMNAT paid nullified prior-period manual amount Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently nullified in the specified period and submitted manually. false 3 PDNFPPMNCT paid nullified prior-period manual count Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently nullified in the specified period and submitted manually. false 3 PDNFSPELAT paid nullified same-period electronic amount Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently nullified in the specified period and submitted electronically. false 3 PDNFSPELCT paid nullified same-period electronic count Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently cancelled in the specified period and submitted electronically. false 3 PDNFSPMNAT paid nullified same-period manual amount Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently nullified in the specified period and submitted manually. false 3 PDNFSPMNCT paid nullified same-period manual count Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently nullified in the specified period and submitted manually. false 3 PDNPPPELAT paid non-payee payable prior-period electronic amount Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically. false 3 PDNPPPELCT paid non-payee payable prior-period electronic count Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically. false 3 PDNPPPMNAT paid non-payee payable prior-period manual amount Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually. false 3 PDNPPPMNCT paid non-payee payable prior-period manual count Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually. false 3 PDNPSPELAT paid non-payee payable same-period electronic amount Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically. false 3 PDNPSPELCT paid non-payee payable same-period electronic count Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically. false 3 PDNPSPMNAT paid non-payee payable same-period manual amount Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually. false 3 PDNPSPMNCT paid non-payee payable same-period manual count Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually. false 3 PDPPPPELAT paid payee payable prior-period electronic amount Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically. false 3 PDPPPPELCT paid payee payable prior-period electronic count Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically. false 3 PDPPPPMNAT paid payee payable prior-period manual amount Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually. false 3 PDPPPPMNCT paid payee payable prior-period manual count Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually. false 3 PDPPSPELAT paid payee payable same-period electronic amount Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically. false 3 PDPPSPELCT paid payee payable same-period electronic count Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically. false 3 PDPPSPMNAT paid payee payable same-period manual amount Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually. false 3 PDPPSPMNCT paid payee payable same-period manual count Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually. false 2 _InvoiceElementSubmitted InvoiceElementSubmitted Total counts and total net amounts billed for all Invoice Groupings that were submitted within a time period. Adjudicated invoice elements are included. true 3 SBBLELAT submitted billed electronic amount Identifies the total net amount billed for all submitted Invoice Groupings within a time period and submitted electronically. Adjudicated invoice elements are included. false 3 SBBLELCT submitted billed electronic count Identifies the total number of submitted Invoice Groupings within a time period and submitted electronically. Adjudicated invoice elements are included. false 3 SBNFELAT submitted nullified electronic amount Identifies the total net amount billed for all submitted Invoice Groupings that were nullified within a time period and submitted electronically. Adjudicated invoice elements are included. false 3 SBNFELCT submitted cancelled electronic count Identifies the total number of submitted Invoice Groupings that were nullified within a time period and submitted electronically. Adjudicated invoice elements are included. false 3 SBPDELAT submitted pending electronic amount Identifies the total net amount billed for all submitted Invoice Groupings that are pended or held by the payor, within a time period and submitted electronically. Adjudicated invoice elements are not included. false 3 SBPDELCT submitted pending electronic count Identifies the total number of submitted Invoice Groupings that are pended or held by the payor, within a time period and submitted electronically. Adjudicated invoice elements are not included. false 1 _ActInvoiceOverrideCode ActInvoiceOverrideCode Includes coded responses that will occur as a result of the adjudication of an electronic invoice at a summary level and provides guidance on interpretation of the referenced adjudication results. true 2 COVGE coverage problem Insurance coverage problems have been encountered. Additional explanation information to be supplied. false 2 EFORM electronic form to follow Electronic form with supporting or additional information to follow. false 2 FAX fax to follow Fax with supporting or additional information to follow. false 2 GFTH good faith indicator The medical service was provided to a patient in good faith that they had medical coverage, although no evidence of coverage was available before service was rendered. false 2 LATE late invoice Knowingly over the payor's published time limit for this invoice possibly due to a previous payor's delays in processing. Additional reason information will be supplied. false 2 MANUAL manual review Manual review of the invoice is requested. Additional information to be supplied. This may be used in the case of an appeal. false 2 OOJ out of jurisdiction The medical service and/or product was provided to a patient that has coverage in another jurisdiction. false 2 ORTHO orthodontic service The service provided is required for orthodontic purposes. If the covered party has orthodontic coverage, then the service may be paid. false 2 PAPER paper documentation to follow Paper documentation (or other physical format) with supporting or additional information to follow. false 2 PIE public insurance exhausted Public Insurance has been exhausted. Invoice has not been sent to Public Insuror and therefore no Explanation Of Benefits (EOB) is provided with this Invoice submission. false 2 PYRDELAY delayed by a previous payor Allows provider to explain lateness of invoice to a subsequent payor. false 2 REFNR referral not required Rules of practice do not require a physician's referral for the provider to perform a billable service. false 2 REPSERV repeated service The same service was delivered within a time period that would usually indicate a duplicate billing. However, the repeated service is a medical necessity and therefore not a duplicate. false 2 UNRELAT unrelated service The service provided is not related to another billed service. For example, 2 unrelated services provided on the same day to the same patient which may normally result in a refused payment for one of the items. false 2 VERBAUTH verbal authorization The provider has received a verbal permission from an authoritative source to perform the service or supply the item being invoiced. false 1 _ActListCode ActListCode Provides codes associated with ActClass value of LIST (working list) true 2 _ActObservationList ActObservationList ActObservationList true 3 CARELIST care plan List of acts representing a care plan. The acts can be in a varierty of moods including event (EVN) to record acts that have been carried out as part of the care plan. false 3 CONDLIST condition list List of condition observations. false 4 INTOLIST intolerance list List of intolerance observations. false 4 PROBLIST problem list List of problem observations. false 4 RISKLIST risk factors List of risk factor observations. false 3 GOALLIST goal list List of observations in goal mood. false 2 _ActTherapyDurationWorkingListCode ActTherapyDurationWorkingListCode Codes used to identify different types of 'duration-based' working lists. Examples include "Continuous/Chronic", "Short-Term" and "As-Needed". true 3 _ActMedicationTherapyDurationWorkingListCode act medication therapy duration working list Definition:A collection of concepts that identifies different types of 'duration-based' mediation working lists. Examples:"Continuous/Chronic" "Short-Term" and "As Needed" true 4 ACU short term/acute Definition:A list of medications which the patient is only expected to consume for the duration of the current order or limited set of orders and which is not expected to be renewed. false 4 CHRON continuous/chronic Definition:A list of medications which are expected to be continued beyond the present order and which the patient should be assumed to be taking unless explicitly stopped. false 4 ONET one time Definition:A list of medications which the patient is intended to be administered only once. false 4 PRN as needed Definition:A list of medications which the patient will consume intermittently based on the behavior of the condition for which the medication is indicated. false 2 MEDLIST medication list List of medications. false 3 CURMEDLIST current medication list List of current medications. false 3 DISCMEDLIST discharge medication list List of discharge medications. false 3 HISTMEDLIST medication history Historical list of medications. false 1 _ActMonitoringProtocolCode ActMonitoringProtocolCode Identifies types of monitoring programs true 2 CTLSUB Controlled Substance A monitoring program that focuses on narcotics and/or commonly abused substances that are subject to legal restriction. false 2 INV investigational Definition:A monitoring program that focuses on a drug which is under investigation and has not received regulatory approval for the condition being investigated false 2 LU limited use Description:A drug that can be prescribed (and reimbursed) only if it meets certain criteria. false 2 OTC non prescription medicine Medicines designated in this way may be supplied for patient use without a prescription. The exact form of categorisation will vary in different realms. false 2 RX prescription only medicine Some form of prescription is required before the related medicine can be supplied for a patient. The exact form of regulation will vary in different realms. false 2 SA special authorization Definition:A drug that requires prior approval (to be reimbursed) before being dispensed false 2 SAC special access Description:A drug that requires special access permission to be prescribed and dispensed. false 1 _ActNonObservationIndicationCode ActNonObservationIndicationCode Description:Concepts representing indications (reasons for clinical action) other than diagnosis and symptoms. true 2 IND01 imaging study requiring contrast Description:Contrast agent required for imaging study. false 2 IND02 colonoscopy prep Description:Provision of prescription or direction to consume a product for purposes of bowel clearance in preparation for a colonoscopy. false 2 IND03 prophylaxis Description:Provision of medication as a preventative measure during a treatment or other period of increased risk. false 2 IND04 surgical prophylaxis Description:Provision of medication during pre-operative phase; e.g. antibiotics before dental surgery or bowel prep before colon surgery. false 2 IND05 pregnancy prophylaxis Description:Provision of medication for pregnancy --e.g. vitamins, antibiotic treatments for vaginal tract colonization, etc. false 1 _ActObservationVerificationType act observation verification Identifies the type of verification investigation being undertaken with respect to the subject of the verification activity. Examples: Verification of eligibility for coverage under a policy or program - aka enrolled/covered by a policy or program Verification of record - e.g. person has record in an immunization registry Verification of enumeration - e.g. NPI Verification of Board Certification - provider specific Verification of Certification - e.g. JAHCO, NCQA, URAC Verification of Conformance - e.g. entity use with HIPAA, conformant to the CCHIT EHR system criteria Verification of Provider Credentials Verification of no adverse findings - e.g. on National Provider Data Bank, Health Integrity Protection Data Base (HIPDB) true 2 VFPAPER verify paper Definition:Indicates that the paper version of the record has, should be or is being verified against the electronic version. false 1 _ActPaymentCode ActPaymentCode Code identifying the method or the movement of payment instructions. Codes are drawn from X12 data element 591 (PaymentMethodCode) true 2 ACH Automated Clearing House Automated Clearing House (ACH). false 2 CHK Cheque A written order to a bank to pay the amount specified from funds on deposit. false 2 DDP Direct Deposit Electronic Funds Transfer (EFT) deposit into the payee's bank account false 2 NON Non-Payment Data Non-Payment Data. false 1 _ActPharmacySupplyType ActPharmacySupplyType Identifies types of dispensing events true 2 DF Daily Fill A fill providing sufficient supply for one day false 2 EM Emergency Supply A supply action where there is no 'valid' order for the supplied medication; e.g. Emergency vacation supply, weekend supply (when prescriber is unavailable to provide a renewal prescription) false 3 SO Script Owing An emergency supply where the expectation is that a formal order authorizing the supply will be provided at a later date. false 2 FF First Fill The initial fill against an order. (This includes initial fills against refill orders.) false 3 FFC First Fill - Complete A first fill where the quantity supplied is equal to one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets). false 3 FFP First Fill - Part Fill A first fill where the quantity supplied is less than one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.) false 3 FFSS first fill, partial strength A first fill where the strength supplied is less than the ordered strength. (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets). false 3 TF Trial Fill A fill where a small portion is provided to allow for determination of the therapy effectiveness and patient tolerance. false 2 FS Floor stock A supply action to restock a smaller more local dispensary. false 2 MS Manufacturer Sample A supply of a manufacturer sample false 2 RF Refill A fill against an order that has already been filled (or partially filled) at least once. false 3 UD Unit Dose A supply action that provides sufficient material for a single dose. false 3 RFC Refill - Complete A refill where the quantity supplied is equal to one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets.) false 4 RFCS refill complete partial strength A refill where the quantity supplied is equal to one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets.) and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets). false 3 RFF Refill (First fill this facility) The first fill against an order that has already been filled at least once at another facility. false 4 RFFS refill partial strength (first fill this facility) The first fill against an order that has already been filled at least once at another facility and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets). false 3 RFP Refill - Part Fill A refill where the quantity supplied is less than one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.) false 4 RFPS refill part fill partial strength A refill where the quantity supplied is less than one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.) and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets). false 3 RFS refill partial strength A fill against an order that has already been filled (or partially filled) at least once and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets). false 3 TB Trial Balance A fill where the remainder of a 'complete' fill is provided after a trial fill has been provided. false 4 TBS trial balance partial strength A fill where the remainder of a 'complete' fill is provided after a trial fill has been provided and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets). false 2 UDE unit dose equivalent A supply action that provides sufficient material for a single dose via multiple products; e.g. 2 50mg tablets for a 100mg unit dose. false 1 _ActPolicyType ActPolicyType Description:Types of policies that further specify the ActClassPolicy value set. true 2 _ActPrivacyPolicy ActPrivacyPolicy A policy deeming certain information to be private to an individual or organization. Definition: A mandate, obligation, requirement, rule, or expectation relating to privacy. Discussion: ActPrivacyPolicyType codes support the designation of the 1..* policies that are applicable to an Act such as a Consent Directive, a Role such as a VIP Patient, or an Entity such as a patient who is a minor. 1..* ActPrivacyPolicyType values may be associated with an Act or Role to indicate the policies that govern the assignment of an Act or Role confidentialityCode. Use of multiple ActPrivacyPolicyType values enables fine grain specification of applicable policies, but must be carefully assigned to ensure cogency and avoid creation of conflicting policy mandates. Usage Note: Statutory title may be named in the ActClassPolicy Act Act.title to specify which privacy policy is being referenced. true 3 _ActConsentDirective ActConsentDirective Definition: Specifies the type of consent directive indicated by an ActClassPolicy e.g. a 3rd party authorization to disclose or consent for a substitute decision maker (SDM) or a notice of privacy policy. Usage Note: ActConsentDirective codes are used to specify the type of Consent Directive to which a Consent Directive Act conforms. true 4 EMRGONLY emergency only 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. Definition: Opt-in to disclosure of health information for emergency only consent directive. false 4 NOPP notice of privacy practices 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. false 4 OPTIN opt-in This general consent directive permits disclosure of health information. Additional parameter may limit authorized users, purpose of use, user obligations, duration, or information types permitted to be disclosed, and impose uses obligations. Definition: Opt-in to disclosure of health information consent directive. false 4 OPTOUT op-out This general consent directive prohibits disclosure of health information. Additional parameters may permit access to some information types by certain users, roles, purposes of use, durations and impose user obligations. Definition: Opt-out of disclosure of health information consent directive. false 3 _InformationSensitivityPolicy InformationSensitivityPolicy A mandate, obligation, requirement, rule, or expectation characterizing the value or importance of a resource and may include its vulnerability. (Based on ISO7498-2:1989. Note: The vulnerability of personally identifiable sensitive information may be based on concerns that the unauthorized disclosure may result in social stigmatization or discrimination.) Description: Types of Sensitivity policy that apply to Acts or Roles. A sensitivity policy is adopted by an enterprise or group of enterprises (a 'policy domain') through a formal data use agreement that stipulates the value, importance, and vulnerability of information. A sensitivity code representing a sensitivity policy may be associated with criteria such as categories of information or sets of information identifiers (e.g. a value set of clinical codes or branch in a code system hierarchy). These criteria may in turn be used for the Policy Decision Point in a Security Engine. A sensitivity code may be used to set the confidentiality code used on information about Acts and Roles to trigger the security mechanisms required to control how security principals (i.e., a person, a machine, a software application) may act on the information (e.g. collection, access, use, or disclosure). Sensitivity codes are never assigned to the transport or business envelope containing patient specific information being exchanged outside of a policy domain as this would disclose the information intended to be protected by the policy. When sensitive information is exchanged with others outside of a policy domain, the confidentiality code on the transport or business envelope conveys the receiver's responsibilities and indicates the how the information is to be safeguarded without unauthorized disclosure of the sensitive information. This ensures that sensitive information is treated by receivers as the sender intends, accomplishing interoperability without point to point negotiations. Usage Note: Sensitivity codes are not useful for interoperability outside of a policy domain because sensitivity policies are typically localized and vary drastically across policy domains even for the same information category because of differing organizational business rules, security policies, and jurisdictional requirements. For example, an employee's sensitivity code would make little sense for use outside of a policy domain. 'Taboo' would rarely be useful outside of a policy domain unless there are jurisdictional requirements requiring that a provider disclose sensitive information to a patient directly. Sensitivity codes may be more appropriate in a legacy system's Master Files in order to notify those who access a patient's orders and observations about the sensitivity policies that apply. Newer systems may have a security engine that uses a sensitivity policy's criteria directly. The specializable InformationSensitivityPolicy Act.code may be useful in some scenarios if used in combination with a sensitivity identifier and/or Act.title. true 4 _ActInformationSensitivityPolicy ActInformationSensitivityPolicy Types of sensitivity policies that apply to Acts. Act.confidentialityCode is defined in the RIM as "constraints around appropriate disclosure of information about this Act, regardless of mood." Usage Note: ActSensitivity codes are used to bind information to an Act.confidentialityCode according to local sensitivity policy so that those confidentiality codes can then govern its handling across enterprises. Internally to a policy domain, however, local policies guide the access control system on how end users in that policy domain are able to use information tagged with these sensitivity values. true 5 ETH substance abuse information sensitivity Policy for handling alcohol or drug-abuse information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to alcohol or drug-abuse information that is deemed sensitive. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. false 5 GDIS genetic disease information sensitivity Policy for handling genetic disease information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to genetic disease information that is deemed sensitive. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. false 5 HIV HIV/AIDS information sensitivity Policy for handling HIV or AIDS information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to HIV or AIDS information that is deemed sensitive. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. false 5 PSY psychiatry information sensitivity Policy for handling psychiatry information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to psychiatry information that is deemed sensitive. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. false 5 SCA sickle cell anemia Policy for handling sickle cell disease information, which is afforded heightened confidentiality. Information handling protocols are based on organizational policies related to sickle cell disease information, which is deemed sensitive. Usage Note: If there is a jurisdictional mandate, then the Act valued with this ActCode should be associated with an Act valued with any applicable laws from the ActPrivacyLaw code system. false 5 SDV sexual assault, abuse, or domestic violence information sensitivity Policy for handling sexual assault, abuse, or domestic violence information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to sexual assault, abuse, or domestic violence information that is deemed sensitive. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. false 5 SEX sexuality and reproductive health information sensitivity Policy for handling sexuality and reproductive health information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to sexuality and reproductive health information that is deemed sensitive. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. false 5 STD sexually transmitted disease information sensitivity Policy for handling sexually transmitted disease information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to sexually transmitted disease information that is deemed sensitive. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. false 5 TBOO taboo Policy for handling information not to be initially disclosed or discussed with patient except by a physician assigned to patient in this case. Information handling protocols based on organizational policies related to sensitive patient information that must be initially discussed with the patient by an attending physician before being disclosed to the patient. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. Open Issue: This definition conflates a rule and a characteristic, and there may be a similar issue with ts sibling codes. false 5 SICKLE sickle cell Types of sensitivity policies that apply to Acts. Act.confidentialityCode is defined in the RIM as "constraints around appropriate disclosure of information about this Act, regardless of mood." Usage Note: ActSensitivity codes are used to bind information to an Act.confidentialityCode according to local sensitivity policy so that those confidentiality codes can then govern its handling across enterprises. Internally to a policy domain, however, local policies guide the access control system on how end users in that policy domain are able to use information tagged with these sensitivity values. false 4 _EntitySensitivityPolicyType EntityInformationSensitivityPolicy Types of sensitivity policies that may apply to a sensitive attribute on an Entity. Usage Note: EntitySensitivity codes are used to convey a policy that is applicable to sensitive information conveyed by an entity attribute. May be used to bind a Role.confidentialityCode associated with an Entity per organizational policy. Role.confidentialityCode is defined in the RIM as "an indication of the appropriate disclosure of information about this Role with respect to the playing Entity." true 5 DEMO all demographic information sensitivity Policy for handling all demographic information about an information subject, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to all demographic about an information subject, the disclosure of which could impact the privacy, well-being, or safety of that subject. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. false 5 DOB date of birth information sensitivity Policy for handling information related to an information subject's date of birth, which will be afforded heightened confidentiality.Policies may govern sensitivity of information related to an information subject's date of birth, the disclosure of which could impact the privacy, well-being, or safety of that subject. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. false 5 GENDER gender and sexual orientation information sensitivity Policy for handling information related to an information subject's gender and sexual orientation, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's gender and sexual orientation, the disclosure of which could impact the privacy, well-being, or safety of that subject. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. false 5 LIVARG living arrangement information sensitivity Policy for handling information related to an information subject's living arrangement, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's living arrangement, the disclosure of which could impact the privacy, well-being, or safety of that subject. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. false 5 MARST marital status information sensitivity Policy for handling information related to an information subject's marital status, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's marital status, the disclosure of which could impact the privacy, well-being, or safety of that subject. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. false 5 RACE race information sensitivity Policy for handling information related to an information subject's race, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's race, the disclosure of which could impact the privacy, well-being, or safety of that subject. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. false 5 REL religion information sensitivity Policy for handling information related to an information subject's religious affiliation, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's religion, the disclosure of which could impact the privacy, well-being, or safety of that subject. Usage Notes: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. false 4 _RoleInformationSensitivityPolicy RoleInformationSensitivityPolicy Types of sensitivity policies that apply to Roles. Usage Notes: RoleSensitivity codes are used to bind information to a Role.confidentialityCode per organizational policy. Role.confidentialityCode is defined in the RIM as "an indication of the appropriate disclosure of information about this Role with respect to the playing Entity." true 5 B business information sensitivity Policy for handling trade secrets such as financial information or intellectual property, which will be afforded heightened confidentiality. Description: Since the service class can represent knowledge structures that may be considered a trade or business secret, there is sometimes (though rarely) the need to flag those items as of business level confidentiality. Usage Notes: No patient related information may ever be of this confidentiality level. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. false 5 EMPL employer information sensitivity Policy for handling information related to an employer which is deemed classified to protect an employee who is the information subject, and which will be afforded heightened confidentiality. Description: Policies may govern sensitivity of information related to an employer, such as law enforcement or national security, the identity of which could impact the privacy, well-being, or safety of an information subject who is an employee. Usage Notes: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. false 5 LOCIS location information sensitivity Policy for handling information related to the location of the information subject, which will be afforded heightened confidentiality. Description: Policies may govern sensitivity of information related to the location of the information subject, the disclosure of which could impact the privacy, well-being, or safety of that subject. Usage Notes: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. false 5 SSP sensitive service provider information sensitivity Policy for handling information related to a provider of sensitive services, which will be afforded heightened confidentiality. Description: Policies may govern sensitivity of information related to providers who deliver sensitive healthcare services in order to protect the privacy, well-being, and safety of the provider and of patients receiving sensitive services. Usage Notes: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. false 4 ADOL adolescent information sensitivity Policy for handling information related to an adolescent, which will be afforded heightened confidentiality per applicable organizational or jurisdictional policy. An enterprise may have a policy that requires that adolescent patient information be provided heightened confidentiality. Information deemed sensitive typically includes health information and patient role information including patient status, demographics, next of kin, and location. Usage Note: For use within an enterprise in which an adolescent is the information subject. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. false 4 CEL celebrity information sensitivity Policy for handling information related to a celebrity (people of public interest (VIP), which will be afforded heightened confidentiality. Celebrities are people of public interest (VIP) about whose information an enterprise may have a policy that requires heightened confidentiality. Information deemed sensitive may include health information and patient role information including patient status, demographics, next of kin, and location. Usage Note: For use within an enterprise in which the information subject is deemed a celebrity or very important person. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. false 4 DIA diagnosis information sensitivity Policy for handling information related to a diagnosis, health condition or health problem, which will be afforded heightened confidentiality. Diagnostic, health condition or health problem related information may be deemed sensitive by organizational policy, and require heightened confidentiality. Usage Note: For use within an enterprise that provides heightened confidentiality to diagnostic, health condition or health problem related information deemed sensitive. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. false 4 DRGIS drug information sensitivity Policy for handling information related to a drug, which will be afforded heightened confidentiality. Drug information may be deemed sensitive by organizational policy, and require heightened confidentiality. Usage Note: For use within an enterprise that provides heightened confidentiality to drug information deemed sensitive. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. false 4 EMP employee information sensitivity Policy for handling information related to an employee, which will be afforded heightened confidentiality. When a patient is an employee, an enterprise may have a policy that requires heightened confidentiality. Information deemed sensitive typically includes health information and patient role information including patient status, demographics, next of kin, and location. Usage Note: Policy for handling information related to an employee, which will be afforded heightened confidentiality. Description: When a patient is an employee, an enterprise may have a policy that requires heightened confidentiality. Information deemed sensitive typically includes health information and patient role information including patient status, demographics, next of kin, and location. false 4 PDS patient default sensitivity Policy for handling information reported by the patient about another person, e.g. a family member, which will be afforded heightened confidentiality. Sensitive information reported by the patient about another person, e.g. family members may be deemed sensitive by default. The flag may be set or cleared on patient's request. Usage Note: For sensitive information relayed by or about a patient, which is deemed sensitive within the enterprise (i.e., by default regardless of whether the patient requested that the information be deemed sensitive.) If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. false 4 PRS patient requested sensitivity For sensitive information relayed by or about a patient, which is deemed sensitive within the enterprise (i.e., by default regardless of whether the patient requested that the information be deemed sensitive.) If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. Usage Note: For use within an enterprise that provides heightened confidentiality to certain types of information designated by a patient as sensitive. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. false 3 COMPT compartment This is the healthcare analog to the US Intelligence Community's concept of a Special Access Program. Compartment codes may be used in as a field value in an initiator's clearance to indicate permission to access and use an IT Resource with a security label having the same compartment value in security category label field. Map: Aligns with ISO 2382-8 definition of Compartment - "A division of data into isolated blocks with separate security controls for the purpose of reducing risk." false 4 HRCOMPT human resource compartment A security category label field value, which indicates that access and use of an IT resource is restricted to members of human resources department or workflow. false 4 RESCOMPT research project compartment A security category label field value, which indicates that access and use of an IT resource is restricted to members of a research project. false 4 RMGTCOMPT records management compartment A security category label field value, which indicates that access and use of an IT resource is restricted to members of records management department or workflow. false 2 ActTrustPolicyType trust policy A mandate, obligation, requirement, rule, or expectation conveyed as security metadata between senders and receivers required to establish the reliability, authenticity, and trustworthiness of their transactions. Trust security metadata are observation made about aspects of trust applicable to an IT resource (data, information object, service, or system capability). Trust applicable to IT resources is established and maintained in and among security domains, and may be comprised of observations about the domain's trust authority, trust framework, trust policy, trust interaction rules, means for assessing and monitoring adherence to trust policies, mechanisms that enforce trust, and quality and reliability measures of assurance in those mechanisms. [Based on ISO IEC 10181-1 and NIST SP 800-63-2] For example, identity proofing , level of assurance, and Trust Framework. true 3 TRSTACCRD trust accreditation Type of security metadata about the formal declaration by an authority or neutral third party that validates the technical, security, trust, and business practice conformance of Trust Agents to facilitate security, interoperability, and trust among participants within a security domain or trust framework. false 3 TRSTAGRE trust agreement Type of security metadata about privacy and security requirements with which a security domain must comply. [ISO IEC 10181-1] false 3 TRSTASSUR trust assurance Type of security metadata about the digital quality or reliability of a trust assertion, activity, capability, information exchange, mechanism, process, or protocol. false 3 TRSTCERT trust certificate Type of security metadata about a set of security-relevant data issued by a security authority or trusted third party, together with security information which is used to provide the integrity and data origin authentication services for an IT resource (data, information object, service, or system capability). [Based on ISO IEC 10181-1] false 3 TRSTFWK trust framework Type of security metadata about a complete set of contracts, regulations, or commitments that enable participating actors to rely on certain assertions by other actors to fulfill their information security requirements. [Kantara Initiative] false 3 TRSTMEC trust mechanism Type of security metadata about a security architecture system component that supports enforcement of security policies. false 2 COVPOL benefit policy Description:A mandate, obligation, requirement, rule, or expectation unilaterally imposed on benefit coverage under a policy or program by a sponsor, underwriter or payor on: The activity of another party The behavior of another party The manner in which an act is executed Examples:A clinical protocol imposed by a payer to which a provider must adhere in order to be paid for providing the service. A formulary from which a provider must select prescribed drugs in order for the patient to incur a lower copay. false 2 SecurityPolicy security policy Types of security policies that further specify the ActClassPolicy value set. Examples: obligation to encrypt refrain from redisclosure without consent false 3 ObligationPolicy obligation policy Conveys the mandated workflow action that an information custodian, receiver, or user must perform. Usage Notes: Per ISO 22600-2, ObligationPolicy instances 'are event-triggered and define actions to be performed by manager agent'. Per HL7 Composite Security and Privacy Domain Analysis Model: This value set refers to the action required to receive the permission specified in the privacy rule. Per OASIS XACML, an obligation is an operation specified in a policy or policy that is performed in conjunction with the enforcement of an access control decision. false 4 ANONY anonymize Custodian system must remove any information that could result in identifying the information subject. false 4 AOD accounting of disclosure Custodian system must make available to an information subject upon request an accounting of certain disclosures of the individual’s protected health information over a period of time. Policy may dictate that the accounting include information about the information disclosed, the date of disclosure, the identification of the receiver, the purpose of the disclosure, the time in which the disclosing entity must provide a response and the time period for which accountings of disclosure can be requested. false 4 AUDIT audit Custodian system must monitor systems to ensure that all users are authorized to operate on information objects. false 4 AUDTR audit trail Custodian system must monitor and maintain retrievable log for each user and operation on information. false 4 CPLYCC comply with confidentiality code Custodian security system must retrieve, evaluate, and comply with the information handling directions of the Confidentiality Code associated with an information target. false 4 CPLYCD comply with consent directive Custodian security system must retrieve, evaluate, and comply with applicable information subject consent directives. false 4 CPLYJPP comply with jurisdictional privacy policy Custodian security system must retrieve, evaluate, and comply with applicable jurisdictional privacy policies associated with the target information. false 4 CPLYOPP comply with organizational privacy policy Custodian security system must retrieve, evaluate, and comply with applicable organizational privacy policies associated with the target information. false 4 CPLYOSP comply with organizational security policy Custodian security system must retrieve, evaluate, and comply with the organizational security policies associated with the target information. false 4 CPLYPOL comply with policy Custodian security system must retrieve, evaluate, and comply with applicable policies associated with the target information. false 4 DEID deidentify Custodian system must strip information of data that would allow the identification of the source of the information or the information subject. false 4 DELAU delete after use Custodian system must remove target information from access after use. false 4 ENCRYPT encrypt Custodian system must render information unreadable by algorithmically transforming plaintext into ciphertext. Usage Notes: A mathematical transposition of a file or data stream so that it cannot be deciphered at the receiving end without the proper key. Encryption is a security feature that assures that only the parties who are supposed to be participating in a videoconference or data transfer are able to do so. It can include a password, public and private keys, or a complex combination of all. (Per Infoway.) false 5 ENCRYPTR encrypt at rest Custodian system must render information unreadable and unusable by algorithmically transforming plaintext into ciphertext when "at rest" or in storage. false 5 ENCRYPTT encrypt in transit Custodian system must render information unreadable and unusable by algorithmically transforming plaintext into ciphertext while "in transit" or being transported by any means. false 5 ENCRYPTU encrypt in use Custodian system must render information unreadable and unusable by algorithmically transforming plaintext into ciphertext while in use such that operations permitted on the target information are limited by the license granted to the end user. false 4 HUAPRV human approval Custodian system must require human review and approval for permission requested. false 4 MASK mask Custodian system must render information unreadable and unusable by algorithmically transforming plaintext into ciphertext. User may be provided a key to decrypt per license or "shared secret". false 4 MINEC minimum necessary Custodian must limit access and disclosure to the minimum information required to support an authorized user's purpose of use. Usage Note: Limiting the information available for access and disclosure to that an authorized user or receiver "needs to know" in order to perform permitted workflow or purpose of use. false 4 PRIVMARK privacy mark Custodian must create and/or maintain human readable security label tags as required by policy. Map: Aligns with ISO 22600-3 Section A.3.4.3 description of privacy mark: "If present, the privacy-mark is not used for access control. The content of the privacy-mark may be defined by the security policy in force (identified by the security-policy-identifier) which may define a list of values to be used. Alternately, the value may be determined by the originator of the security-label." false 4 PSEUD pseudonymize Custodian system must strip information of data that would allow the identification of the source of the information or the information subject. Custodian may retain a key to relink data necessary to reidentify the information subject. false 4 REDACT redact Custodian system must remove information, which is not authorized to be access, used, or disclosed from records made available to otherwise authorized users. false 3 RefrainPolicy refrain policy Conveys prohibited actions which an information custodian, receiver, or user is not permitted to perform unless otherwise authorized or permitted under specified circumstances. Usage Notes: ISO 22600-2 species that a Refrain Policy "defines actions the subjects must refrain from performing". Per HL7 Composite Security and Privacy Domain Analysis Model: May be used to indicate that a specific action is prohibited based on specific access control attributes e.g. purpose of use, information type, user role, etc. false 4 NOAUTH no disclosure without subject authorization Prohibition on disclosure without information subject's authorization. false 4 NOCOLLECT no collection Prohibition on collection or storage of the information. false 4 NODSCLCD no disclosure without consent directive Prohibition on disclosure without organizational approved patient restriction. false 4 NODSCLCDS no disclosure without information subject's consent directive Prohibition on disclosure without a consent directive from the information subject. false 4 NOINTEGRATE no integration Prohibition on Integration into other records. false 4 NOLIST no unlisted entity disclosure Prohibition on disclosure except to entities on specific access list. false 4 NOMOU no disclosure without MOU Prohibition on disclosure without an interagency service agreement or memorandum of understanding (MOU). false 4 NOORGPOL no disclosure without organizational authorization Prohibition on disclosure without organizational authorization. false 4 NOPAT no disclosure to patient, family or caregivers without attending provider's authorization Prohibition on disclosing information to patient, family or caregivers without attending provider's authorization. Usage Note: The information may be labeled with the ActInformationSensitivity TBOO code, triggering application of this RefrainPolicy code as a handling caveat controlling access. Maps to FHIR NOPAT: Typically, this is used on an Alert resource, when the alert records information on patient abuse or non-compliance. FHIR print name is "keep information from patient". Maps to the French realm - code: INVISIBLE_PATIENT. displayName: Document non visible par le patient codingScheme: 1.2.250.1.213.1.1.4.13 French use case: A label for documents that the author chose to hide from the patient until the content can be disclose to the patient in a face to face meeting between a healthcare professional and the patient (in French law some results like cancer diagnosis or AIDS diagnosis must be announced to the patient by a healthcare professional and should not be find out by the patient alone). false 4 NOPERSISTP no collection beyond purpose of use Prohibition on collection of the information beyond time necessary to accomplish authorized purpose of use is prohibited. false 4 NORDSCLCD no redisclosure without consent directive Prohibition on redisclosure without patient consent directive. false 4 NORDSCLCDS no redisclosure without information subject's consent directive Prohibition on redisclosure without a consent directive from the information subject. false 4 NORDSCLW no disclosure without jurisdictional authorization Prohibition on disclosure without authorization under jurisdictional law. false 4 NORELINK no relinking Prohibition on associating de-identified or pseudonymized information with other information in a manner that could or does result in disclosing information intended to be masked. false 4 NOREUSE no reuse beyond purpose of use Prohibition on use of the information beyond the purpose of use initially authorized. false 4 NOVIP no unauthorized VIP disclosure Prohibition on disclosure except to principals with access permission to specific VIP information. false 4 ORCON no disclosure without originator authorization Prohibition on disclosure except as permitted by the information originator. false 1 _ActProductAcquisitionCode ActProductAcquisitionCode The method that a product is obtained for use by the subject of the supply act (e.g. patient). Product examples are consumable or durable goods. true 2 LOAN Loan Temporary supply of a product without transfer of ownership for the product. false 3 RENT Rent Temporary supply of a product with financial compensation, without transfer of ownership for the product. false 2 TRANSFER Transfer Transfer of ownership for a product. false 3 SALE Sale Transfer of ownership for a product for financial compensation. false 1 _ActSpecimenTransportCode ActSpecimenTransportCode Transportation of a specimen. true 2 SREC specimen received Description:Specimen has been received by the participating organization/department. false 2 SSTOR specimen in storage Description:Specimen has been placed into storage at a participating location. false 2 STRAN specimen in transit Description:Specimen has been put in transit to a participating receiver. false 1 _ActSpecimenTreatmentCode ActSpecimenTreatmentCode Set of codes related to specimen treatments true 2 ACID Acidification The lowering of specimen pH through the addition of an acid false 2 ALK Alkalization The act rendering alkaline by impregnating with an alkali; a conferring of alkaline qualities. false 2 DEFB Defibrination The removal of fibrin from whole blood or plasma through physical or chemical means false 2 FILT Filtration The passage of a liquid through a filter, accomplished by gravity, pressure or vacuum (suction). false 2 LDLP LDL Precipitation LDL Precipitation false 2 NEUT Neutralization The act or process by which an acid and a base are combined in such proportions that the resulting compound is neutral. false 2 RECA Recalcification The addition of calcium back to a specimen after it was removed by chelating agents false 2 UFIL Ultrafiltration The filtration of a colloidal substance through a semipermeable medium that allows only the passage of small molecules. false 1 _ActSubstanceAdministrationCode ActSubstanceAdministrationCode Description: Describes the type of substance administration being performed. This should not be used to carry codes for identification of products. Use an associated role or entity to carry such information. true 2 DRUG Drug therapy The introduction of a drug into a subject with the intention of altering its biologic state with the intent of improving its health status. false 2 FD food Description: The introduction of material into a subject with the intent of providing nutrition or other dietary supplements (e.g. minerals or vitamins). false 2 IMMUNIZ Immunization The introduction of an immunogen with the intent of stimulating an immune response, aimed at preventing subsequent infections by more viable agents. false 3 BOOSTER Booster Immunization An additional immunization administration within a series intended to bolster or enhance immunity. false 3 INITIMMUNIZ Initial Immunization The first immunization administration in a series intended to produce immunity false 1 _ActTaskCode ActTaskCode Description: A task or action that a user may perform in a clinical information system (e.g. medication order entry, laboratory test results review, problem list entry). true 2 OE order entry task A clinician creates a request for a service to be performed for a given patient. false 3 LABOE laboratory test order entry task A clinician creates a request for a laboratory test to be done for a given patient. false 3 MEDOE medication order entry task A clinician creates a request for the administration of one or more medications to a given patient. false 2 PATDOC patient documentation task A person enters documentation about a given patient. false 3 ALLERLREV allergy list review Description: A person reviews a list of known allergies of a given patient. false 3 CLINNOTEE clinical note entry task A clinician enters a clinical note about a given patient false 4 DIAGLISTE diagnosis list entry task A clinician enters a diagnosis for a given patient. false 4 DISCHINSTE discharge instruction entry A person provides a discharge instruction to a patient. false 4 DISCHSUME discharge summary entry task A clinician enters a discharge summary for a given patient. false 4 PATEDUE patient education entry A person provides a patient-specific education handout to a patient. false 4 PATREPE pathology report entry task A pathologist enters a report for a given patient. false 4 PROBLISTE problem list entry task A clinician enters a problem for a given patient. false 4 RADREPE radiology report entry task A radiologist enters a report for a given patient. false 3 IMMLREV immunization list review Description: A person reviews a list of immunizations due or received for a given patient. false 3 REMLREV reminder list review Description: A person reviews a list of health care reminders for a given patient. false 4 WELLREMLREV wellness reminder list review Description: A person reviews a list of wellness or preventive care reminders for a given patient. false 2 PATINFO patient information review task A person (e.g. clinician, the patient herself) reviews patient information in the electronic medical record. false 3 ALLERLE allergy list entry Description: A person enters a known allergy for a given patient. false 3 CDSREV clinical decision support intervention review A person reviews a recommendation/assessment provided automatically by a clinical decision support application for a given patient. false 3 CLINNOTEREV clinical note review task A person reviews a clinical note of a given patient. false 4 DISCHSUMREV discharge summary review task A person reviews a discharge summary of a given patient. false 3 DIAGLISTREV diagnosis list review task A person reviews a list of diagnoses of a given patient. false 3 IMMLE immunization list entry Description: A person enters an immunization due or received for a given patient. false 3 LABRREV laboratory results review task A person reviews a list of laboratory results of a given patient. false 3 MICRORREV microbiology results review task A person reviews a list of microbiology results of a given patient. false 4 MICROORGRREV microbiology organisms results review task A person reviews organisms of microbiology results of a given patient. false 4 MICROSENSRREV microbiology sensitivity test results review task A person reviews the sensitivity test of microbiology results of a given patient. false 3 MLREV medication list review task A person reviews a list of medication orders submitted to a given patient false 4 MARWLREV medication administration record work list review task A clinician reviews a work list of medications to be administered to a given patient. false 3 OREV orders review task A person reviews a list of orders submitted to a given patient. false 3 PATREPREV pathology report review task A person reviews a pathology report of a given patient. false 3 PROBLISTREV problem list review task A person reviews a list of problems of a given patient. false 3 RADREPREV radiology report review task A person reviews a radiology report of a given patient. false 3 REMLE reminder list entry Description: A person enters a health care reminder for a given patient. false 4 WELLREMLE wellness reminder list entry Description: A person enters a wellness or preventive care reminder for a given patient. false 3 RISKASSESS risk assessment instrument task A person reviews a Risk Assessment Instrument report of a given patient. false 4 FALLRISK falls risk assessment instrument task A person reviews a Falls Risk Assessment Instrument report of a given patient. false 1 _ActTransportationModeCode ActTransportationModeCode Characterizes how a transportation act was or will be carried out. Examples: Via private transport, via public transit, via courier. true 2 _ActPatientTransportationModeCode ActPatientTransportationModeCode Definition: Characterizes how a patient was or will be transported to the site of a patient encounter. Examples: Via ambulance, via public transit, on foot. true 3 AFOOT pedestrian transport pedestrian transport false 3 AMBT ambulance transport ambulance transport false 4 AMBAIR fixed-wing ambulance transport fixed-wing ambulance transport false 4 AMBGRND ground ambulance transport ground ambulance transport false 4 AMBHELO helicopter ambulance transport helicopter ambulance transport false 3 LAWENF law enforcement transport law enforcement transport false 3 PRVTRN private transport private transport false 3 PUBTRN public transport public transport false 1 _ObservationType ObservationType Identifies the kinds of observations that can be performed true 2 _ActSpecObsCode ActSpecObsCode Identifies the type of observation that is made about a specimen that may affect its processing, analysis or further result interpretation true 3 ARTBLD ActSpecObsArtBldCode Describes the artificial blood identifier that is associated with the specimen. false 3 DILUTION ActSpecObsDilutionCode An observation that reports the dilution of a sample. false 4 AUTO-HIGH Auto-High Dilution The dilution of a sample performed by automated equipment. The value is specified by the equipment false 4 AUTO-LOW Auto-Low Dilution The dilution of a sample performed by automated equipment. The value is specified by the equipment false 4 PRE Pre-Dilution The dilution of the specimen made prior to being loaded onto analytical equipment false 4 RERUN Rerun Dilution The value of the dilution of a sample after it had been analyzed at a prior dilution value false 3 EVNFCTS ActSpecObsEvntfctsCode Domain provides codes that qualify the ActLabObsEnvfctsCode domain. (Environmental Factors) false 3 INTFR ActSpecObsInterferenceCode An observation that relates to factors that may potentially cause interference with the observation false 4 FIBRIN Fibrin The Fibrin Index of the specimen. In the case of only differentiating between Absent and Present, recommend using 0 and 1 false 4 HEMOLYSIS Hemolysis An observation of the hemolysis index of the specimen in g/L false 4 ICTERUS Icterus An observation that describes the icterus index of the specimen. It is recommended to use mMol/L of bilirubin false 4 LIPEMIA Lipemia An observation used to describe the Lipemia Index of the specimen. It is recommended to use the optical turbidity at 600 nm (in absorbance units). false 3 VOLUME ActSpecObsVolumeCode An observation that reports the volume of a sample. false 4 AVAILABLE Available Volume The available quantity of specimen. This is the current quantity minus any planned consumption (e.g. tests that are planned) false 4 CONSUMPTION Consumption Volume The quantity of specimen that is used each time the equipment uses this substance false 4 CURRENT Current Volume The current quantity of the specimen, i.e., initial quantity minus what has been actually used. false 4 INITIAL Initial Volume The initial quantity of the specimen in inventory false 2 _AnnotationType AnnotationType AnnotationType true 3 _ActPatientAnnotationType ActPatientAnnotationType Description:Provides a categorization for annotations recorded directly against the patient . false 4 ANNDI diagnostic image note Description:A note that is specific to a patient's diagnostic images, either historical, current or planned. false 4 ANNGEN general note Description:A general or uncategorized note. false 4 ANNIMM immunization note A note that is specific to a patient's immunizations, either historical, current or planned. false 4 ANNLAB laboratory note Description:A note that is specific to a patient's laboratory results, either historical, current or planned. false 4 ANNMED medication note Description:A note that is specific to a patient's medications, either historical, current or planned. false 2 _GeneticObservationType GeneticObservationType Description: None provided true 3 GENE gene Description: A DNA segment that contributes to phenotype/function. In the absence of demonstrated function a gene may be characterized by sequence, transcription or homology false 2 _ImmunizationObservationType ImmunizationObservationType Description: Observation codes which describe characteristics of the immunization material. false 3 OBSANTC antigen count Description: Indicates the valid antigen count. false 3 OBSANTV antigen validity Description: Indicates whether an antigen is valid or invalid. false 2 _IndividualCaseSafetyReportType Individual Case Safety Report Type A code that is used to indicate the type of case safety report received from sender. The current code example reference is from the International Conference on Harmonisation (ICH) Expert Workgroup guideline on Clinical Safety Data Management: Data Elements for Transmission of Individual Case Safety Reports. The unknown/unavailable option allows the transmission of information from a secondary sender where the initial sender did not specify the type of report. Example concepts include: Spontaneous, Report from study, Other. true 3 PAT_ADV_EVNT patient adverse event Indicates that the ICSR is describing problems that a patient experienced after receiving a vaccine product. false 3 VAC_PROBLEM vaccine product problem Indicates that the ICSR is describing a problem with the actual vaccine product such as physical defects (cloudy, particulate matter) or inability to confer immunity. false 2 _LOINCObservationActContextAgeType LOINCObservationActContextAgeType Definition:The set of LOINC codes for the act of determining the period of time that has elapsed since an entity was born or created. true 3 21611-9 age patient qn est Definition:Estimated age. false 3 21612-7 age patient qn reported Definition:Reported age. false 3 29553-5 age patient qn calc Definition:Calculated age. false 3 30525-0 age patient qn definition Definition:General specification of age with no implied method of determination. false 3 30972-4 age at onset of adverse event Definition:Age at onset of associated adverse event; no implied method of determination. false 2 _MedicationObservationType MedicationObservationType MedicationObservationType true 3 REP_HALF_LIFE representative half-life Description:This observation represents an 'average' or 'expected' half-life typical of the product. false 3 SPLCOATING coating Definition: A characteristic of an oral solid dosage form of a medicinal product, indicating whether it has one or more coatings such as sugar coating, film coating, or enteric coating. Only coatings to the external surface or the dosage form should be considered (for example, coatings to individual pellets or granules inside a capsule or tablet are excluded from consideration). Constraints: The Observation.value must be a Boolean (BL) with true for the presence or false for the absence of one or more coatings on a solid dosage form. false 3 SPLCOLOR color Definition: A characteristic of an oral solid dosage form of a medicinal product, specifying the color or colors that most predominantly define the appearance of the dose form. SPLCOLOR is not an FDA specification for the actual color of solid dosage forms or the names of colors that can appear in labeling. Constraints: The Observation.value must be a single coded value or a list of multiple coded values, specifying one or more distinct colors that approximate of the color(s) of distinct areas of the solid dosage form, such as the different sides of a tablet or one-part capsule, or the different halves of a two-part capsule. Bands on banded capsules, regardless of the color, are not considered when assigning an SPLCOLOR. Imprints on the dosage form, regardless of their color are not considered when assigning an SPLCOLOR. If more than one color exists on a particular side or half, then the most predominant color on that side or half is recorded. If the gelatin capsule shell is colorless and transparent, use the predominant color of the contents that appears through the colorless and transparent capsule shell. Colors can include: Black;Gray;White;Red;Pink;Purple;Green;Yellow;Orange;Brown;Blue;Turquoise. false 3 SPLIMAGE image Description: A characteristic representing a single file reference that contains two or more views of the same dosage form of the product; in most cases this should represent front and back views of the dosage form, but occasionally additional views might be needed in order to capture all of the important physical characteristics of the dosage form. Any imprint and/or symbol should be clearly identifiable, and the viewer should not normally need to rotate the image in order to read it. Images that are submitted with SPL should be included in the same directory as the SPL file. false 3 SPLIMPRINT imprint Definition: A characteristic of an oral solid dosage form of a medicinal product, specifying the alphanumeric text that appears on the solid dosage form, including text that is embossed, debossed, engraved or printed with ink. The presence of other non-textual distinguishing marks or symbols is recorded by SPLSYMBOL. Examples: Included in SPLIMPRINT are alphanumeric text that appears on the bands of banded capsules and logos and other symbols that can be interpreted as letters or numbers. Constraints: The Observation.value must be of type Character String (ST). Excluded from SPLIMPRINT are internal and external cut-outs in the form of alphanumeric text and the letter 'R' with a circle around it (when referring to a registered trademark) and the letters 'TM' (when referring to a 'trade mark'). To record text, begin on either side or part of the dosage form. Start at the top left and progress as one would normally read a book. Enter a semicolon to show separation between words or line divisions. false 3 SPLSCORING scoring Definition: A characteristic of an oral solid dosage form of a medicinal product, specifying the number of equal pieces that the solid dosage form can be divided into using score line(s). Example: One score line creating two equal pieces is given a value of 2, two parallel score lines creating three equal pieces is given a value of 3. Constraints: Whether three parallel score lines create four equal pieces or two intersecting score lines create two equal pieces using one score line and four equal pieces using both score lines, both have the scoring value of 4. Solid dosage forms that are not scored are given a value of 1. Solid dosage forms that can only be divided into unequal pieces are given a null-value with nullFlavor other (OTH). false 3 SPLSHAPE shape Description: A characteristic of an oral solid dosage form of a medicinal product, specifying the two dimensional representation of the solid dose form, in terms of the outside perimeter of a solid dosage form when the dosage form, resting on a flat surface, is viewed from directly above, including slight rounding of corners. SPLSHAPE does not include embossing, scoring, debossing, or internal cut-outs. SPLSHAPE is independent of the orientation of the imprint and logo. Shapes can include: Triangle (3 sided); Square; Round; Semicircle; Pentagon (5 sided); Diamond; Double circle; Bullet; Hexagon (6 sided); Rectangle; Gear; Capsule; Heptagon (7 sided); Trapezoid; Oval; Clover; Octagon (8 sided); Tear; Freeform. false 3 SPLSIZE size Definition: A characteristic of an oral solid dosage form of a medicinal product, specifying the longest single dimension of the solid dosage form as a physical quantity in the dimension of length (e.g. 3 mm). The length is should be specified in millimeters and should be rounded to the nearest whole millimeter. Example: SPLSIZE for a rectangular shaped tablet is the length and SPLSIZE for a round shaped tablet is the diameter. false 3 SPLSYMBOL symbol Definition: A characteristic of an oral solid dosage form of a medicinal product, to describe whether or not the medicinal product has a mark or symbol appearing on it for easy and definite recognition. Score lines, letters, numbers, and internal and external cut-outs are not considered marks or symbols. See SPLSCORING and SPLIMPRINT for these characteristics. Constraints: The Observation.value must be a Boolean (BL) with true indicating the presence and false for the absence of marks or symbols. Example: false 2 _ObservationIssueTriggerCodedObservationType ObservationIssueTriggerCodedObservationType Distinguishes the kinds of coded observations that could be the trigger for clinical issue detection. These are observations that are not measurable, but instead can be defined with codes. Coded observation types include: Allergy, Intolerance, Medical Condition, Pregnancy status, etc. true 3 _CaseTransmissionMode case transmission mode Code for the mechanism by which disease was acquired by the living subject involved in the public health case. Includes sexually transmitted, airborne, bloodborne, vectorborne, foodborne, zoonotic, nosocomial, mechanical, dermal, congenital, environmental exposure, indeterminate. true 4 AIRTRNS airborne transmission Communication of an agent from a living subject or environmental source to a living subject through indirect contact via oral or nasal inhalation. false 4 ANANTRNS animal to animal transmission Communication of an agent from one animal to another proximate animal. false 4 ANHUMTRNS animal to human transmission Communication of an agent from an animal to a proximate person. false 4 BDYFLDTRNS body fluid contact transmission Communication of an agent from one living subject to another living subject through direct contact with any body fluid. false 4 BLDTRNS blood borne transmission Communication of an agent to a living subject through direct contact with blood or blood products whether the contact with blood is part of a therapeutic procedure or not. false 4 DERMTRNS transdermal transmission Communication of an agent from a living subject or environmental source to a living subject via agent migration through intact skin. false 4 ENVTRNS environmental exposure transmission Communication of an agent from an environmental surface or source to a living subject by direct contact. false 4 FECTRNS fecal-oral transmission Communication of an agent from a living subject or environmental source to a living subject through oral contact with material contaminated by person or animal fecal material. false 4 FOMTRNS fomite transmission Communication of an agent from an non-living material to a living subject through direct contact. false 4 FOODTRNS food-borne transmission Communication of an agent from a food source to a living subject via oral consumption. false 4 HUMHUMTRNS human to human transmission Communication of an agent from a person to a proximate person. false 4 INDTRNS indeterminate disease transmission mode Communication of an agent to a living subject via an undetermined route. false 4 LACTTRNS lactation transmission Communication of an agent from one living subject to another living subject through direct contact with mammalian milk or colostrum. false 4 NOSTRNS nosocomial transmission Communication of an agent from any entity to a living subject while the living subject is in the patient role in a healthcare facility. false 4 PARTRNS parenteral transmission Communication of an agent from a living subject or environmental source to a living subject where the acquisition of the agent is not via the alimentary canal. false 4 PLACTRNS transplacental transmission Communication of an agent from a living subject to the progeny of that living subject via agent migration across the maternal-fetal placental membranes while in utero. false 4 SEXTRNS sexual transmission Communication of an agent from one living subject to another living subject through direct contact with genital or oral tissues as part of a sexual act. false 4 TRNSFTRNS transfusion transmission Communication of an agent from one living subject to another living subject through direct contact with blood or blood products where the contact with blood is part of a therapeutic procedure. false 4 VECTRNS vector-borne transmission Communication of an agent from a living subject acting as a required intermediary in the agent transmission process to a recipient living subject via direct contact. false 4 WATTRNS water-borne transmission Communication of an agent from a contaminated water source to a living subject whether the water is ingested as a food or not. The route of entry of the water may be through any bodily orifice. false 2 _ObservationQualityMeasureAttribute ObservationQualityMeasureAttribute Codes used to define various metadata aspects of a health quality measure. false 3 AGGREGATE aggregate measure observation Indicates that the observation is carrying out an aggregation calculation, contained in the value element. false 3 COPY copyright Identifies the organization(s) who own the intellectual property represented by the eMeasure. false 3 CRS clinical recommendation statement Summary of relevant clinical guidelines or other clinical recommendations supporting this eMeasure. false 3 DEF definition Description of individual terms, provided as needed. false 3 DISC disclaimer Disclaimer information for the eMeasure. false 3 FINALDT finalized date/time The timestamp when the eMeasure was last packaged in the Measure Authoring Tool. false 3 GUIDE guidance Used to allow measure developers to provide additional guidance for implementers to understand greater specificity than could be provided in the logic for data criteria. false 3 IDUR improvement notation Information on whether an increase or decrease in score is the preferred result (e.g. a higher score indicates better quality OR a lower score indicates better quality OR quality is within a range). false 3 ITMCNT items counted Describes the items counted by the measure (e.g. patients, encounters, procedures, etc.) false 3 KEY keyword A significant word that aids in discoverability. false 3 MEDT measurement end date The end date of the measurement period. false 3 MSD measurement start date The start date of the measurement period. false 3 MSRADJ risk adjustment The method of adjusting for clinical severity and conditions present at the start of care that can influence patient outcomes for making valid comparisons of outcome measures across providers. Indicates whether an eMeasure is subject to the statistical process for reducing, removing, or clarifying the influences of confounding factors to allow more useful comparisons. false 3 MSRAGG rate aggregation Describes how to combine information calculated based on logic in each of several populations into one summarized result. It can also be used to describe how to risk adjust the data based on supplemental data elements described in the eMeasure. (e.g. pneumonia hospital measures antibiotic selection in the ICU versus non-ICU and then the roll-up of the two). Open Issue: The description does NOT align well with the definition used in the HQMF specfication; correct the MSGAGG definition, and the possible distinction of MSRAGG as a child of AGGREGATE. false 3 MSRIMPROV health quality measure improvement notation Information on whether an increase or decrease in score is the preferred result. This should reflect information on which way is better, an increase or decrease in score. false 3 MSRJUR jurisdiction The list of jurisdiction(s) for which the measure applies. false 3 MSRRPTR reporter type Type of person or organization that is expected to report the issue. false 3 MSRRPTTIME timeframe for reporting The maximum time that may elapse following completion of the measure until the measure report must be sent to the receiver. false 3 MSRSCORE measure scoring Indicates how the calculation is performed for the eMeasure (e.g. proportion, continuous variable, ratio) false 3 MSRSET health quality measure care setting Location(s) in which care being measured is rendered Usage Note: MSRSET is used rather than RoleCode because the setting applies to what is being measured, as opposed to participating directly in the health quality measure documantion itself). false 3 MSRTOPIC health quality measure topic type health quality measure topic type false 3 MSRTP measurement period The time period for which the eMeasure applies. false 3 MSRTYPE measure type Indicates whether the eMeasure is used to examine a process or an outcome over time (e.g. Structure, Process, Outcome). false 3 RAT rationale Succinct statement of the need for the measure. Usually includes statements pertaining to Importance criterion: impact, gap in care and evidence. false 3 REF reference Identifies bibliographic citations or references to clinical practice guidelines, sources of evidence, or other relevant materials supporting the intent and rationale of the eMeasure. false 3 SDE supplemental data elements Comparison of results across strata can be used to show where disparities exist or where there is a need to expose differences in results. For example, Centers for Medicare & Medicaid Services (CMS) in the U.S. defines four required Supplemental Data Elements (payer, ethnicity, race, and gender), which are variables used to aggregate data into various subgroups. Additional supplemental data elements required for risk adjustment or other purposes of data aggregation can be included in the Supplemental Data Element section. false 3 STRAT stratification Describes the strata for which the measure is to be evaluated. There are three examples of reasons for stratification based on existing work. These include: (1) evaluate the measure based on different age groupings within the population described in the measure (e.g. evaluate the whole [age 14-25] and each sub-stratum [14-19] and [20-25]); (2) evaluate the eMeasure based on either a specific condition, a specific discharge location, or both; (3) evaluate the eMeasure based on different locations within a facility (e.g. evaluate the overall rate for all intensive care units and also some strata include additional findings [specific birth weights for neonatal intensive care units]). false 3 TRANF transmission format Can be a URL or hyperlinks that link to the transmission formats that are specified for a particular reporting program. false 3 USE notice of use Usage notes. false 2 _ObservationSequenceType ObservationSequenceType ObservationSequenceType true 3 TIME_ABSOLUTE absolute time sequence A sequence of values in the "absolute" time domain. This is the same time domain that all HL7 timestamps use. It is time as measured by the Gregorian calendar false 3 TIME_RELATIVE relative time sequence A sequence of values in a "relative" time domain. The time is measured relative to the earliest effective time in the Observation Series containing this sequence. false 2 _ObservationSeriesType ObservationSeriesType ObservationSeriesType true 3 _ECGObservationSeriesType ECGObservationSeriesType ECGObservationSeriesType true 4 REPRESENTATIVE_BEAT ECG representative beat waveforms This Observation Series type contains waveforms of a "representative beat" (a.k.a. "median beat" or "average beat"). The waveform samples are measured in relative time, relative to the beginning of the beat as defined by the Observation Series effective time. The waveforms are not directly acquired from the subject, but rather algorithmically derived from the "rhythm" waveforms. false 4 RHYTHM ECG rhythm waveforms This Observation type contains ECG "rhythm" waveforms. The waveform samples are measured in absolute time (a.k.a. "subject time" or "effective time"). These waveforms are usually "raw" with some minimal amount of noise reduction and baseline filtering applied. false 2 _PatientImmunizationRelatedObservationType PatientImmunizationRelatedObservationType Description: Reporting codes that are related to an immunization event. false 3 CLSSRM classroom Description: The class room associated with the patient during the immunization event. false 3 GRADE grade Description: The school grade or level the patient was in when immunized. false 3 SCHL school Description: The school the patient attended when immunized. false 3 SCHLDIV school division Description: The school division or district associated with the patient during the immunization event. false 3 TEACHER teacher Description: The patient's teacher when immunized. false 2 _PopulationInclusionObservationType PopulationInclusionObservationType Observation types for specifying criteria used to assert that a subject is included in a particular population. true 3 DENEX denominator exclusions Criteria which specify subjects who should be removed from the eMeasure population and denominator before determining if numerator criteria are met. Denominator exclusions are used in proportion and ratio measures to help narrow the denominator. false 3 DENEXCEP denominator exceptions Criteria which specify the removal of a subject, procedure or unit of measurement from the denominator, only if the numerator criteria are not met. Denominator exceptions allow for adjustment of the calculated score for those providers with higher risk populations. Denominator exceptions are used only in proportion eMeasures. They are not appropriate for ratio or continuous variable eMeasures. Denominator exceptions allow for the exercise of clinical judgment and should be specifically defined where capturing the information in a structured manner fits the clinical workflow. Generic denominator exception reasons used in proportion eMeasures fall into three general categories: Medical reasons Patient (or subject) reasons System reasons false 3 DENOM denominator Criteria for specifying the entities to be evaluated by a specific quality measure, based on a shared common set of characteristics (within a specific measurement set to which a given measure belongs). The denominator can be the same as the initial population, or it may be a subset of the initial population to further constrain it for the purpose of the eMeasure. Different measures within an eMeasure set may have different denominators. Continuous Variable eMeasures do not have a denominator, but instead define a measure population. false 3 IPOP initial population Criteria for specifying the entities to be evaluated by a specific quality measure, based on a shared common set of characteristics (within a specific measurement set to which a given measure belongs). false 4 IPPOP initial patient population Criteria for specifying the patients to be evaluated by a specific quality measure, based on a shared common set of characteristics (within a specific measurement set to which a given measure belongs). Details often include information based upon specific age groups, diagnoses, diagnostic and procedure codes, and enrollment periods. false 3 MSRPOPL measure population Criteria for specifying the measure population as a narrative description (e.g. all patients seen in the Emergency Department during the measurement period). This is used only in continuous variable eMeasures. false 3 MSRPOPLEX measure population exclusions Criteria for specifying subjects who should be removed from the eMeasure's Initial Population and Measure Population. Measure Population Exclusions are used in Continuous Variable measures to help narrow the Measure Population before determining the value(s) of the continuous variable(s). false 3 NUMER numerator Criteria for specifying the processes or outcomes expected for each patient, procedure, or other unit of measurement defined in the denominator for proportion measures, or related to (but not directly derived from) the denominator for ratio measures (e.g. a numerator listing the number of central line blood stream infections and a denominator indicating the days per thousand of central line usage in a specific time period). false 3 NUMEX numerator exclusions Criteria for specifying instances that should not be included in the numerator data. (e.g. if the number of central line blood stream infections per 1000 catheter days were to exclude infections with a specific bacterium, that bacterium would be listed as a numerator exclusion). Numerator Exclusions are used only in ratio eMeasures. false 2 _PreferenceObservationType _PreferenceObservationType Types of observations that can be made about Preferences. true 3 PREFSTRENGTH preference strength An observation about how important a preference is to the target of the preference. false 2 ADVERSE_REACTION Adverse Reaction Indicates that the observation is of an unexpected negative occurrence in the subject suspected to result from the subject's exposure to one or more agents. Observation values would be the symptom resulting from the reaction. false 2 ASSERTION Assertion Description:Refines classCode OBS to indicate an observation in which observation.value contains a finding or other nominalized statement, where the encoded information in Observation.value is not altered by Observation.code. For instance, observation.code="ASSERTION" and observation.value="fracture of femur present" is an assertion of a clinical finding of femur fracture. false 2 CASESER case seriousness criteria Definition:An observation that provides a characterization of the level of harm to an investigation subject as a result of a reaction or event. false 2 CDIO case disease imported observation An observation that states whether the disease was likely acquired outside the jurisdiction of observation, and if so, the nature of the inter-jurisdictional relationship. OpenIssue: This code could be moved to LOINC if it can be done before there are significant implemenations using it. false 2 CRIT criticality A clinical judgment as to the worst case result of a future exposure (including substance administration). When the worst case result is assessed to have a life-threatening or organ system threatening potential, it is considered to be of high criticality. false 2 CTMO case transmission mode observation An observation that states the mechanism by which disease was acquired by the living subject involved in the public health case. OpenIssue: This code could be moved to LOINC if it can be done before there are significant implemenations using it. false 2 DX ObservationDiagnosisTypes Includes all codes defining types of indications such as diagnosis, symptom and other indications such as contrast agents for lab tests. false 3 ADMDX admitting diagnosis Admitting diagnosis are the diagnoses documented for administrative purposes as the basis for a hospital admission. false 3 DISDX discharge diagnosis Discharge diagnosis are the diagnoses documented for administrative purposes as the time of hospital discharge. false 3 INTDX intermediate diagnosis Intermediate diagnoses are those diagnoses documented for administrative purposes during the course of a hospital stay. false 3 NOI nature of injury The type of injury that the injury coding specifies. false 2 GISTIER GIS tier Description: Accuracy determined as per the GIS tier code system. false 2 HHOBS household situation observation Indicates that the observation is of a person’s living situation in a household including the household composition and circumstances. false 2 ISSUE detected issue There is a clinical issue for the therapy that makes continuation of the therapy inappropriate. Open Issue: The definition of this code does not correctly represent the concept space of its specializations (children) false 3 _ActAdministrativeDetectedIssueCode ActAdministrativeDetectedIssueCode Identifies types of detectyed issues for Act class "ALRT" for the administrative and patient administrative acts domains. true 4 _ActAdministrativeAuthorizationDetectedIssueCode ActAdministrativeAuthorizationDetectedIssueCode ActAdministrativeAuthorizationDetectedIssueCode true 5 NAT Insufficient authorization The requesting party has insufficient authorization to invoke the interaction. false 5 SUPPRESSED record suppressed Description: One or more records in the query response have been suppressed due to consent or privacy restrictions. false 5 VALIDAT validation issue Description:The specified element did not pass business-rule validation. false 6 KEY204 Unknown key identifier The ID of the patient, order, etc., was not found. Used for transactions other than additions, e.g. transfer of a non-existent patient. false 6 KEY205 Duplicate key identifier The ID of the patient, order, etc., already exists. Used in response to addition transactions (Admit, New Order, etc.). false 6 COMPLY Compliance Alert There may be an issue with the patient complying with the intentions of the proposed therapy false 7 DUPTHPY Duplicate Therapy Alert The proposed therapy appears to duplicate an existing therapy false 8 DUPTHPCLS duplicate therapeutic alass alert Description:The proposed therapy appears to have the same intended therapeutic benefit as an existing therapy, though the specific mechanisms of action vary. false 8 DUPTHPGEN duplicate generic alert Description:The proposed therapy appears to have the same intended therapeutic benefit as an existing therapy and uses the same mechanisms of action as the existing therapy. false 7 ABUSE commonly abused/misused alert Description:The proposed therapy is frequently misused or abused and therefore should be used with caution and/or monitoring. false 7 FRAUD potential fraud Description:The request is suspected to have a fraudulent basis. false 7 PLYDOC Poly-orderer Alert A similar or identical therapy was recently ordered by a different practitioner. false 7 PLYPHRM Poly-supplier Alert This patient was recently supplied a similar or identical therapy from a different pharmacy or supplier. false 6 DOSE Dosage problem Proposed dosage instructions for therapy differ from standard practice. false 7 DOSECOND dosage-condition alert Description:Proposed dosage is inappropriate due to patient's medical condition. false 7 DOSEDUR Dose-Duration Alert Proposed length of therapy differs from standard practice. false 8 DOSEDURH Dose-Duration High Alert Proposed length of therapy is longer than standard practice false 9 DOSEDURHIND Dose-Duration High for Indication Alert Proposed length of therapy is longer than standard practice for the identified indication or diagnosis false 8 DOSEDURL Dose-Duration Low Alert Proposed length of therapy is shorter than that necessary for therapeutic effect false 9 DOSEDURLIND Dose-Duration Low for Indication Alert Proposed length of therapy is shorter than standard practice for the identified indication or diagnosis false 7 DOSEH High Dose Alert Proposed dosage exceeds standard practice false 8 DOSEHINDA High Dose for Age Alert Proposed dosage exceeds standard practice for the patient's age false 8 DOSEHIND High Dose for Indication Alert High Dose for Indication Alert false 8 DOSEHINDSA High Dose for Height/Surface Area Alert Proposed dosage exceeds standard practice for the patient's height or body surface area false 8 DOSEHINDW High Dose for Weight Alert Proposed dosage exceeds standard practice for the patient's weight false 7 DOSEIVL Dose-Interval Alert Proposed dosage interval/timing differs from standard practice false 8 DOSEIVLIND Dose-Interval for Indication Alert Proposed dosage interval/timing differs from standard practice for the identified indication or diagnosis false 7 DOSEL Low Dose Alert Proposed dosage is below suggested therapeutic levels false 8 DOSELINDA Low Dose for Age Alert Proposed dosage is below suggested therapeutic levels for the patient's age false 8 DOSELIND Low Dose for Indication Alert Low Dose for Indication Alert false 8 DOSELINDSA Low Dose for Height/Surface Area Alert Proposed dosage is below suggested therapeutic levels for the patient's height or body surface area false 8 DOSELINDW Low Dose for Weight Alert Proposed dosage is below suggested therapeutic levels for the patient's weight false 7 MDOSE maximum dosage reached Description:The maximum quantity of this drug allowed to be administered within a particular time-range (month, year, lifetime) has been reached or exceeded. false 6 OBSA Observation Alert Proposed therapy may be inappropriate or contraindicated due to conditions or characteristics of the patient false 7 AGE Age Alert Proposed therapy may be inappropriate or contraindicated due to patient age false 8 ADALRT adult alert Proposed therapy is outside of the standard practice for an adult patient. false 8 GEALRT geriatric alert Proposed therapy is outside of standard practice for a geriatric patient. false 8 PEALRT pediatric alert Proposed therapy is outside of the standard practice for a pediatric patient. false 7 COND Condition Alert Proposed therapy may be inappropriate or contraindicated due to an existing/recent patient condition or diagnosis false 8 HGHT false 8 LACT Lactation Alert Proposed therapy may be inappropriate or contraindicated when breast-feeding false 8 PREG Pregnancy Alert Proposed therapy may be inappropriate or contraindicated during pregnancy false 8 WGHT false 7 CREACT common reaction alert Description:Proposed therapy may be inappropriate or contraindicated because of a common but non-patient specific reaction to the product. Example:There is no record of a specific sensitivity for the patient, but the presence of the sensitivity is common and therefore caution is warranted. false 7 GEN Genetic Alert Proposed therapy may be inappropriate or contraindicated due to patient genetic indicators. false 7 GEND Gender Alert Proposed therapy may be inappropriate or contraindicated due to patient gender. false 7 LAB Lab Alert Proposed therapy may be inappropriate or contraindicated due to recent lab test results false 7 REACT Reaction Alert Proposed therapy may be inappropriate or contraindicated based on the potential for a patient reaction to the proposed product false 8 ALGY Allergy Alert Proposed therapy may be inappropriate or contraindicated because of a recorded patient allergy to the proposed product. (Allergies are immune based reactions.) false 8 INT Intolerance Alert Proposed therapy may be inappropriate or contraindicated because of a recorded patient intolerance to the proposed product. (Intolerances are non-immune based sensitivities.) false 7 RREACT Related Reaction Alert Proposed therapy may be inappropriate or contraindicated because of a potential patient reaction to a cross-sensitivity related product. false 8 RALG Related Allergy Alert Proposed therapy may be inappropriate or contraindicated because of a recorded patient allergy to a cross-sensitivity related product. (Allergies are immune based reactions.) false 8 RAR Related Prior Reaction Alert Proposed therapy may be inappropriate or contraindicated because of a recorded prior adverse reaction to a cross-sensitivity related product. false 8 RINT Related Intolerance Alert Proposed therapy may be inappropriate or contraindicated because of a recorded patient intolerance to a cross-sensitivity related product. (Intolerances are non-immune based sensitivities.) false 6 BUS business constraint violation Description:A local business rule relating multiple elements has been violated. false 6 CODE_INVAL code is not valid Description:The specified code is not valid against the list of codes allowed for the element. false 7 CODE_DEPREC code has been deprecated Description:The specified code has been deprecated and should no longer be used. Select another code from the code system. false 6 FORMAT invalid format Description:The element does not follow the formatting or type rules defined for the field. false 6 ILLEGAL illegal Description:The request is missing elements or contains elements which cause it to not meet the legal standards for actioning. false 6 LEN_RANGE length out of range Description:The length of the data specified falls out of the range defined for the element. false 7 LEN_LONG length is too long Description:The length of the data specified is greater than the maximum length defined for the element. false 7 LEN_SHORT length is too short Description:The length of the data specified is less than the minimum length defined for the element. false 6 MISSCOND conditional element missing Description:The specified element must be specified with a non-null value under certain conditions. In this case, the conditions are true but the element is still missing or null. false 6 MISSMAND mandatory element missing Description:The specified element is mandatory and was not included in the instance. false 6 NODUPS duplicate values are not permitted Description:More than one element with the same value exists in the set. Duplicates not permission in this set in a set. false 6 NOPERSIST element will not be persisted Description: Element in submitted message will not persist in data storage based on detected issue. false 6 REP_RANGE repetitions out of range Description:The number of repeating elements falls outside the range of the allowed number of repetitions. false 7 MAXOCCURS repetitions above maximum Description:The number of repeating elements is above the maximum number of repetitions allowed. false 7 MINOCCURS repetitions below minimum Description:The number of repeating elements is below the minimum number of repetitions allowed. false 4 _ActAdministrativeRuleDetectedIssueCode ActAdministrativeRuleDetectedIssueCode ActAdministrativeRuleDetectedIssueCode true 5 KEY206 non-matching identification Description: Metadata associated with the identification (e.g. name or gender) does not match the identification being verified. false 5 OBSOLETE obsolete record returned Description: One or more records in the query response have a status of 'obsolete'. false 3 _ActSuppliedItemDetectedIssueCode ActSuppliedItemDetectedIssueCode Identifies types of detected issues regarding the administration or supply of an item to a patient. true 4 _AdministrationDetectedIssueCode AdministrationDetectedIssueCode Administration of the proposed therapy may be inappropriate or contraindicated as proposed true 5 _AppropriatenessDetectedIssueCode AppropriatenessDetectedIssueCode AppropriatenessDetectedIssueCode true 6 _InteractionDetectedIssueCode InteractionDetectedIssueCode InteractionDetectedIssueCode true 7 FOOD Food Interaction Alert Proposed therapy may interact with certain foods false 7 TPROD Therapeutic Product Alert Proposed therapy may interact with an existing or recent therapeutic product false 8 DRG Drug Interaction Alert Proposed therapy may interact with an existing or recent drug therapy false 8 NHP Natural Health Product Alert Proposed therapy may interact with existing or recent natural health product therapy false 8 NONRX Non-Prescription Interaction Alert Proposed therapy may interact with a non-prescription drug (e.g. alcohol, tobacco, Aspirin) false 6 PREVINEF previously ineffective Definition:The same or similar treatment has previously been attempted with the patient without achieving a positive effect. false 5 DACT drug action detected issue Description:Proposed therapy may be contraindicated or ineffective based on an existing or recent drug therapy. false 5 TIME timing detected issue Description:Proposed therapy may be inappropriate or ineffective based on the proposed start or end time. false 6 ALRTENDLATE end too late alert Definition:Proposed therapy may be inappropriate or ineffective because the end of administration is too close to another planned therapy. false 6 ALRTSTRTLATE start too late alert Definition:Proposed therapy may be inappropriate or ineffective because the start of administration is too late after the onset of the condition. false 5 _TimingDetectedIssueCode TimingDetectedIssueCode Proposed therapy may be inappropriate or ineffective based on the proposed start or end time. true 6 ENDLATE End Too Late Alert Proposed therapy may be inappropriate or ineffective because the end of administration is too close to another planned therapy false 6 STRTLATE Start Too Late Alert Proposed therapy may be inappropriate or ineffective because the start of administration is too late after the onset of the condition false 4 _SupplyDetectedIssueCode SupplyDetectedIssueCode Supplying the product at this time may be inappropriate or indicate compliance issues with the associated therapy true 5 ALLDONE already performed Definition:The requested action has already been performed and so this request has no effect false 5 FULFIL fulfillment alert Definition:The therapy being performed is in some way out of alignment with the requested therapy. false 6 NOTACTN no longer actionable Definition:The status of the request being fulfilled has changed such that it is no longer actionable. This may be because the request has expired, has already been completely fulfilled or has been otherwise stopped or disabled. (Not used for 'suspended' orders.) false 6 NOTEQUIV not equivalent alert Definition:The therapy being performed is not sufficiently equivalent to the therapy which was requested. false 7 NOTEQUIVGEN not generically equivalent alert Definition:The therapy being performed is not generically equivalent (having the identical biological action) to the therapy which was requested. false 7 NOTEQUIVTHER not therapeutically equivalent alert Definition:The therapy being performed is not therapeutically equivalent (having the same overall patient effect) to the therapy which was requested. false 6 TIMING event timing incorrect alert Definition:The therapy is being performed at a time which diverges from the time the therapy was requested false 7 INTERVAL outside requested time Definition:The therapy action is being performed outside the bounds of the time period requested false 7 MINFREQ too soon within frequency based on the usage Definition:The therapy action is being performed too soon after the previous occurrence based on the requested frequency false 5 HELD held/suspended alert Definition:There should be no actions taken in fulfillment of a request that has been held or suspended. false 5 TOOLATE Refill Too Late Alert The patient is receiving a subsequent fill significantly later than would be expected based on the amount previously supplied and the therapy dosage instructions false 5 TOOSOON Refill Too Soon Alert The patient is receiving a subsequent fill significantly earlier than would be expected based on the amount previously supplied and the therapy dosage instructions false 4 HISTORIC record recorded as historical Description: While the record was accepted in the repository, there is a more recent version of a record of this type. false 4 PATPREF violates stated preferences Definition:The proposed therapy goes against preferences or consent constraints recorded in the patient's record. false 5 PATPREFALT violates stated preferences, alternate available Definition:The proposed therapy goes against preferences or consent constraints recorded in the patient's record. An alternate therapy meeting those constraints is available. false 2 KSUBJ knowledge subject Categorization of types of observation that capture the main clinical knowledge subject which may be a medication, a laboratory test, a disease. false 2 KSUBT knowledge subtopic Categorization of types of observation that capture a knowledge subtopic which might be treatment, etiology, or prognosis. false 2 OINT intolerance Hypersensitivity resulting in an adverse reaction upon exposure to an agent. false 3 ALG Allergy Hypersensitivity to an agent caused by an immunologic response to an initial exposure false 4 DALG Drug Allergy An allergy to a pharmaceutical product. false 4 EALG Environmental Allergy An allergy to a substance other than a drug or a food; e.g. Latex, pollen, etc. false 4 FALG Food Allergy An allergy to a substance generally consumed for nutritional purposes. false 3 DINT Drug Intolerance Hypersensitivity resulting in an adverse reaction upon exposure to a drug. false 4 DNAINT Drug Non-Allergy Intolerance Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure false 3 EINT Environmental Intolerance Hypersensitivity resulting in an adverse reaction upon exposure to environmental conditions. false 4 ENAINT Environmental Non-Allergy Intolerance Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure false 3 FINT Food Intolerance Hypersensitivity resulting in an adverse reaction upon exposure to food. false 4 FNAINT Food Non-Allergy Intolerance Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure false 3 NAINT Non-Allergy Intolerance Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure false 2 SEV Severity Observation A subjective evaluation of the seriousness or intensity associated with another observation. false 2 _FDALabelData FDALabelData FDA label data true 3 FDACOATING coating FDA label coating false 3 FDACOLOR color FDA label color false 3 FDAIMPRINTCD imprint code FDA label imprint code false 3 FDALOGO logo FDA label logo false 3 FDASCORING scoring FDA label scoring false 3 FDASHAPE shape FDA label shape false 3 FDASIZE size FDA label size false 1 _ROIOverlayShape ROIOverlayShape Shape of the region on the object being referenced true 2 CIRCLE circle A circle defined by two (column,row) pairs. The first point is the center of the circle and the second point is a point on the perimeter of the circle. false 2 ELLIPSE ellipse An ellipse defined by four (column,row) pairs, the first two points specifying the endpoints of the major axis and the second two points specifying the endpoints of the minor axis. false 2 POINT point A single point denoted by a single (column,row) pair, or multiple points each denoted by a (column,row) pair. false 2 POLY polyline A series of connected line segments with ordered vertices denoted by (column,row) pairs; if the first and last vertices are the same, it is a closed polygon. false 1 C corrected Description:Indicates that result data has been corrected. false 1 DIET Diet Code set to define specialized/allowed diets false 2 BR breikost (GE) A diet exclusively composed of oatmeal, semolina, or rice, to be extremely easy to eat and digest. false 2 DM diabetes mellitus diet A diet that uses carbohydrates sparingly. Typically with a restriction in daily energy content (e.g. 1600-2000 kcal). false 2 FAST fasting No enteral intake of foot or liquids whatsoever, no smoking. Typically 6 to 8 hours before anesthesia. false 2 FORMULA formula diet A diet consisting of a formula feeding, either for an infant or an adult, to provide nutrition either orally or through the gastrointestinal tract via tube, catheter or stoma. false 2 GF gluten free Gluten free diet for celiac disease. false 2 LF low fat A diet low in fat, particularly to patients with hepatic diseases. false 2 LP low protein A low protein diet for patients with renal failure. false 2 LQ liquid A strictly liquid diet, that can be fully absorbed in the intestine, and therefore may not contain fiber. Used before enteral surgeries. false 2 LS low sodium A diet low in sodium for patients with congestive heart failure and/or renal failure. false 2 N normal diet A normal diet, i.e. no special preparations or restrictions for medical reasons. This is notwithstanding any preferences the patient might have regarding special foods, such as vegetarian, kosher, etc. false 2 NF no fat A no fat diet for acute hepatic diseases. false 2 PAF phenylalanine free Phenylketonuria diet. false 2 PAR parenteral Patient is supplied with parenteral nutrition, typically described in terms of i.v. medications. false 2 RD reduction diet A diet that seeks to reduce body fat, typically low energy content (800-1600 kcal). false 2 SCH schonkost (GE) A diet that avoids ingredients that might cause digestion problems, e.g. avoid excessive fat, avoid too much fiber (cabbage, peas, beans). false 2 SUPPLEMENT nutritional supplement A diet that is not intended to be complete but is added to other diets. false 2 T tea only This is not really a diet, since it contains little nutritional value, but is essentially just water. Used before coloscopy examinations. false 2 VLI low valin, leucin, isoleucin Diet with low content of the amino-acids valin, leucin, and isoleucin, for "maple syrup disease." false 1 DRUGPRG drug program Definition: A public or government health program that administers and funds coverage for prescription drugs to assist program eligible who meet financial and health status criteria. false 1 F final Description:Indicates that a result is complete. No further results are to come. This maps to the 'complete' state in the observation result status code. false 1 PRLMN preliminary Description:Indicates that a result is incomplete. There are further results to come. This maps to the 'active' state in the observation result status code. false 1 SECOBS SecurityObservationType An observation identifying security metadata about an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security metadata are used to name security labels. Rationale: According to ISO/TS 22600-3:2009(E) A.9.1.7 SECURITY LABEL MATCHING, Security label matching compares the initiator's clearance to the target's security label. All of the following must be true for authorization to be granted: The security policy identifiers shall be identical The classification level of the initiator shall be greater than or equal to that of the target (that is, there shall be at least one value in the classification list of the clearance greater than or equal to the classification of the target), and For each security category in the target label, there shall be a security category of the same type in the initiator's clearance and the initiator's classification level shall dominate that of the target. Examples: SecurityObservationType security label fields include: Confidentiality classification Compartment category Sensitivity category Security mechanisms used to ensure data integrity or to perform authorized data transformation Indicators of an IT resource completeness, veracity, reliability, trustworthiness, or provenance. Usage Note: SecurityObservationType codes designate security label field types, which are valued with an applicable SecurityObservationValue code as the "security label tag". true 2 SECCATOBS security category observation Type of security metadata observation made about the category of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security category metadata is defined by ISO/IEC 2382-8:1998(E/F)/ T-REC-X.812-1995 as: "A nonhierarchical grouping of sensitive information used to control access to data more finely than with hierarchical security classification alone." Rationale: A security category observation supports requirement to specify the type of IT resource to facilitate application of appropriate levels of information security according to a range of levels of impact or consequences that might result from the unauthorized disclosure, modification, or use of the information or information system. A resource is assigned to a specific category of information (e.g. privacy, medical, proprietary, financial, investigative, contractor sensitive, security management) defined by an organization or in some instances, by a specific law, Executive Order, directive, policy, or regulation. [FIPS 199] Examples: Types of security categories include: Compartment: A division of data into isolated blocks with separate security controls for the purpose of reducing risk. (ISO 2382-8). A security label tag that "segments" an IT resource by indicating that access and use is restricted to members of a defined community or project. (HL7 Healthcare Classification System) Sensitivity: The characteristic of an IT resource which implies its value or importance and may include its vulnerability. (ISO 7492-2) Privacy metadata for information perceived as undesirable to share. (HL7 Healthcare Classification System) false 2 SECCLASSOBS security classification observation Type of security metadata observation made about the classification of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security classification is defined by ISO/IEC 2382-8:1998(E/F)/ T-REC-X.812-1995 as: "The determination of which specific degree of protection against access the data or information requires, together with a designation of that degree of protection." Security classification metadata is based on an analysis of applicable policies and the risk of financial, reputational, or other harm that could result from unauthorized disclosure. Rationale: A security classification observation may indicate that the confidentiality level indicated by an Act or Role confidentiality attribute has been overridden by the entity responsible for ascribing the SecurityClassificationObservationValue. This supports the business requirement for increasing or decreasing the level of confidentiality (classification or declassification) based on parameters beyond the original assignment of an Act or Role confidentiality. Examples: Types of security classification include: HL7 Confidentiality Codes such as very restricted, unrestricted, and normal. Intelligence community examples include top secret, secret, and confidential. Usage Note: Security classification observation type codes designate security label field types, which are valued with an applicable SecurityClassificationObservationValue code as the "security label tag". false 2 SECCONOBS security control observation Type of security metadata observation made about the control of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security control metadata convey instructions to users and receivers for secure distribution, transmission, and storage; dictate obligations or mandated actions; specify any action prohibited by refrain policy such as dissemination controls; and stipulate the permissible purpose of use of an IT resource. Rationale: A security control observation supports requirement to specify applicable management, operational, and technical controls (i.e., safeguards or countermeasures) prescribed for an information system to protect the confidentiality, integrity, and availability of the system and its information. [FIPS 199] Examples: Types of security control metadata include: handling caveats dissemination controls obligations refrain policies purpose of use constraints false 2 SECINTOBS security integrity observation Type of security metadata observation made about the integrity of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Rationale: A security integrity observation supports the requirement to guard against improper information modification or destruction, and includes ensuring information non-repudiation and authenticity. (44 U.S.C., SEC. 3542) Examples: Types of security integrity metadata include: Integrity status, which indicates the completeness or workflow status of an IT resource (data, information object, service, or system capability) Integrity confidence, which indicates the reliability and trustworthiness of an IT resource Integrity control, which indicates pertinent handling caveats, obligations, refrain policies, and purpose of use for the resource Data integrity, which indicate the security mechanisms used to ensure that the accuracy and consistency are preserved regardless of changes made (ISO/IEC DIS 2382-8) Alteration integrity, which indicate the security mechanisms used for authorized transformations of the resource Integrity provenance, which indicates the entity responsible for a report or assertion relayed "second-hand" about an IT resource false 3 SECALTINTOBS security alteration integrity observation Type of security metadata observation made about the alteration integrity of an IT resource (data, information object, service, or system capability), which indicates the mechanism used for authorized transformations of the resource. Examples: Types of security alteration integrity observation metadata, which may value the observation with a code used to indicate the mechanism used for authorized transformation of an IT resource, including: translation syntactic transformation semantic mapping redaction masking pseudonymization anonymization false 3 SECDATINTOBS security data integrity observation Type of security metadata observation made about the data integrity of an IT resource (data, information object, service, or system capability), which indicates the security mechanism used to preserve resource accuracy and consistency. Data integrity is defined by ISO 22600-23.3.21 as: "The property that data has not been altered or destroyed in an unauthorized manner", and by ISO/IEC 2382-8: The property of data whose accuracy and consistency are preserved regardless of changes made." Examples: Types of security data integrity observation metadata, which may value the observation, include cryptographic hash function and digital signature. false 3 SECINTCONOBS security integrity confidence observation Type of security metadata observation made about the integrity confidence of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Examples: Types of security integrity confidence observation metadata, which may value the observation, include highly reliable, uncertain reliability, and not reliable. Usage Note: A security integrity confidence observation on an Act may indicate that a valued Act.uncertaintycode attribute has been overridden by the entity responsible for ascribing the SecurityIntegrityConfidenceObservationValue. This supports the business requirements for increasing or decreasing the assessment of the reliability or trustworthiness of an IT resource based on parameters beyond the original assignment of an Act statement level of uncertainty. false 3 SECINTPRVOBS security integrity provenance observation Type of security metadata observation made about the provenance integrity of an IT resource (data, information object, service, or system capability), which indicates the lifecycle completeness of an IT resource in terms of workflow status such as its creation, modification, suspension, and deletion; locations in which the resource has been collected or archived, from which it may be retrieved, and the history of its distribution and disclosure. Integrity provenance metadata about an IT resource may be used to assess its veracity, reliability, and trustworthiness. Examples: Types of security integrity provenance observation metadata, which may value the observation about an IT resource, include: completeness or workflow status, such as authentication the entity responsible for original authoring or informing about an IT resource the entity responsible for a report or assertion about an IT resource relayed “second-handâ€? the entity responsible for excerpting, transforming, or compiling an IT resource true 4 SECINTPRVABOBS security integrity provenance asserted by observation Type of security metadata observation made about the integrity provenance of an IT resource (data, information object, service, or system capability), which indicates the entity that made assertions about the resource. The asserting entity may not be the original informant about the resource. Examples: Types of security integrity provenance asserted by observation metadata, which may value the observation, including: assertions about an IT resource by a patient assertions about an IT resource by a clinician assertions about an IT resource by a device false 4 SECINTPRVRBOBS security integrity provenance reported by observation Type of security metadata observation made about the integrity provenance of an IT resource (data, information object, service, or system capability), which indicates the entity that reported the existence of the resource. The reporting entity may not be the original author of the resource. Examples: Types of security integrity provenance reported by observation metadata, which may value the observation, include: reports about an IT resource by a patient reports about an IT resource by a clinician reports about an IT resource by a device false 3 SECINTSTOBS security integrity status observation Type of security metadata observation made about the integrity status of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Indicates the completeness of an IT resource in terms of workflow status, which may impact users that are authorized to access and use the resource. Examples: Types of security integrity status observation metadata, which may value the observation, include codes from the HL7 DocumentCompletion code system such as legally authenticated, in progress, and incomplete. false 2 SECTRSTOBS SECTRSTOBS An observation identifying trust metadata about an IT resource (data, information object, service, or system capability), which may be used as a trust attribute to populate a computable trust policy, trust credential, trust assertion, or trust label field in a security label or trust policy, which are principally used for authentication, authorization, and access control decisions. true 3 TRSTACCRDOBS trust accreditation observation Type of security metadata observation made about the formal declaration by an authority or neutral third party that validates the technical, security, trust, and business practice conformance of Trust Agents to facilitate security, interoperability, and trust among participants within a security domain or trust framework. false 3 TRSTAGREOBS trust agreement observation Type of security metadata observation made about privacy and security requirements with which a security domain must comply. [ISO IEC 10181-1] false 3 TRSTCERTOBS trust certificate observation Type of security metadata observation made about a set of security-relevant data issued by a security authority or trusted third party, together with security information which is used to provide the integrity and data origin authentication services for an IT resource (data, information object, service, or system capability). [Based on ISO IEC 10181-1] For example, A Certificate Policy (CP), which is a named set of rules that indicates the applicability of a certificate to a particular community and/or class of application with common security requirements. For example, a particular Certificate Policy might indicate the applicability of a type of certificate to the authentication of electronic data interchange transactions for the trading of goods within a given price range. [Trust Service Principles and Criteria for Certification Authorities Version 2.0 March 2011 Copyright 2011 by Canadian Institute of Chartered Accountants. A Certificate Practice Statement (CSP), which is a statement of the practices which an Authority employs in issuing and managing certificates. [Trust Service Principles and Criteria for Certification Authorities Version 2.0 March 2011 Copyright 2011 by Canadian Institute of Chartered Accountants.] false 3 TRSTFWKOBS trust framework observation Type of security metadata observation made about a complete set of contracts, regulations or commitments that enable participating actors to rely on certain assertions by other actors to fulfill their information security requirements. [Kantara Initiative] false 3 TRSTLOAOBS trust assurance observation Type of security metadata observation made about the digital quality or reliability of a trust assertion, activity, capability, information exchange, mechanism, process, or protocol. false 3 TRSTMECOBS trust mechanism observation Type of security metadata observation made about a security architecture system component that supports enforcement of security policies. false 1 SUBSIDFFS subsidized fee for service program Definition: A government health program that provides coverage on a fee for service basis for health services to persons meeting eligibility criteria such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds. Discussion: The structure and business processes for underwriting and administering a subsidized fee for service program is further specified by the Underwriter and Payer Role.class and Role.code. false 1 WRKCOMP (workers compensation program Definition: Government mandated program providing coverage, disability income, and vocational rehabilitation for injuries sustained in the work place or in the course of employment. Employers may either self-fund the program, purchase commercial coverage, or pay a premium to a government entity that administers the program. Employees may be required to pay premiums toward the cost of coverage as well. false 1 _ActProcedureCode ActProcedureCode An identifying code for healthcare interventions/procedures. true 2 _ActBillableServiceCode ActBillableServiceCode Definition: An identifying code for billable services, as opposed to codes for similar services used to identify them for functional purposes. true 1 _HL7DefinedActCodes HL7DefinedActCodes Domain provides the root for HL7-defined detailed or rich codes for the Act classes. true 1 COPAY false 1 DEDUCT false 1 DOSEIND false 1 PRA false 1 STORE Storage The act of putting something away for safe keeping. The "something" may be physical object such as a specimen, or information, such as observations regarding a specimen. false
An account represents a grouping of financial transactions that are tracked and reported together with a single balance. Examples of account codes (types) are Patient billing accounts (collection of charges), Cost centers; Cash.
An account for collecting charges, reversals, adjustments and payments, including deductibles, copayments, coinsurance (financial transactions) credited or debited to the account receivable account for a patient's encounter.
Description: Types of advance payment to be made on a plastic card usually issued by a financial institution used of purchasing services and/or products.
An account representing charges and credits (financial transactions) for a patient's encounter.
Includes coded responses that will occur as a result of the adjudication of an electronic invoice at a summary level and provides guidance on interpretation of the referenced adjudication results.
Catagorization of grouping criteria for the associated transactions and/or summary (totals, subtotals).
Transaction counts and value totals by Contract Identifier.
Transaction counts and value totals for each calendar day within the date range specified.
Transaction counts and value totals by service location (e.g. clinic).
Transaction counts and value totals for each calendar month within the date range specified.
Transaction counts and value totals for the date range specified.
Transaction counts and value totals by Provider Identifier.
Transaction counts and value totals for each calendar week within the date range specified.
Transaction counts and value totals for each calendar year within the date range specified.
The invoice element has been accepted for payment but one or more adjustment(s) have been made to one or more invoice element line items (component charges). Also includes the concept 'Adjudicate as zero' and items not covered under a particular Policy. Invoice element can be reversed (nullified). Recommend that the invoice element is saved for DUR (Drug Utilization Reporting).
adjudicated with adjustments and no financial impact
The invoice element has been accepted for payment but one or more adjustment(s) have been made to one or more invoice element line items (component charges) without changing the amount. Invoice element can be reversed (nullified). Recommend that the invoice element is saved for DUR (Drug Utilization Reporting).
The invoice element has passed through the adjudication process but payment is refused due to one or more reasons. Includes items such as patient not covered, or invoice element is not constructed according to payer rules (e.g. 'invoice submitted too late'). If one invoice element line item in the invoice element structure is rejected, the remaining line items may not be adjudicated and the complete group is treated as rejected. A refused invoice element can be forwarded to the next payer (for Coordination of Benefits) or modified and resubmitted to refusing payer. Invoice element cannot be reversed (nullified) as there is nothing to reverse. Recommend that the invoice element is not saved for DUR (Drug Utilization Reporting).
The invoice element was/will be paid exactly as submitted, without financial adjustment(s). If the dollar amount stays the same, but the billing codes have been amended or financial adjustments have been applied through the adjudication process, the invoice element is treated as "Adjudicated with Adjustment". If information items are included in the adjudication results that do not affect the monetary amounts paid, then this is still Adjudicated as Submitted (e.g. 'reached Plan Maximum on this Claim'). Invoice element can be reversed (nullified). Recommend that the invoice element is saved for DUR (Drug Utilization Reporting).
Actions to be carried out by the recipient of the Adjudication Result information.
The adjudication result associated is to be displayed to the receiver of the adjudication result.
The adjudication result associated is to be printed on the specified form, which is then provided to the covered party.
Definition:An identifying modifier code for healthcare interventions or procedures.
Description:CPT modifier codes are found in Appendix A of CPT 2000 Standard Edition.
Description:HCPCS Level II (HCFA-assigned) and Carrier-assigned (Level III) modifiers are reported in Appendix A of CPT 2000 Standard Edition and in the Medicare Bulletin.
The type of provision(s) made for reimbursing for the deliver of healthcare services and/or goods provided by a Provider, over a specified period.
A billing arrangement where a Provider charges a lump sum to provide a prescribed group (volume) of services to a single patient which occur over a period of time. Services included in the block may vary. This billing arrangement is also known as Program of Care for some specific Payors and Program Fees for other Payors.
A billing arrangement where the payment made to a Provider is determined by analyzing one or more demographic attributes about the persons/patients who are enrolled with the Provider (in their practice).
A billing arrangement where a Provider charges a lump sum to provide a particular volume of one or more interventions/procedures or groups of interventions/procedures.
A billing arrangement where a Provider charges for non-clinical items. This includes interest in arrears, mileage, etc. Clinical content is not included in Invoices submitted with this type of billing arrangement.
A billing arrangement where funding is based on a list of individuals registered as patients of the Provider.
A billing arrangement where a Provider charges a sum to provide a group (volume) of interventions/procedures to one or more patients within a defined period of time, typically on the same date. Interventions/procedures included in the session may vary.
A billing arrangement where a Provider charges a separate fee for each intervention/procedure/event or product. Fee for Service is used when an individual intervention/procedure/event is used for billing purposes. In other words, fees are associated with the intervention/procedure/event. For example, a specific CCI (Canadian Classification of Interventions) code has an associated fee and is used for billing purposes.
A first fill where the quantity supplied is less than one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.) and also where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets)
A first fill where the quantity supplied is equal to one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets) and also where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).
A fill where a small portion is provided to allow for determination of the therapy effectiveness and patient tolerance and also where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).
A fully specified bounded Region of Interest (ROI) delineates a ROI in which only those dimensions participate that are specified by boundary criteria, whereas all other dimensions are excluded. For example a ROI to mark an episode of "ST elevation" in a subset of the EKG leads V2, V3, and V4 would include 4 boundaries, one each for time, V2, V3, and V4.
A partially specified bounded Region of Interest (ROI) specifies a ROI in which at least all values in the dimensions specified by the boundary criteria participate. For example, if an episode of ventricular fibrillations (VFib) is observed, it usually doesn't make sense to exclude any EKG leads from the observation and the partially specified ROI would contain only one boundary for time indicating the time interval where VFib was observed.
Description:The type and scope of responsibility taken-on by the performer of the Act for a specific subject of care.
Description:The type and scope of legal and/or professional responsibility taken-on by the performer of the Act for a specific subject of care as described by a credentialing agency, i.e. government or non-government agency. Failure in executing this Act may result in loss of credential to the person or organization who participates as performer of the Act. Excludes employment agreements. Example:Hospital license; physician license; clinic accreditation.
Description:The type and scope of legal and/or professional responsibility taken-on by the performer of the Act for a specific subject of care as described by an agency for credentialing individuals.
certified anatomic pathology and clinical pathology care
Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.
certified clinical biochemical genetics care
certified clinical molecular genetics care
Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board
certified neurology with special qualifications in child neurology care
certified obstetrics and gynecology care
certified public health and general preventive medicine care
certified physical medicine and rehabilitation care
Description:Scope of responsibility taken-on for physician care of a patient as defined by a governmental licensing agency.
Description:The type and scope of legal and/or professional responsibility taken-on by the performer of the Act for a specific subject of care as described by an agency for credentialing programs within organizations.
Description:Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency.
accredited critical access hospital care
Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.
certified acute myocardial infarction care
certified digestive/gastrointestinal disorders care
certified orthopedic joint replacement care
certified chronic obstructive pulmonary disease care
certified stroke disease management care
Domain provides codes that qualify the ActEncounterClass (ENC)
A comprehensive term for health care provided in a healthcare facility (e.g. a practitioneraTMs office, clinic setting, or hospital) on a nonresident basis. The term ambulatory usually implies that the patient has come to the location and is not assigned to a bed. Sometimes referred to as an outpatient encounter.
A patient encounter that takes place at a dedicated healthcare service delivery location where the patient receives immediate evaluation and treatment, provided until the patient can be discharged or responsibility for the patient's care is transferred elsewhere (for example, the patient could be admitted as an inpatient or transferred to another facility.)
A patient encounter that takes place both outside a dedicated service delivery location and outside a patient's residence. Example locations might include an accident site and at a supermarket.
Healthcare encounter that takes place in the residence of the patient or a designee
A patient encounter where a patient is admitted by a hospital or equivalent facility, assigned to a location where patients generally stay at least overnight and provided with room, board, and continuous nursing service.
Any category of inpatient encounter except 'acute'
A patient encounter where patient is scheduled or planned to receive service delivery in the future, and the patient is given a pre-admission account number. When the patient comes back for subsequent service, the pre-admission encounter is selected and is encapsulated into the service registration, and a new account number is generated. Usage Note: This is intended to be used in advance of encounter types such as ambulatory, inpatient encounter, virtual, etc.
An encounter where the patient is admitted to a health care facility for a predetermined length of time, usually less than 24 hours.
A patient encounter where the patient and the practitioner(s) are not in the same physical location. Examples include telephone conference, email exchange, robotic surgery, and televideo conference.
General category of medical service provided to the patient during their encounter.
Provision of Alternate Level of Care to a patient in an acute bed. Patient is waiting for placement in a long-term care facility and is unable to return home.
Provision of diagnosis and treatment of diseases and disorders affecting the heart
Provision of recurring care for chronic illness.
Provision of treatment for oral health and/or dental surgery.
General care performed by a general practitioner or family doctor as a responsible provider for a patient.
Provision of diagnostic and/or therapeutic treatment.
Provision of care of women during pregnancy, childbirth and immediate postpartum period. Also known as Maternity.
Provision of treatment and/or diagnosis related to tumors and/or cancer.
Provision of care for patients who are living or dying from an advanced illness.
Provision of diagnosis and treatment of diseases and disorders affecting children.
Pharmaceutical care performed by a pharmacist.
Provision of treatment for physical injury.
Provision of treatment of psychiatric disorder relating to mental illness.
Description: Coded types of attachments included to support a healthcare claim.
Description: Automobile Information Attachment
Description: Work Injury related additional Information Attachment
Definition: The type of consent directive, e.g. to consent or dissent to collect, access, or use in specific ways within an EHRS or for health information exchange; or to disclose health information for purposes such as research.
Definition: Consent to have healthcare information collected in an electronic health record. This entails that the information may be used in analysis, modified, updated.
Definition: Consent to have collected healthcare information disclosed.
Definition: Consent to access healthcare information.
Definition: Consent to access or "read" only, which entails that the information is not to be copied, screen printed, saved, emailed, stored, re-disclosed or altered in any way. This level ensures that data which is masked or to which access is restricted will not be. Example: Opened and then emailed or screen printed for use outside of the consent directive purpose.
Definition: Consent to access and save only, which entails that access to the saved copy will remain locked.
Definition: Information re-disclosed without the patient's consent.
Definition: Consent to have healthcare information in an electronic health record accessed for research purposes.
Definition: 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.
Definition: 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. Example:: Where there is a need to inform the subject of potential health issues.
Constrains the ActCode to the domain of Container Registration
Used by one system to inform another that it has received a container.
Used by one system to inform another that the container is in position for specimen transfer (e.g. container removal from track, pipetting, etc.).
Used by one system to inform another that the container has been released from that system.
Used by one system to inform another that the container did not arrive at its next expected location.
Used by one system to inform another that the specific container is being processed by the equipment. It is useful as a response to a query about Container Status, when the specific step of the process is not relevant.
Status is used by one system to inform another that the processing has been completed, but the container has not been released from that system.
Used by one system to inform another that the container is no longer available within the scope of the system (e.g. tube broken or discarded).
An observation form that determines parameters or attributes of an Act. Examples are the settings of a ventilator machine as parameters of a ventilator treatment act; the controls on dillution factors of a chemical analyzer as a parameter of a laboratory observation act; the settings of a physiologic measurement assembly (e.g. time skew) or the position of the body while measuring blood pressure. Control variables are forms of observations because just as with clinical observations, the Observation.code determines the parameter and the Observation.value assigns the value. While control variables sometimes can be observed (by noting the control settings or an actually measured feedback loop) they are not primary observations, in the sense that a control variable without a primary act is of no use (e.g. it makes no sense to record a blood pressure position without recording a blood pressure, whereas it does make sense to record a systolic blood pressure without a diastolic blood pressure).
Specifies whether or not automatic repeat testing is to be initiated on specimens.
A baseline value for the measured test that is inherently contained in the diluent. In the calculation of the actual result for the measured test, this baseline value is normally considered.
Specifies whether or not further testing may be automatically or manually initiated on specimens.
Response to an insurance coverage eligibility query or authorization request.
Indication of authorization for healthcare service(s) and/or product(s). If authorization is approved, funds are set aside.
Authorization approved and funds have been set aside to pay for specified healthcare service(s) and/or product(s) within defined criteria for the authorization.
Authorization for specified healthcare service(s) and/or product(s) denied.
Indication of eligibility coverage for healthcare service(s) and/or product(s).
Insurance coverage is in effect for healthcare service(s) and/or product(s).
Insurance coverage is not in effect for healthcare service(s) and/or product(s). May optionally include reasons for the ineligibility.
Criteria that are applicable to the authorized coverage.
Maximum amount paid or maximum number of services/products covered; or maximum amount or number covered during a specified time period under the policy or program.
Codes representing the time period during which coverage is available; or financial participation requirements are in effect.
Definition: Maximum amount paid by payer or covered party; or maximum number of services or products covered under the policy or program during a covered party's lifetime.
Maximum net amount that will be covered for the product or service specified.
Definition: Maximum amount paid by payer or covered party; or maximum number of services/products covered under the policy or program by time period specified by the effective time on the act.
Maximum unit price that will be covered for the authorized product or service.
Maximum number of items that will be covered of the product or service specified.
Definition: Codes representing the maximum coverate or financial participation requirements.
Codes representing the types of covered parties that may receive covered benefits under a policy or program.
Definition: Set of codes indicating the type of insurance policy or program that pays for the cost of benefits provided to covered parties.
Set of codes indicating the type of insurance policy or other source of funds to cover healthcare costs.
Private insurance policy that provides coverage in addition to other policies (e.g. in addition to a Public Healthcare insurance policy).
Insurance policy that provides for an allotment of funds replenished on a periodic (e.g. annual) basis. The use of the funds under this policy is at the discretion of the covered party.
Insurance policy for injuries sustained in an automobile accident. Will also typically covered non-named parties to the policy, such as pedestrians and passengers.
Definition: An automobile insurance policy under which the insurance company will cover the cost of damages to an automobile owned by the named insured that are caused by accident or intentionally by another party.
Definition: An automobile insurance policy under which the insurance company will indemnify a loss for which another motorist is liable if that motorist is unable to pay because he or she is uninsured. Coverage under the policy applies to bodily injury damages only. Injuries to the covered party caused by a hit-and-run driver are also covered.
Insurance policy funded by a public health system such as a provincial or national health plan. Examples include BC MSP (British Columbia Medical Services Plan) OHIP (Ontario Health Insurance Plan), NHS (National Health Service).
Definition: A public or government health program that administers and funds coverage for dental care to assist program eligible who meet financial and health status criteria.
Definition: A public or government health program that administers and funds coverage for health and social services to assist program eligible who meet financial and health status criteria related to a particular disease. Example: Reproductive health, sexually transmitted disease, and end renal disease programs.
Definition: A program that provides low-income, uninsured, and underserved women access to timely, high-quality screening and diagnostic services, to detect breast and cervical cancer at the earliest stages. Example: To improve women's access to screening for breast and cervical cancers, Congress passed the Breast and Cervical Cancer Mortality Prevention Act of 1990, which guided CDC in creating the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), which provides access to critical breast and cervical cancer screening services for underserved women in the United States. An estimated 7 to 10% of U.S. women of screening age are eligible to receive NBCCEDP services. Federal guidelines establish an eligibility baseline to direct services to uninsured and underinsured women at or below 250% of federal poverty level; ages 18 to 64 for cervical screening; ages 40 to 64 for breast screening.
Definition: A public or government program that administers publicly funded coverage of kidney dialysis and kidney transplant services. Example: In the U.S., the Medicare End-stage Renal Disease program (ESRD), the National Kidney Foundation (NKF) American Kidney Fund (AKF) The Organ Transplant Fund.
Definition: Government administered and funded HIV-AIDS program for beneficiaries meeting financial and health status criteria. Administration, funding levels, eligibility criteria, covered benefits, provider types, and financial participation are typically set by a regulatory process. Payer responsibilities for administering the program may be delegated to contractors. Example: In the U.S., the Ryan White program, which is administered by the Health Resources and Services Administration.
Definition: Government administered and funded mental health program for beneficiaries meeting financial and mental health status criteria. Administration, funding levels, eligibility criteria, covered benefits, provider types, and financial participation are typically set by a regulatory process. Payer responsibilities for administering the program may be delegated to contractors. Example: In the U.S., states receive funding for substance use programs from the Substance Abuse Mental Health Administration (SAMHSA).
Definition: Government administered and funded program to support provision of care to underserved populations through safety net clinics. Example: In the U.S., safety net providers such as federally qualified health centers (FQHC) receive funding under PHSA Section 330 grants administered by the Health Resources and Services Administration.
Definition: Government administered and funded substance use program for beneficiaries meeting financial, substance use behavior, and health status criteria. Beneficiaries may be required to enroll as a result of legal proceedings. Administration, funding levels, eligibility criteria, covered benefits, provider types, and financial participation are typically set by a regulatory process. Payer responsibilities for administering the program may be delegated to contractors. Example: In the U.S., states receive funding for substance use programs from the Substance Abuse Mental Health Administration (SAMHSA).
Definition: A government health program that provides coverage for health services to persons meeting eligibility criteria such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds.
Definition: A government health program that provides coverage through managed care contracts for health services to persons meeting eligibility criteria such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds. Discussion: The structure and business processes for underwriting and administering a subsidized managed care program is further specified by the Underwriter and Payer Role.class and Role.code.
Definition: A government health program that provides coverage for health services to persons meeting eligibility criteria for a supplemental health policy or program such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds. Example: Supplemental health coverage program may cover the cost of a health program or policy financial participations, such as the copays and the premiums, and may provide coverage for services in addition to those covered under the supplemented health program or policy. In the U.S., Medicaid programs may pay the premium for a covered party who is also covered under the Medicare program or a private health policy. Discussion: The structure and business processes for underwriting and administering a subsidized supplemental retiree health program is further specified by the Underwriter and Payer Role.class and Role.code.
Insurance policy for injuries sustained in the work place or in the course of employment.
Definition: Set of codes indicating the type of insurance policy. Insurance, in law and economics, is a form of risk management primarily used to hedge against the risk of potential financial loss. Insurance is defined as the equitable transfer of the risk of a potential loss, from one entity to another, in exchange for a premium and duty of care. A policy holder is an individual or an organization enters into a contract with an underwriter which stipulates that, in exchange for payment of a sum of money (a premium), one or more covered parties (insureds) is guaranteed compensation for losses resulting from certain perils under specified conditions. The underwriter analyzes the risk of loss, makes a decision as to whether the risk is insurable, and prices the premium accordingly. A policy provides benefits that indemnify or cover the cost of a loss incurred by a covered party, and may include coverage for services required to remediate a loss. An insurance policy contains pertinent facts about the policy holder, the insurance coverage, the covered parties, and the insurer. A policy may include exemptions and provisions specifying the extent to which the indemnification clause cannot be enforced for intentional tortious conduct of a covered party, e.g. whether the covered parties are jointly or severably insured. Discussion: In contrast to programs, an insurance policy has one or more policy holders, who own the policy. The policy holder may be the covered party, a relative of the covered party, a partnership, or a corporation, e.g. an employer. A subscriber of a self-insured health insurance policy is a policy holder. A subscriber of an employer sponsored health insurance policy is holds a certificate of coverage, but is not a policy holder; the policy holder is the employer. See CoveredRoleType.
Definition: Set of codes indicating the type of health insurance policy that covers health services provided to covered parties. A health insurance policy is a written contract for insurance between the insurance company and the policyholder, and contains pertinent facts about the policy owner (the policy holder), the health insurance coverage, the insured subscribers and dependents, and the insurer. Health insurance is typically administered in accordance with a plan, which specifies (1) the type of health services and health conditions that will be covered under what circumstances (e.g. exclusion of a pre-existing condition, service must be deemed medically necessary; service must not be experimental; service must provided in accordance with a protocol; drug must be on a formulary; service must be prior authorized; or be a referral from a primary care provider); (2) the type and affiliation of providers (e.g. only allopathic physicians, only in network, only providers employed by an HMO); (3) financial participations required of covered parties (e.g. co-pays, coinsurance, deductibles, out-of-pocket); and (4) the manner in which services will be paid (e.g. under indemnity or fee-for-service health plans, the covered party typically pays out-of-pocket and then file a claim for reimbursement, while health plans that have contractual relationships with providers, i.e., network providers, typically do not allow the providers to bill the covered party for the cost of the service until after filing a claim with the payer and receiving reimbursement).
Definition: A health insurance policy that that covers benefits for dental services.
Definition: A health insurance policy that covers benefits for healthcare services provided for named conditions under the policy, e.g. cancer, diabetes, or HIV-AIDS.
Definition: A health insurance policy that covers benefits for prescription drugs, pharmaceuticals, and supplies.
Definition: A health insurance policy that covers healthcare benefits by protecting covered parties from medical expenses arising from health conditions, sickness, or accidental injury as well as preventive care. Health insurance policies explicitly exclude coverage for losses insured under a disability policy, workers' compensation program, liability insurance (including automobile insurance); or for medical expenses, coverage for on-site medical clinics or for limited dental or vision benefits when these are provided under a separate policy. Discussion: Health insurance policies are offered by health insurance plans that typically reimburse providers for covered services on a fee-for-service basis, that is, a fee that is the allowable amount that a provider may charge. This is in contrast to managed care plans, which typically prepay providers a per-member/per-month amount or capitation as reimbursement for all covered services rendered. Health insurance plans include indemnity and healthcare services plans.
Definition: An insurance policy that covers benefits for long-term care services people need when they no longer can care for themselves. This may be due to an accident, disability, prolonged illness or the simple process of aging. Long-term care services assist with activities of daily living including: Help at home with day-to-day activities, such as cooking, cleaning, bathing and dressing Care in the community, such as in an adult day care facility Supervised care provided in an assisted living facility Skilled care provided in a nursing home
Definition: Government mandated program providing coverage, disability income, and vocational rehabilitation for injuries sustained in the work place or in the course of employment. Employers may either self-fund the program, purchase commercial coverage, or pay a premium to a government entity that administers the program. Employees may be required to pay premiums toward the cost of coverage as well. Managed care policies specifically exclude coverage for losses insured under a disability policy, workers' compensation program, liability insurance (including automobile insurance); or for medical expenses, coverage for on-site medical clinics or for limited dental or vision benefits when these are provided under a separate policy. Discussion: Managed care policies are offered by managed care plans that contract with selected providers or health care organizations to provide comprehensive health care at a discount to covered parties and coordinate the financing and delivery of health care. Managed care uses medical protocols and procedures agreed on by the medical profession to be cost effective, also known as medical practice guidelines. Providers are typically reimbursed for covered services by a capitated amount on a per member per month basis that may reflect difference in the health status and level of services anticipated to be needed by the member.
Definition: A policy for a health plan that has features of both an HMO and a FFS plan. Like an HMO, a POS plan encourages the use its HMO network to maintain discounted fees with participating providers, but recognizes that sometimes covered parties want to choose their own provider. The POS plan allows a covered party to use providers who are not part of the HMO network (non-participating providers). However, there is a greater cost associated with choosing these non-network providers. A covered party will usually pay deductibles and coinsurances that are substantially higher than the payments when he or she uses a plan provider. Use of non-participating providers often requires the covered party to pay the provider directly and then to file a claim for reimbursement, like in an FFS plan.
Definition: A policy for a health plan that provides coverage for health care only through contracted or employed physicians and hospitals located in particular geographic or service areas. HMOs emphasize prevention and early detection of illness. Eligibility to enroll in an HMO is determined by where a covered party lives or works.
Definition: A network-based, managed care plan that allows a covered party to choose any health care provider. However, if care is received from a "preferred" (participating in-network) provider, there are generally higher benefit coverage and lower deductibles.
Definition: A health insurance policy that covers benefits for mental health services and prescriptions.
Definition: A health insurance policy that covers benefits for substance use services.
Definition: Set of codes for a policy that provides coverage for health care expenses arising from vision services. A health insurance policy that covers benefits for vision care services, prescriptions, and products.
Definition: An insurance policy that provides a regular payment to compensate for income lost due to the covered party's inability to work because of illness or injury.
Definition: An insurance policy under a benefit plan run by an employer or employee organization for the purpose of providing benefits other than pension-related to employees and their families. Typically provides health-related benefits, benefits for disability, disease or unemployment, or day care and scholarship benefits, among others. An employer sponsored health policy includes coverage of health care expenses arising from sickness or accidental injury, coverage for on-site medical clinics or for dental or vision benefits, which are typically provided under a separate policy. Coverage excludes health care expenses covered by accident or disability, workers' compensation, liability or automobile insurance.
Definition: An insurance policy that covers qualified benefits under a Flexible Benefit plan such as group medical insurance, long and short term disability income insurance, group term life insurance for employees only up to $50,000 face amount, specified disease coverage such as a cancer policy, dental and/or vision insurance, hospital indemnity insurance, accidental death and dismemberment insurance, a medical expense reimbursement plan and a dependent care reimbursement plan. Discussion: See UnderwriterRoleTypeCode flexible benefit plan which is defined as a benefit plan that allows employees to choose from several life, health, disability, dental, and other insurance plans according to their individual needs. Also known as cafeteria plans. Authorized under Section 125 of the Revenue Act of 1978.
Definition: A policy under which the insurer agrees to pay a sum of money upon the occurrence of the covered partys death. In return, the policyholder agrees to pay a stipulated amount called a premium at regular intervals. Life insurance indemnifies the beneficiary for the loss of the insurable interest that a beneficiary has in the life of a covered party. For persons related by blood, a substantial interest established through love and affection, and for all other persons, a lawful and substantial economic interest in having the life of the insured continue. An insurable interest is required when purchasing life insurance on another person. Specific exclusions are often written into the contract to limit the liability of the insurer; for example claims resulting from suicide or relating to war, riot and civil commotion. Discussion:A life insurance policy may be used by the covered party as a source of health care coverage in the case of a viatical settlement, which is the sale of a life insurance policy by the policy owner, before the policy matures. Such a sale, at a price discounted from the face amount of the policy but usually in excess of the premiums paid or current cash surrender value, provides the seller an immediate cash settlement. Generally, viatical settlements involve insured individuals with a life expectancy of less than two years. In countries without state-subsidized healthcare and high healthcare costs (e.g. United States), this is a practical way to pay extremely high health insurance premiums that severely ill people face. Some people are also familiar with life settlements, which are similar transactions but involve insureds with longer life expectancies (two to fifteen years).
Definition: A policy that, after an initial premium or premiums, pays out a sum at pre-determined intervals. For example, a policy holder may pay $10,000, and in return receive $150 each month until he dies; or $1,000 for each of 14 years or death benefits if he dies before the full term of the annuity has elapsed.
Definition: Life insurance under which the benefit is payable only if the insured dies during a specified period. If an insured dies during that period, the beneficiary receives the death payments. If the insured survives, the policy ends and the beneficiary receives nothing.
Definition: Life insurance under which the benefit is payable upon the insuredaTMs death or diagnosis of a terminal illness. If an insured dies during that period, the beneficiary receives the death payments. If the insured survives, the policy ends and the beneficiary receives nothing
Definition: A type of insurance that covers damage to or loss of the policyholderaTMs property by providing payments for damages to property damage or the injury or death of living subjects. The terms "casualty" and "liability" insurance are often used interchangeably. Both cover the policyholder's legal liability for damages caused to other persons and/or their property.
Definition: An agreement between two or more insurance companies by which the risk of loss is proportioned. Thus the risk of loss is spread and a disproportionately large loss under a single policy does not fall on one insurance company. Acceptance by an insurer, called a reinsurer, of all or part of the risk of loss of another insurance company. Discussion: Reinsurance is a means by which an insurance company can protect itself against the risk of losses with other insurance companies. Individuals and corporations obtain insurance policies to provide protection for various risks (hurricanes, earthquakes, lawsuits, collisions, sickness and death, etc.). Reinsurers, in turn, provide insurance to insurance companies. For example, an HMO may purchase a reinsurance policy to protect itself from losing too much money from one insured's particularly expensive health care costs. An insurance company issuing an automobile liability policy, with a limit of $100,000 per accident may reinsure its liability in excess of $10,000. A fire insurance company which issues a large policy generally reinsures a portion of the risk with one or several other companies. Also called risk control insurance or stop-loss insurance.
Definition: A risk or part of a risk for which there is no normal insurance market available. Insurance written by unauthorized insurance companies. Surplus lines insurance is insurance placed with unauthorized insurance companies through licensed surplus lines agents or brokers.
Definition: A form of insurance protection that provides additional liability coverage after the limits of your underlying policy are reached. An umbrella liability policy also protects you (the insured) in many situations not covered by the usual liability policies.
Definition: A set of codes used to indicate coverage under a program. A program is an organized structure for administering and funding coverage of a benefit package for covered parties meeting eligibility criteria, typically related to employment, health, financial, and demographic status. Programs are typically established or permitted by legislation with provisions for ongoing government oversight. Regulations may mandate the structure of the program, the manner in which it is funded and administered, covered benefits, provider types, eligibility criteria and financial participation. A government agency may be charged with implementing the program in accordance to the regulation. Risk of loss under a program in most cases would not meet what an underwriter would consider an insurable risk, i.e., the risk is not random in nature, not financially measurable, and likely requires subsidization with government funds. Discussion: Programs do not have policy holders or subscribers. Program eligibles are enrolled based on health status, statutory eligibility, financial status, or age. Program eligibles who are covered parties under the program may be referred to as members, beneficiaries, eligibles, or recipients. Programs risk are underwritten by not for profit organizations such as governmental entities, and the beneficiaries typically do not pay for any or some portion of the cost of coverage. See CoveredPartyRoleType.
Definition: A program that covers the cost of services provided directly to a beneficiary who typically has no other source of coverage without charge.
Definition: A program that covers the cost of services provided to crime victims for injuries or losses related to the occurrence of a crime.
Definition: An employee assistance program is run by an employer or employee organization for the purpose of providing benefits and covering all or part of the cost for employees to receive counseling, referrals, and advice in dealing with stressful issues in their lives. These may include substance abuse, bereavement, marital problems, weight issues, or general wellness issues. The services are usually provided by a third-party, rather than the company itself, and the company receives only summary statistical data from the service provider. Employee's names and services received are kept confidential.
Definition: A set of codes used to indicate a government program that is an organized structure for administering and funding coverage of a benefit package for covered parties meeting eligibility criteria, typically related to employment, health and financial status. Government programs are established or permitted by legislation with provisions for ongoing government oversight. Regulation mandates the structure of the program, the manner in which it is funded and administered, covered benefits, provider types, eligibility criteria and financial participation. A government agency is charged with implementing the program in accordance to the regulation Example: Federal employee health benefit program in the U.S.
Definition: A government program that provides health coverage to individuals who are considered medically uninsurable or high risk, and who have been denied health insurance due to a serious health condition. In certain cases, it also applies to those who have been quoted very high premiums a" again, due to a serious health condition. The pool charges premiums for coverage. Because the pool covers high-risk people, it incurs a higher level of claims than premiums can cover. The insurance industry pays into the pool to make up the difference and help it remain viable.
Definition: Services provided directly and through contracted and operated indigenous peoples health programs. Example: Indian Health Service in the U.S.
Definition: A government program that provides coverage for health services to military personnel, retirees, and dependents. A covered party who is a subscriber can choose from among Fee-for-Service (FFS) plans, and their Preferred Provider Organizations (PPO), or Plans offering a Point of Service (POS) Product, or Health Maintenance Organizations. Example: In the U.S., TRICARE, CHAMPUS.
Definition: A government mandated program with specific eligibility requirements based on premium contributions made during employment, length of employment, age, and employment status, e.g. being retired, disabled, or a dependent of a covered party under this program. Benefits typically include ambulatory, inpatient, and long-term care, such as hospice care, home health care and respite care.
Definition: A social service program funded by a public or governmental entity. Example: Programs providing habilitation, food, lodging, medicine, transportation, equipment, devices, products, education, training, counseling, alteration of living or work space, and other resources to persons meeting eligibility criteria.
Definition: Services provided directly and through contracted and operated veteran health programs.
Codes dealing with the management of Detected Issue observations
Codes dealing with the management of Detected Issue observations for the administrative and patient administrative acts domains.
Used to temporarily override normal authorization rules to gain access to data in a case of emergency. Use of this override code will typically be monitored, and a procedure to verify its proper use may be triggered when used.
Description: Indicates that the permissions have been externally verified and the request should be processed.
Consulted other supplier/pharmacy, therapy confirmed
Assessed patient, therapy is appropriate
Description: The patient has the appropriate indication or diagnosis for the action to be taken.
Description: It has been confirmed that the appropriate pre-requisite therapy has been tried.
Consulted other supply source, therapy still appropriate
Consulted prescriber and recommended change, prescriber declined
Interacting Therapy No Longer Active/Planned
Concurrent therapy triggering alert is no longer on-going or planned
Patient's existing supply was lost/wasted
Supply date is intended to carry patient over weekend
Supply is intended for use during a leave of absence from an institution.
additional quantity on separate dispense
Description: Supply is different than expected as an additional quantity has been supplied in a separate dispense.
Order is performed as issued, but other action taken to mitigate potential adverse effects
Provided education or training to the patient on appropriate therapy use
Instituted an additional therapy to mitigate potential negative effects
Temporarily Suspended Concurrent Therapy
Suspended existing therapy that triggered interaction for the duration of this therapy
Aborted existing therapy that triggered interaction.
Arranged to monitor patient for adverse effects
Concepts that identify the type or nature of exposure interaction. Examples include "household", "care giver", "intimate partner", "common space", "common substance", etc. to further describe the nature of interaction.
Description: Exposure participants' interaction occurred in a child care setting
Description: An interaction where the exposure participants traveled in/on the same vehicle (not necessarily concurrently, e.g. both are passengers of the same plane, but on different flights of that plane).
Health Care Interaction - Not Patient Care
Description: Exposure participants' interaction occurred during the course of health care delivery or in a health care delivery setting, but did not involve the direct provision of care (e.g. a janitor cleaning a patient's hospital room).
Description: Exposure interaction occurred in context of one providing care for the other, i.e. a babysitter providing care for a child, a home-care aide providing assistance to a paraplegic.
Description: Exposure participants' interaction occurred when both were patients being treated in the same (acute) health care delivery facility.
Description: Exposure participants' interaction occurred when one visited the other who was a patient being treated in a health care delivery facility.
Description: Exposure interaction occurred in context of domestic interaction, i.e. both participants reside in the same household.
Description: Exposure participants' interaction occurred in the course of one or both participants being incarcerated at a correctional facility
Description: Exposure interaction was intimate, i.e. participants are intimate companions (e.g. spouses, domestic partners).
Description: Exposure participants' interaction occurred in the course of one or both participants being resident at a long term care facility (second participant may be a visitor, worker, resident or a physical place or object within the facility).
Description: An interaction where the exposure participants were both present in the same location/place/space.
Description: Exposure participants' interaction occurred during the course of health care delivery by a provider (e.g. a physician treating a patient in her office).
Description: Exposure participants' interaction occurred in an academic setting (e.g. participants are fellow students, or student and teacher).
Description: An interaction where the exposure participants are social associates or members of the same extended family
Description: An interaction where the exposure participants shared or co-used a common substance (e.g. drugs, needles, or common food item).
Description: An interaction where the exposure participants traveled together in/on the same vehicle/trip (e.g. concurrent co-passengers).
Description: Exposure interaction occurred in a work setting, i.e. participants are co-workers.
A type of transaction that represents a charge for a service or product. Expressed in monetary terms.
A type of transaction that represents a reversal of a previous charge for a service or product. Expressed in monetary terms. It has the opposite effect of a standard charge.
Set of codes indicating the type of incident or accident.
Incident or accident as the result of a motor vehicle accident
Incident or accident is the result of a school place accident.
Incident or accident is the result of a sporting accident.
Incident or accident is the result of a work place accident
Description: The type of health information to which the subject of the information or the subject's delegate consents or dissents.
Description: Provide consent to collect, use, disclose, or access adverse drug reaction information for a patient.
Description: Provide consent to collect, use, disclose, or access all information for a patient.
Description: Provide consent to collect, use, disclose, or access allergy information for a patient.
Description: Provide consent to collect, use, disclose, or access informational consent information for a patient.
Description: Provide consent to collect, use, disclose, or access demographics information for a patient.
Description: Provide consent to collect, use, disclose, or access diagnostic imaging information for a patient.
Description: Provide consent to collect, use, disclose, or access immunization information for a patient.
Description: Provide consent to collect, use, disclose, or access lab test result information for a patient.
Description: Provide consent to collect, use, disclose, or access medical condition information for a patient.
Definition: Provide consent to view or access medical condition information for a patient.
Description:Provide consent to collect, use, disclose, or access mental health information for a patient.
Description: Provide consent to collect, use, disclose, or access common observation information for a patient.
Description: Provide consent to collect, use, disclose, or access coverage policy or program for a patient.
Description: Provide consent to collect, use, disclose, or access provider information for a patient.
Description: Provide consent to collect, use, disclose, or access professional service information for a patient.
Description:Provide consent to collect, use, disclose, or access substance abuse information for a patient.
Concepts conveying the context in which consent to transfer specified patient health information for collection, access, use or disclosure applies.
Description: Information transfer in accordance with subjectaTMs consent directive.
Consent to collect, access, use, or disclose specified patient health information only after explicit consent.
Description: Information transfer in accordance with judicial system protocol.
Consent to collect, access, use, or disclose specified patient health information only if necessary to avert potential danger to other persons.
Description: Information transfer in accordance with emergency information transfer protocol.
Consent to collect, access, use, or disclose specified patient health information only if necessary to avert potential public welfare risk.
Description: Information transfer in accordance with regulatory protocol, e.g. for public health, welfare, and safety.
Definition:Indicates the set of information types which may be manipulated or referenced, such as for recommending access restrictions.
Definition:All information pertaining to a patient's allergy and intolerance records.
Description: All information pertaining to a patient's adverse drug reactions.
Definition:All information pertaining to a patient's common observation records (height, weight, blood pressure, temperature, etc.).
Definition:All information pertaining to a patient's demographics (such as name, date of birth, gender, address, etc.).
Definition:All information pertaining to a patient's diagnostic image records (orders & results).
Definition:All information pertaining to a patient's vaccination records.
Description: All information pertaining to a patient's lab test records (orders & results)
Definition:All information pertaining to a patient's medical condition records.
Description: All information pertaining to a patient's mental health records.
Definition:All information pertaining to a patient's professional service records (such as smoking cessation, counseling, medication review, mental health).
Definition:All information pertaining to a patient's medication records (orders, dispenses and other active medications).
Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results.
Codes representing a grouping of invoice elements (totals, sub-totals), reported through a Payment Advice or a Statement of Financial Activity (SOFA). The code can represent summaries by day, location, payee and other cost elements such as bonus, retroactive adjustment and transaction fees.
Codes representing adjustments to a Payment Advice such as retroactive, clawback, garnishee, etc.
Payment initiated by the payor as the result of adjudicating a submitted invoice that arrived to the payor from an electronic source that did not provide a conformant set of HL7 messages (e.g. web claim submission).
Bonus payments based on performance, volume, etc. as agreed to by the payor.
An amount still owing to the payor but the payment is 0$ and this cannot be settled until a future payment is made.
Fees deducted on behalf of a payee for tuition and continuing education.
Fees deducted on behalf of a payee for charges based on a shorter payment frequency (i.e. next day versus biweekly payments.
Fees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee.
Payment is based on a payment intent for a previously submitted Invoice, based on formal adjudication results..
Payment initiated by the payor as the result of adjudicating a paper (original, may have been faxed) invoice.
An amount that was owed to the payor as indicated, by a carry forward adjusment, in a previous payment advice
Professional association fee that is collected by the payor from the practitioner/provider on behalf of the association
Retroactive adjustment such as fee rate adjustment due to contract negotiations.
Codes representing a grouping of invoice elements (totals, sub-totals), reported through a Payment Advice or a Statement of Financial Activity (SOFA). The code can represent summaries by day, location, payee, etc.
Transaction counts and value totals by invoice type (e.g. RXDINV - Pharmacy Dispense)
Transaction counts and value totals by each instance of an invoice payee.
Transaction counts and value totals by each instance of an invoice payor.
Transaction counts and value totals by each instance of a messaging application on a single processor. It is a registered identifier known to the receivers.
Codes representing a service or product that is being invoiced (billed). The code can represent such concepts as "office visit", "drug X", "wheelchair" and other billable items such as taxes, service charges and discounts.
An identifying data string for healthcare products.
United Nations Standard Products and Services Classification
Description:United Nations Standard Products and Services Classification, managed by Uniform Code Council (UCC): www.unspsc.org
An identifying data string for A substance used as a medication or in the preparation of medication.
Description:Global Trade Item Number is an identifier for trade items developed by GS1 (comprising the former EAN International and Uniform Code Council).
Description:Universal Product Code is one of a wide variety of bar code languages widely used in the United States and Canada for items in stores.
The detail item codes to identify charges or changes to the total billing of a claim due to insurance rules and payments.
The billable item codes to identify adjudicator specified components to the total billing of a claim.
That portion of the eligible charges which a covered party must pay for each service and/or product. It is a percentage of the eligible amount for the service/product that is typically charged after the covered party has met the policy deductible. This amount represents the covered party's coinsurance that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results.
That portion of the eligible charges which a covered party must pay for each service and/or product. It is a defined amount per service/product of the eligible amount for the service/product. This amount represents the covered party's copayment that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results.
That portion of the eligible charges which a covered party must pay in a particular period (e.g. annual) before the benefits are payable by the adjudicator. This amount represents the covered party's deductible that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results.
The guarantor, who may be the patient, pays the entire charge for a service. Reasons for such action may include: there is no insurance coverage for the service (e.g. cosmetic surgery); the patient wishes to self-pay for the service; or the insurer denies payment for the service due to contractual provisions such as the need for prior authorization.
That total amount of the eligible charges which a covered party must periodically pay for services and/or products prior to the Medicaid program providing any coverage. This amount represents the covered party's spend down that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results
The covered party pays a percentage of the cost of covered services.
The billable item codes to identify modifications to a billable item charge. As for example after hours increase in the office visit fee.
Premium paid on service fees in compensation for practicing outside of normal working hours.
Premium paid on service fees in compensation for practicing in a remote location.
Premium paid on service fees in compensation for practicing at a location other than normal working location.
The billable item codes to identify provider supplied charges or changes to the total billing of a claim.
A charge to compensate the provider when a patient cancels an appointment with insufficient time for the provider to make another appointment with another patient.
A reduction in the amount charged as a percentage of the amount. For example a 5% discount for volume purchase.
A premium on a service fee is requested because, due to extenuating circumstances, the service took an extraordinary amount of time or supplies.
Under agreement between the parties (payor and provider), a guaranteed level of income is established for the provider over a specific, pre-determined period of time. The normal course of business for the provider is submission of fee-for-service claims. Should the fee-for-service income during the specified period of time be less than the agreed to amount, a top-up amount is paid to the provider equal to the difference between the fee-for-service total and the guaranteed income amount for that period of time. The details of the agreement may specify (or not) a requirement for repayment to the payor in the event that the fee-for-service income exceeds the guaranteed amount.
Anticipated or actual final fee associated with treating a patient.
Anticipated or actual initial fee associated with treating a patient.
An increase in the amount charged as a percentage of the amount. For example, 12% markup on product cost.
A charge to compensate the provider when a patient does not show for an appointment.
Anticipated or actual periodic fee associated with treating a patient. For example, expected billing cycle such as monthly, quarterly. The actual period (e.g. monthly, quarterly) is specified in the unit quantity of the Invoice Element.
The amount for a performance bonus that is being requested from a payor for the performance of certain services (childhood immunizations, influenza immunizations, mammograms, pap smears) on a sliding scale. That is, for 90% of childhood immunizations to a maximum of $2200/yr. An invoice is created at the end of the service period (one year) and a code is submitted indicating the percentage achieved and the dollar amount claimed.
A charge is requested because the patient failed to pick up the item and it took an amount of time to return it to stock for future use.
A charge to cover the cost of travel time and/or cost in conjuction with providing a service or product. It may be charged per kilometer or per hour based on the effective agreement.
Premium paid on service fees in compensation for providing an expedited response to an urgent situation.
The billable item codes to identify modifications to a billable item charge by a tax factor applied to the amount. As for example 7% provincial sales tax.
Federal tax on transactions such as the Goods and Services Tax (GST)
Tax levied by the provincial or state jurisdiction such as Provincial Sales Tax
An identifying data string for medical facility accommodations.
Accommodation type. In Intent mood, represents the accommodation type requested. In Event mood, represents accommodation assigned/used. In Definition mood, represents the available accommodation type.
Description:Accommodation type. In Intent mood, represents the accommodation type requested. In Event mood, represents accommodation assigned/used. In Definition mood, represents the available accommodation type.
Accommodations used in the care of diseases that are transmitted through casual contact or respiratory transmission.
Accommodations in which there is only 1 bed.
Uniquely designed and elegantly decorated accommodations with many amenities available for an additional charge.
Accommodations in which there are 2 beds.
Accommodations in which there are 3 or more beds.
An identifying data string for healthcare procedures.
Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results. Invoice elements of this type signify a grouping of one or more children (detail) invoice elements. They do not have intrinsic costing associated with them, but merely reflect the sum of all costing for it's immediate children invoice elements.
Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results. Invoice elements of this type signify a grouping of one or more children (detail) invoice elements. They do not have intrinsic costing associated with them, but merely reflect the sum of all costing for it's immediate children invoice elements. The domain is only specified for an intermediate invoice element group (non-root or non-top level) for an Invoice.
A grouping of invoice element groups and details including the ones specifying the compound ingredients being invoiced. It may also contain generic detail items such as markup.
A grouping of invoice element details including the one specifying an ingredient drug being invoiced. It may also contain generic detail items such as tax or markup.
A grouping of invoice element groups and details including the ones specifying the compound supplies being invoiced. It may also contain generic detail items such as markup.
A grouping of invoice element details including the one specifying the drug being invoiced. It may also contain generic detail items such as markup.
A grouping of invoice element details including the ones specifying the frame fee and the frame dispensing cost that are being invoiced.
A grouping of invoice element details including the ones specifying the lens fee and the lens dispensing cost that are being invoiced.
A grouping of invoice element details including the one specifying the product (good or supply) being invoiced. It may also contain generic detail items such as tax or discount.
Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results. Invoice elements of this type signify a grouping of one or more children (detail) invoice elements. They do not have intrinsic costing associated with them, but merely reflect the sum of all costing for it's immediate children invoice elements. Codes from this domain reflect the type of Invoice such as Pharmacy Dispense, Clinical Service and Clinical Product. The domain is only specified for the root (top level) invoice element group for an Invoice.
Clinical product invoice where the Invoice Grouping contains one or more billable item and is supported by clinical product(s). For example, a crutch or a wheelchair.
Clinical Services Invoice which can be used to describe a single service, multiple services or repeated services. [1] Single Clinical services invoice where the Invoice Grouping contains one billable item and is supported by one clinical service. For example, a single service for an office visit or simple clinical procedure (e.g. knee mobilization). [2] Multiple Clinical services invoice where the Invoice Grouping contains more than one billable item, supported by one or more clinical services. The services can be distinct and over multiple dates, but for the same patient. This type of invoice includes a series of treatments which must be adjudicated together. For example, an adjustment and ultrasound for a chiropractic session where fees are associated for each of the services and adjudicated (invoiced) together. [3] Repeated Clinical services invoice where the Invoice Grouping contains one or more billable item, supported by the same clinical service repeated over a period of time. For example, the same Chiropractic adjustment (service or treatment) delivered on 3 separate occasions over a period of time at the discretion of the provider (e.g. month).
A clinical Invoice Grouping consisting of one or more services and one or more product. Billing for these service(s) and product(s) are supported by multiple clinical billable events (acts). All items in the Invoice Grouping must be adjudicated together to be acceptable to the Adjudicator. For example , a brace (product) invoiced together with the fitting (service).
Invoice Grouping without clinical justification. These will not require identification of participants and associations from a clinical context such as patient and provider. Examples are interest charges and mileage.
A clinical Invoice Grouping consisting of one or more oral health services. Billing for these service(s) are supported by multiple clinical billable events (acts). All items in the Invoice Grouping must be adjudicated together to be acceptable to the Adjudicator.
HealthCare facility preferred accommodation invoice.
Pharmacy dispense invoice for a compound.
Pharmacy dispense invoice not involving a compound
Clinical services invoice where the Invoice Group contains one billable item for multiple clinical services in one or more sessions.
Vision dispense invoice for up to 2 lens (left and right), frame and optional discount. Eye exams are invoiced as a clinical service invoice.
Identifies the different types of summary information that can be reported by queries dealing with Statement of Financial Activity (SOFA). The summary information is generally used to help resolve balance discrepancies between providers and payors.
Total counts and total net amounts adjudicated for all Invoice Groupings that were adjudicated within a time period based on the adjudication date of the Invoice Grouping.
adjud. nullified prior-period electronic amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically.
adjud. nullified prior-period electronic count
Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically.
adjud. nullified prior-period manual amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.
adjud. nullified prior-period manual count
Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.
adjud. nullified same-period electronic amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently nullified in the specified period and submitted electronically.
adjud. nullified same-period electronic count
Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently nullified in the specified period and submitted electronically.
adjud. nullified same-period manual amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.
adjud. nullified same-period manual count
Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.
adjud. non-payee payable prior-period electronic amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.
adjud. non-payee payable prior-period electronic count
Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.
adjud. non-payee payable prior-period manual amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.
adjud. non-payee payable prior-period manual count
Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.
adjud. non-payee payable same-period electronic amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.
adjud. non-payee payable same-period electronic count
Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.
adjud. non-payee payable same-period manual amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.
adjud. non-payee payable same-period manual count
Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.
adjud. payee payable prior-period electronic amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.
adjud. payee payable prior-period electronic count
Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.
adjud. payee payable prior-period manual amout
Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.
adjud. payee payable prior-period manual count
Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.
adjud. payee payable same-period electronic amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.
adjud. payee payable same-period electronic count
Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.
adjud. payee payable same-period manual amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.
adjud. payee payable same-period manual count
Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.
adjud. refused prior-period electronic amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted electronically.
adjud. refused prior-period electronic count
Identifies the total number of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted electronically.
adjud. refused prior-period manual amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted manually.
adjud. refused prior-period manual count
Identifies the total number of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted manually.
adjud. refused same-period electronic amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted electronically.
adjud. refused same-period electronic count
Identifies the total number of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted electronically.
adjud. refused same-period manual amount
Identifies the total net amount of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted manually.
Identifies the total number of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted manually.
Total counts and total net amounts paid for all Invoice Groupings that were paid within a time period based on the payment date.
paid nullified prior-period electronic amount
Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently nullified in the specified period and submitted electronically.
paid nullified prior-period electronic count
Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently nullified in the specified period and submitted electronically.
paid nullified prior-period manual amount
Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently nullified in the specified period and submitted manually.
paid nullified prior-period manual count
Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently nullified in the specified period and submitted manually.
paid nullified same-period electronic amount
Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently nullified in the specified period and submitted electronically.
paid nullified same-period electronic count
Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently cancelled in the specified period and submitted electronically.
paid nullified same-period manual amount
Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently nullified in the specified period and submitted manually.
Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently nullified in the specified period and submitted manually.
paid non-payee payable prior-period electronic amount
Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.
paid non-payee payable prior-period electronic count
Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.
paid non-payee payable prior-period manual amount
Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually.
paid non-payee payable prior-period manual count
Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually.
paid non-payee payable same-period electronic amount
Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.
paid non-payee payable same-period electronic count
Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.
paid non-payee payable same-period manual amount
Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually.
paid non-payee payable same-period manual count
Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually.
paid payee payable prior-period electronic amount
Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically.
paid payee payable prior-period electronic count
Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically.
paid payee payable prior-period manual amount
Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually.
paid payee payable prior-period manual count
Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually.
paid payee payable same-period electronic amount
Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically.
paid payee payable same-period electronic count
Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically.
paid payee payable same-period manual amount
Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually.
paid payee payable same-period manual count
Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually.
Total counts and total net amounts billed for all Invoice Groupings that were submitted within a time period. Adjudicated invoice elements are included.
Identifies the total net amount billed for all submitted Invoice Groupings within a time period and submitted electronically. Adjudicated invoice elements are included.
Identifies the total number of submitted Invoice Groupings within a time period and submitted electronically. Adjudicated invoice elements are included.
Identifies the total net amount billed for all submitted Invoice Groupings that were nullified within a time period and submitted electronically. Adjudicated invoice elements are included.
Identifies the total number of submitted Invoice Groupings that were nullified within a time period and submitted electronically. Adjudicated invoice elements are included.
Identifies the total net amount billed for all submitted Invoice Groupings that are pended or held by the payor, within a time period and submitted electronically. Adjudicated invoice elements are not included.
Identifies the total number of submitted Invoice Groupings that are pended or held by the payor, within a time period and submitted electronically. Adjudicated invoice elements are not included.
Insurance coverage problems have been encountered. Additional explanation information to be supplied.
Electronic form with supporting or additional information to follow.
Fax with supporting or additional information to follow.
The medical service was provided to a patient in good faith that they had medical coverage, although no evidence of coverage was available before service was rendered.
Knowingly over the payor's published time limit for this invoice possibly due to a previous payor's delays in processing. Additional reason information will be supplied.
Manual review of the invoice is requested. Additional information to be supplied. This may be used in the case of an appeal.
The medical service and/or product was provided to a patient that has coverage in another jurisdiction.
The service provided is required for orthodontic purposes. If the covered party has orthodontic coverage, then the service may be paid.
Paper documentation (or other physical format) with supporting or additional information to follow.
Public Insurance has been exhausted. Invoice has not been sent to Public Insuror and therefore no Explanation Of Benefits (EOB) is provided with this Invoice submission.
Allows provider to explain lateness of invoice to a subsequent payor.
Rules of practice do not require a physician's referral for the provider to perform a billable service.
The same service was delivered within a time period that would usually indicate a duplicate billing. However, the repeated service is a medical necessity and therefore not a duplicate.
The service provided is not related to another billed service. For example, 2 unrelated services provided on the same day to the same patient which may normally result in a refused payment for one of the items.
The provider has received a verbal permission from an authoritative source to perform the service or supply the item being invoiced.
Provides codes associated with ActClass value of LIST (working list)
List of acts representing a care plan. The acts can be in a varierty of moods including event (EVN) to record acts that have been carried out as part of the care plan.
Codes used to identify different types of 'duration-based' working lists. Examples include "Continuous/Chronic", "Short-Term" and "As-Needed".
act medication therapy duration working list
Definition:A collection of concepts that identifies different types of 'duration-based' mediation working lists. Examples:"Continuous/Chronic" "Short-Term" and "As Needed"
Definition:A list of medications which the patient is only expected to consume for the duration of the current order or limited set of orders and which is not expected to be renewed.
Definition:A list of medications which are expected to be continued beyond the present order and which the patient should be assumed to be taking unless explicitly stopped.
Definition:A list of medications which the patient is intended to be administered only once.
Definition:A list of medications which the patient will consume intermittently based on the behavior of the condition for which the medication is indicated.
A monitoring program that focuses on narcotics and/or commonly abused substances that are subject to legal restriction.
Definition:A monitoring program that focuses on a drug which is under investigation and has not received regulatory approval for the condition being investigated
Description:A drug that can be prescribed (and reimbursed) only if it meets certain criteria.
Medicines designated in this way may be supplied for patient use without a prescription. The exact form of categorisation will vary in different realms.
Some form of prescription is required before the related medicine can be supplied for a patient. The exact form of regulation will vary in different realms.
Definition:A drug that requires prior approval (to be reimbursed) before being dispensed
Description:A drug that requires special access permission to be prescribed and dispensed.
Description:Concepts representing indications (reasons for clinical action) other than diagnosis and symptoms.
Description:Contrast agent required for imaging study.
Description:Provision of prescription or direction to consume a product for purposes of bowel clearance in preparation for a colonoscopy.
Description:Provision of medication as a preventative measure during a treatment or other period of increased risk.
Description:Provision of medication during pre-operative phase; e.g. antibiotics before dental surgery or bowel prep before colon surgery.
Description:Provision of medication for pregnancy --e.g. vitamins, antibiotic treatments for vaginal tract colonization, etc.
Identifies the type of verification investigation being undertaken with respect to the subject of the verification activity. Examples: Verification of eligibility for coverage under a policy or program - aka enrolled/covered by a policy or program Verification of record - e.g. person has record in an immunization registry Verification of enumeration - e.g. NPI Verification of Board Certification - provider specific Verification of Certification - e.g. JAHCO, NCQA, URAC Verification of Conformance - e.g. entity use with HIPAA, conformant to the CCHIT EHR system criteria Verification of Provider Credentials Verification of no adverse findings - e.g. on National Provider Data Bank, Health Integrity Protection Data Base (HIPDB)
Definition:Indicates that the paper version of the record has, should be or is being verified against the electronic version.
Code identifying the method or the movement of payment instructions. Codes are drawn from X12 data element 591 (PaymentMethodCode)
A written order to a bank to pay the amount specified from funds on deposit.
Electronic Funds Transfer (EFT) deposit into the payee's bank account
A fill providing sufficient supply for one day
A supply action where there is no 'valid' order for the supplied medication; e.g. Emergency vacation supply, weekend supply (when prescriber is unavailable to provide a renewal prescription)
An emergency supply where the expectation is that a formal order authorizing the supply will be provided at a later date.
The initial fill against an order. (This includes initial fills against refill orders.)
A first fill where the quantity supplied is equal to one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets).
A first fill where the quantity supplied is less than one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.)
A first fill where the strength supplied is less than the ordered strength. (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).
A fill where a small portion is provided to allow for determination of the therapy effectiveness and patient tolerance.
A supply action to restock a smaller more local dispensary.
A fill against an order that has already been filled (or partially filled) at least once.
A supply action that provides sufficient material for a single dose.
A refill where the quantity supplied is equal to one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets.)
A refill where the quantity supplied is equal to one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets.) and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).
The first fill against an order that has already been filled at least once at another facility.
refill partial strength (first fill this facility)
The first fill against an order that has already been filled at least once at another facility and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).
A refill where the quantity supplied is less than one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.)
A refill where the quantity supplied is less than one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.) and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).
A fill against an order that has already been filled (or partially filled) at least once and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).
A fill where the remainder of a 'complete' fill is provided after a trial fill has been provided.
A fill where the remainder of a 'complete' fill is provided after a trial fill has been provided and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).
A supply action that provides sufficient material for a single dose via multiple products; e.g. 2 50mg tablets for a 100mg unit dose.
Description:Types of policies that further specify the ActClassPolicy value set.
A policy deeming certain information to be private to an individual or organization. Definition: A mandate, obligation, requirement, rule, or expectation relating to privacy. Discussion: ActPrivacyPolicyType codes support the designation of the 1..* policies that are applicable to an Act such as a Consent Directive, a Role such as a VIP Patient, or an Entity such as a patient who is a minor. 1..* ActPrivacyPolicyType values may be associated with an Act or Role to indicate the policies that govern the assignment of an Act or Role confidentialityCode. Use of multiple ActPrivacyPolicyType values enables fine grain specification of applicable policies, but must be carefully assigned to ensure cogency and avoid creation of conflicting policy mandates. Usage Note: Statutory title may be named in the ActClassPolicy Act Act.title to specify which privacy policy is being referenced.
Definition: Specifies the type of consent directive indicated by an ActClassPolicy e.g. a 3rd party authorization to disclose or consent for a substitute decision maker (SDM) or a notice of privacy policy. Usage Note: ActConsentDirective codes are used to specify the type of Consent Directive to which a Consent Directive Act conforms.
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. Definition: Opt-in to disclosure of health information for emergency only consent directive.
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.
This general consent directive permits disclosure of health information. Additional parameter may limit authorized users, purpose of use, user obligations, duration, or information types permitted to be disclosed, and impose uses obligations. Definition: Opt-in to disclosure of health information consent directive.
This general consent directive prohibits disclosure of health information. Additional parameters may permit access to some information types by certain users, roles, purposes of use, durations and impose user obligations. Definition: Opt-out of disclosure of health information consent directive.
A mandate, obligation, requirement, rule, or expectation characterizing the value or importance of a resource and may include its vulnerability. (Based on ISO7498-2:1989. Note: The vulnerability of personally identifiable sensitive information may be based on concerns that the unauthorized disclosure may result in social stigmatization or discrimination.) Description: Types of Sensitivity policy that apply to Acts or Roles. A sensitivity policy is adopted by an enterprise or group of enterprises (a 'policy domain') through a formal data use agreement that stipulates the value, importance, and vulnerability of information. A sensitivity code representing a sensitivity policy may be associated with criteria such as categories of information or sets of information identifiers (e.g. a value set of clinical codes or branch in a code system hierarchy). These criteria may in turn be used for the Policy Decision Point in a Security Engine. A sensitivity code may be used to set the confidentiality code used on information about Acts and Roles to trigger the security mechanisms required to control how security principals (i.e., a person, a machine, a software application) may act on the information (e.g. collection, access, use, or disclosure). Sensitivity codes are never assigned to the transport or business envelope containing patient specific information being exchanged outside of a policy domain as this would disclose the information intended to be protected by the policy. When sensitive information is exchanged with others outside of a policy domain, the confidentiality code on the transport or business envelope conveys the receiver's responsibilities and indicates the how the information is to be safeguarded without unauthorized disclosure of the sensitive information. This ensures that sensitive information is treated by receivers as the sender intends, accomplishing interoperability without point to point negotiations. Usage Note: Sensitivity codes are not useful for interoperability outside of a policy domain because sensitivity policies are typically localized and vary drastically across policy domains even for the same information category because of differing organizational business rules, security policies, and jurisdictional requirements. For example, an employee's sensitivity code would make little sense for use outside of a policy domain. 'Taboo' would rarely be useful outside of a policy domain unless there are jurisdictional requirements requiring that a provider disclose sensitive information to a patient directly. Sensitivity codes may be more appropriate in a legacy system's Master Files in order to notify those who access a patient's orders and observations about the sensitivity policies that apply. Newer systems may have a security engine that uses a sensitivity policy's criteria directly. The specializable InformationSensitivityPolicy Act.code may be useful in some scenarios if used in combination with a sensitivity identifier and/or Act.title.
Types of sensitivity policies that apply to Acts. Act.confidentialityCode is defined in the RIM as "constraints around appropriate disclosure of information about this Act, regardless of mood." Usage Note: ActSensitivity codes are used to bind information to an Act.confidentialityCode according to local sensitivity policy so that those confidentiality codes can then govern its handling across enterprises. Internally to a policy domain, however, local policies guide the access control system on how end users in that policy domain are able to use information tagged with these sensitivity values.
Policy for handling alcohol or drug-abuse information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to alcohol or drug-abuse information that is deemed sensitive. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling genetic disease information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to genetic disease information that is deemed sensitive. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling HIV or AIDS information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to HIV or AIDS information that is deemed sensitive. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling psychiatry information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to psychiatry information that is deemed sensitive. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling sickle cell disease information, which is afforded heightened confidentiality. Information handling protocols are based on organizational policies related to sickle cell disease information, which is deemed sensitive. Usage Note: If there is a jurisdictional mandate, then the Act valued with this ActCode should be associated with an Act valued with any applicable laws from the ActPrivacyLaw code system.
sexual assault, abuse, or domestic violence information sensitivity
Policy for handling sexual assault, abuse, or domestic violence information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to sexual assault, abuse, or domestic violence information that is deemed sensitive. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
sexuality and reproductive health information sensitivity
Policy for handling sexuality and reproductive health information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to sexuality and reproductive health information that is deemed sensitive. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
sexually transmitted disease information sensitivity
Policy for handling sexually transmitted disease information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to sexually transmitted disease information that is deemed sensitive. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling information not to be initially disclosed or discussed with patient except by a physician assigned to patient in this case. Information handling protocols based on organizational policies related to sensitive patient information that must be initially discussed with the patient by an attending physician before being disclosed to the patient. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. Open Issue: This definition conflates a rule and a characteristic, and there may be a similar issue with ts sibling codes.
Types of sensitivity policies that may apply to a sensitive attribute on an Entity. Usage Note: EntitySensitivity codes are used to convey a policy that is applicable to sensitive information conveyed by an entity attribute. May be used to bind a Role.confidentialityCode associated with an Entity per organizational policy. Role.confidentialityCode is defined in the RIM as "an indication of the appropriate disclosure of information about this Role with respect to the playing Entity."
Policy for handling all demographic information about an information subject, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to all demographic about an information subject, the disclosure of which could impact the privacy, well-being, or safety of that subject. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling information related to an information subject's date of birth, which will be afforded heightened confidentiality.Policies may govern sensitivity of information related to an information subject's date of birth, the disclosure of which could impact the privacy, well-being, or safety of that subject. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
gender and sexual orientation information sensitivity
Policy for handling information related to an information subject's gender and sexual orientation, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's gender and sexual orientation, the disclosure of which could impact the privacy, well-being, or safety of that subject. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
living arrangement information sensitivity
Policy for handling information related to an information subject's living arrangement, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's living arrangement, the disclosure of which could impact the privacy, well-being, or safety of that subject. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling information related to an information subject's marital status, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's marital status, the disclosure of which could impact the privacy, well-being, or safety of that subject. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling information related to an information subject's race, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's race, the disclosure of which could impact the privacy, well-being, or safety of that subject. Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling information related to an information subject's religious affiliation, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's religion, the disclosure of which could impact the privacy, well-being, or safety of that subject. Usage Notes: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Types of sensitivity policies that apply to Roles. Usage Notes: RoleSensitivity codes are used to bind information to a Role.confidentialityCode per organizational policy. Role.confidentialityCode is defined in the RIM as "an indication of the appropriate disclosure of information about this Role with respect to the playing Entity."
Policy for handling trade secrets such as financial information or intellectual property, which will be afforded heightened confidentiality. Description: Since the service class can represent knowledge structures that may be considered a trade or business secret, there is sometimes (though rarely) the need to flag those items as of business level confidentiality. Usage Notes: No patient related information may ever be of this confidentiality level. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling information related to an employer which is deemed classified to protect an employee who is the information subject, and which will be afforded heightened confidentiality. Description: Policies may govern sensitivity of information related to an employer, such as law enforcement or national security, the identity of which could impact the privacy, well-being, or safety of an information subject who is an employee. Usage Notes: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling information related to the location of the information subject, which will be afforded heightened confidentiality. Description: Policies may govern sensitivity of information related to the location of the information subject, the disclosure of which could impact the privacy, well-being, or safety of that subject. Usage Notes: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
sensitive service provider information sensitivity
Policy for handling information related to a provider of sensitive services, which will be afforded heightened confidentiality. Description: Policies may govern sensitivity of information related to providers who deliver sensitive healthcare services in order to protect the privacy, well-being, and safety of the provider and of patients receiving sensitive services. Usage Notes: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling information related to an adolescent, which will be afforded heightened confidentiality per applicable organizational or jurisdictional policy. An enterprise may have a policy that requires that adolescent patient information be provided heightened confidentiality. Information deemed sensitive typically includes health information and patient role information including patient status, demographics, next of kin, and location. Usage Note: For use within an enterprise in which an adolescent is the information subject. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling information related to a celebrity (people of public interest (VIP), which will be afforded heightened confidentiality. Celebrities are people of public interest (VIP) about whose information an enterprise may have a policy that requires heightened confidentiality. Information deemed sensitive may include health information and patient role information including patient status, demographics, next of kin, and location. Usage Note: For use within an enterprise in which the information subject is deemed a celebrity or very important person. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling information related to a diagnosis, health condition or health problem, which will be afforded heightened confidentiality. Diagnostic, health condition or health problem related information may be deemed sensitive by organizational policy, and require heightened confidentiality. Usage Note: For use within an enterprise that provides heightened confidentiality to diagnostic, health condition or health problem related information deemed sensitive. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling information related to a drug, which will be afforded heightened confidentiality. Drug information may be deemed sensitive by organizational policy, and require heightened confidentiality. Usage Note: For use within an enterprise that provides heightened confidentiality to drug information deemed sensitive. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Policy for handling information related to an employee, which will be afforded heightened confidentiality. When a patient is an employee, an enterprise may have a policy that requires heightened confidentiality. Information deemed sensitive typically includes health information and patient role information including patient status, demographics, next of kin, and location. Usage Note: Policy for handling information related to an employee, which will be afforded heightened confidentiality. Description: When a patient is an employee, an enterprise may have a policy that requires heightened confidentiality. Information deemed sensitive typically includes health information and patient role information including patient status, demographics, next of kin, and location.
Policy for handling information reported by the patient about another person, e.g. a family member, which will be afforded heightened confidentiality. Sensitive information reported by the patient about another person, e.g. family members may be deemed sensitive by default. The flag may be set or cleared on patient's request. Usage Note: For sensitive information relayed by or about a patient, which is deemed sensitive within the enterprise (i.e., by default regardless of whether the patient requested that the information be deemed sensitive.) If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
For sensitive information relayed by or about a patient, which is deemed sensitive within the enterprise (i.e., by default regardless of whether the patient requested that the information be deemed sensitive.) If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code. Usage Note: For use within an enterprise that provides heightened confidentiality to certain types of information designated by a patient as sensitive. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
This is the healthcare analog to the US Intelligence Community's concept of a Special Access Program. Compartment codes may be used in as a field value in an initiator's clearance to indicate permission to access and use an IT Resource with a security label having the same compartment value in security category label field. Map: Aligns with ISO 2382-8 definition of Compartment - "A division of data into isolated blocks with separate security controls for the purpose of reducing risk."
A security category label field value, which indicates that access and use of an IT resource is restricted to members of human resources department or workflow.
A security category label field value, which indicates that access and use of an IT resource is restricted to members of a research project.
A security category label field value, which indicates that access and use of an IT resource is restricted to members of records management department or workflow.
A mandate, obligation, requirement, rule, or expectation conveyed as security metadata between senders and receivers required to establish the reliability, authenticity, and trustworthiness of their transactions. Trust security metadata are observation made about aspects of trust applicable to an IT resource (data, information object, service, or system capability). Trust applicable to IT resources is established and maintained in and among security domains, and may be comprised of observations about the domain's trust authority, trust framework, trust policy, trust interaction rules, means for assessing and monitoring adherence to trust policies, mechanisms that enforce trust, and quality and reliability measures of assurance in those mechanisms. [Based on ISO IEC 10181-1 and NIST SP 800-63-2] For example, identity proofing , level of assurance, and Trust Framework.
Type of security metadata about the formal declaration by an authority or neutral third party that validates the technical, security, trust, and business practice conformance of Trust Agents to facilitate security, interoperability, and trust among participants within a security domain or trust framework.
Type of security metadata about privacy and security requirements with which a security domain must comply. [ISO IEC 10181-1]
Type of security metadata about the digital quality or reliability of a trust assertion, activity, capability, information exchange, mechanism, process, or protocol.
Type of security metadata about a set of security-relevant data issued by a security authority or trusted third party, together with security information which is used to provide the integrity and data origin authentication services for an IT resource (data, information object, service, or system capability). [Based on ISO IEC 10181-1]
Type of security metadata about a complete set of contracts, regulations, or commitments that enable participating actors to rely on certain assertions by other actors to fulfill their information security requirements. [Kantara Initiative]
Type of security metadata about a security architecture system component that supports enforcement of security policies.
Description:A mandate, obligation, requirement, rule, or expectation unilaterally imposed on benefit coverage under a policy or program by a sponsor, underwriter or payor on: The activity of another party The behavior of another party The manner in which an act is executed Examples:A clinical protocol imposed by a payer to which a provider must adhere in order to be paid for providing the service. A formulary from which a provider must select prescribed drugs in order for the patient to incur a lower copay.
Types of security policies that further specify the ActClassPolicy value set. Examples: obligation to encrypt refrain from redisclosure without consent
Conveys the mandated workflow action that an information custodian, receiver, or user must perform. Usage Notes: Per ISO 22600-2, ObligationPolicy instances 'are event-triggered and define actions to be performed by manager agent'. Per HL7 Composite Security and Privacy Domain Analysis Model: This value set refers to the action required to receive the permission specified in the privacy rule. Per OASIS XACML, an obligation is an operation specified in a policy or policy that is performed in conjunction with the enforcement of an access control decision.
Custodian system must remove any information that could result in identifying the information subject.
Custodian system must make available to an information subject upon request an accounting of certain disclosures of the individual’s protected health information over a period of time. Policy may dictate that the accounting include information about the information disclosed, the date of disclosure, the identification of the receiver, the purpose of the disclosure, the time in which the disclosing entity must provide a response and the time period for which accountings of disclosure can be requested.
Custodian system must monitor systems to ensure that all users are authorized to operate on information objects.
Custodian system must monitor and maintain retrievable log for each user and operation on information.
Custodian security system must retrieve, evaluate, and comply with the information handling directions of the Confidentiality Code associated with an information target.
Custodian security system must retrieve, evaluate, and comply with applicable information subject consent directives.
comply with jurisdictional privacy policy
Custodian security system must retrieve, evaluate, and comply with applicable jurisdictional privacy policies associated with the target information.
comply with organizational privacy policy
Custodian security system must retrieve, evaluate, and comply with applicable organizational privacy policies associated with the target information.
comply with organizational security policy
Custodian security system must retrieve, evaluate, and comply with the organizational security policies associated with the target information.
Custodian security system must retrieve, evaluate, and comply with applicable policies associated with the target information.
Custodian system must strip information of data that would allow the identification of the source of the information or the information subject.
Custodian system must remove target information from access after use.
Custodian system must render information unreadable by algorithmically transforming plaintext into ciphertext. Usage Notes: A mathematical transposition of a file or data stream so that it cannot be deciphered at the receiving end without the proper key. Encryption is a security feature that assures that only the parties who are supposed to be participating in a videoconference or data transfer are able to do so. It can include a password, public and private keys, or a complex combination of all. (Per Infoway.)
Custodian system must render information unreadable and unusable by algorithmically transforming plaintext into ciphertext when "at rest" or in storage.
Custodian system must render information unreadable and unusable by algorithmically transforming plaintext into ciphertext while "in transit" or being transported by any means.
Custodian system must render information unreadable and unusable by algorithmically transforming plaintext into ciphertext while in use such that operations permitted on the target information are limited by the license granted to the end user.
Custodian system must require human review and approval for permission requested.
Custodian system must render information unreadable and unusable by algorithmically transforming plaintext into ciphertext. User may be provided a key to decrypt per license or "shared secret".
Custodian must limit access and disclosure to the minimum information required to support an authorized user's purpose of use. Usage Note: Limiting the information available for access and disclosure to that an authorized user or receiver "needs to know" in order to perform permitted workflow or purpose of use.
Custodian must create and/or maintain human readable security label tags as required by policy. Map: Aligns with ISO 22600-3 Section A.3.4.3 description of privacy mark: "If present, the privacy-mark is not used for access control. The content of the privacy-mark may be defined by the security policy in force (identified by the security-policy-identifier) which may define a list of values to be used. Alternately, the value may be determined by the originator of the security-label."
Custodian system must strip information of data that would allow the identification of the source of the information or the information subject. Custodian may retain a key to relink data necessary to reidentify the information subject.
Custodian system must remove information, which is not authorized to be access, used, or disclosed from records made available to otherwise authorized users.
Conveys prohibited actions which an information custodian, receiver, or user is not permitted to perform unless otherwise authorized or permitted under specified circumstances. Usage Notes: ISO 22600-2 species that a Refrain Policy "defines actions the subjects must refrain from performing". Per HL7 Composite Security and Privacy Domain Analysis Model: May be used to indicate that a specific action is prohibited based on specific access control attributes e.g. purpose of use, information type, user role, etc.
no disclosure without subject authorization
Prohibition on disclosure without information subject's authorization.
Prohibition on collection or storage of the information.
Prohibition on disclosure without organizational approved patient restriction.
no disclosure without information subject's consent directive
Prohibition on disclosure without a consent directive from the information subject.
Prohibition on Integration into other records.
Prohibition on disclosure except to entities on specific access list.
Prohibition on disclosure without an interagency service agreement or memorandum of understanding (MOU).
no disclosure without organizational authorization
Prohibition on disclosure without organizational authorization.
no disclosure to patient, family or caregivers without attending provider's authorization
Prohibition on disclosing information to patient, family or caregivers without attending provider's authorization. Usage Note: The information may be labeled with the ActInformationSensitivity TBOO code, triggering application of this RefrainPolicy code as a handling caveat controlling access. Maps to FHIR NOPAT: Typically, this is used on an Alert resource, when the alert records information on patient abuse or non-compliance. FHIR print name is "keep information from patient". Maps to the French realm - code: INVISIBLE_PATIENT. displayName: Document non visible par le patient codingScheme: 1.2.250.1.213.1.1.4.13 French use case: A label for documents that the author chose to hide from the patient until the content can be disclose to the patient in a face to face meeting between a healthcare professional and the patient (in French law some results like cancer diagnosis or AIDS diagnosis must be announced to the patient by a healthcare professional and should not be find out by the patient alone).
Prohibition on collection of the information beyond time necessary to accomplish authorized purpose of use is prohibited.
no redisclosure without consent directive
Prohibition on redisclosure without patient consent directive.
no redisclosure without information subject's consent directive
Prohibition on redisclosure without a consent directive from the information subject.
no disclosure without jurisdictional authorization
Prohibition on disclosure without authorization under jurisdictional law.
Prohibition on associating de-identified or pseudonymized information with other information in a manner that could or does result in disclosing information intended to be masked.
Prohibition on use of the information beyond the purpose of use initially authorized.
Prohibition on disclosure except to principals with access permission to specific VIP information.
no disclosure without originator authorization
Prohibition on disclosure except as permitted by the information originator.
The method that a product is obtained for use by the subject of the supply act (e.g. patient). Product examples are consumable or durable goods.
Temporary supply of a product without transfer of ownership for the product.
Temporary supply of a product with financial compensation, without transfer of ownership for the product.
Transfer of ownership for a product for financial compensation.
Description:Specimen has been received by the participating organization/department.
Description:Specimen has been placed into storage at a participating location.
Description:Specimen has been put in transit to a participating receiver.
Set of codes related to specimen treatments
The lowering of specimen pH through the addition of an acid
The act rendering alkaline by impregnating with an alkali; a conferring of alkaline qualities.
The removal of fibrin from whole blood or plasma through physical or chemical means
The passage of a liquid through a filter, accomplished by gravity, pressure or vacuum (suction).
The act or process by which an acid and a base are combined in such proportions that the resulting compound is neutral.
The addition of calcium back to a specimen after it was removed by chelating agents
The filtration of a colloidal substance through a semipermeable medium that allows only the passage of small molecules.
Description: Describes the type of substance administration being performed. This should not be used to carry codes for identification of products. Use an associated role or entity to carry such information.
The introduction of a drug into a subject with the intention of altering its biologic state with the intent of improving its health status.
Description: The introduction of material into a subject with the intent of providing nutrition or other dietary supplements (e.g. minerals or vitamins).
The introduction of an immunogen with the intent of stimulating an immune response, aimed at preventing subsequent infections by more viable agents.
An additional immunization administration within a series intended to bolster or enhance immunity.
The first immunization administration in a series intended to produce immunity
Description: A task or action that a user may perform in a clinical information system (e.g. medication order entry, laboratory test results review, problem list entry).
A clinician creates a request for a service to be performed for a given patient.
A clinician creates a request for a laboratory test to be done for a given patient.
A clinician creates a request for the administration of one or more medications to a given patient.
A person enters documentation about a given patient.
Description: A person reviews a list of known allergies of a given patient.
A clinician enters a clinical note about a given patient
A clinician enters a diagnosis for a given patient.
A person provides a discharge instruction to a patient.
A clinician enters a discharge summary for a given patient.
A person provides a patient-specific education handout to a patient.
A pathologist enters a report for a given patient.
A clinician enters a problem for a given patient.
A radiologist enters a report for a given patient.
Description: A person reviews a list of immunizations due or received for a given patient.
Description: A person reviews a list of health care reminders for a given patient.
Description: A person reviews a list of wellness or preventive care reminders for a given patient.
A person (e.g. clinician, the patient herself) reviews patient information in the electronic medical record.
Description: A person enters a known allergy for a given patient.
clinical decision support intervention review
A person reviews a recommendation/assessment provided automatically by a clinical decision support application for a given patient.
A person reviews a clinical note of a given patient.
A person reviews a discharge summary of a given patient.
A person reviews a list of diagnoses of a given patient.
Description: A person enters an immunization due or received for a given patient.
A person reviews a list of laboratory results of a given patient.
A person reviews a list of microbiology results of a given patient.
microbiology organisms results review task
A person reviews organisms of microbiology results of a given patient.
microbiology sensitivity test results review task
A person reviews the sensitivity test of microbiology results of a given patient.
A person reviews a list of medication orders submitted to a given patient
medication administration record work list review task
A clinician reviews a work list of medications to be administered to a given patient.
A person reviews a list of orders submitted to a given patient.
A person reviews a pathology report of a given patient.
A person reviews a list of problems of a given patient.
A person reviews a radiology report of a given patient.
Description: A person enters a health care reminder for a given patient.
Description: A person enters a wellness or preventive care reminder for a given patient.
A person reviews a Risk Assessment Instrument report of a given patient.
A person reviews a Falls Risk Assessment Instrument report of a given patient.
Characterizes how a transportation act was or will be carried out. Examples: Via private transport, via public transit, via courier.
Definition: Characterizes how a patient was or will be transported to the site of a patient encounter. Examples: Via ambulance, via public transit, on foot.
Identifies the kinds of observations that can be performed
Identifies the type of observation that is made about a specimen that may affect its processing, analysis or further result interpretation
Describes the artificial blood identifier that is associated with the specimen.
An observation that reports the dilution of a sample.
The dilution of a sample performed by automated equipment. The value is specified by the equipment
The dilution of the specimen made prior to being loaded onto analytical equipment
The value of the dilution of a sample after it had been analyzed at a prior dilution value
Domain provides codes that qualify the ActLabObsEnvfctsCode domain. (Environmental Factors)
An observation that relates to factors that may potentially cause interference with the observation
The Fibrin Index of the specimen. In the case of only differentiating between Absent and Present, recommend using 0 and 1
An observation of the hemolysis index of the specimen in g/L
An observation that describes the icterus index of the specimen. It is recommended to use mMol/L of bilirubin
An observation used to describe the Lipemia Index of the specimen. It is recommended to use the optical turbidity at 600 nm (in absorbance units).
An observation that reports the volume of a sample.
The available quantity of specimen. This is the current quantity minus any planned consumption (e.g. tests that are planned)
The quantity of specimen that is used each time the equipment uses this substance
The current quantity of the specimen, i.e., initial quantity minus what has been actually used.
The initial quantity of the specimen in inventory
Description:Provides a categorization for annotations recorded directly against the patient .
Description:A note that is specific to a patient's diagnostic images, either historical, current or planned.
Description:A general or uncategorized note.
A note that is specific to a patient's immunizations, either historical, current or planned.
Description:A note that is specific to a patient's laboratory results, either historical, current or planned.
Description:A note that is specific to a patient's medications, either historical, current or planned.
Description: A DNA segment that contributes to phenotype/function. In the absence of demonstrated function a gene may be characterized by sequence, transcription or homology
Description: Observation codes which describe characteristics of the immunization material.
Description: Indicates the valid antigen count.
Description: Indicates whether an antigen is valid or invalid.
A code that is used to indicate the type of case safety report received from sender. The current code example reference is from the International Conference on Harmonisation (ICH) Expert Workgroup guideline on Clinical Safety Data Management: Data Elements for Transmission of Individual Case Safety Reports. The unknown/unavailable option allows the transmission of information from a secondary sender where the initial sender did not specify the type of report. Example concepts include: Spontaneous, Report from study, Other.
Indicates that the ICSR is describing problems that a patient experienced after receiving a vaccine product.
Indicates that the ICSR is describing a problem with the actual vaccine product such as physical defects (cloudy, particulate matter) or inability to confer immunity.
Definition:The set of LOINC codes for the act of determining the period of time that has elapsed since an entity was born or created.
Definition:General specification of age with no implied method of determination.
Definition:Age at onset of associated adverse event; no implied method of determination.
Description:This observation represents an 'average' or 'expected' half-life typical of the product.
Definition: A characteristic of an oral solid dosage form of a medicinal product, indicating whether it has one or more coatings such as sugar coating, film coating, or enteric coating. Only coatings to the external surface or the dosage form should be considered (for example, coatings to individual pellets or granules inside a capsule or tablet are excluded from consideration). Constraints: The Observation.value must be a Boolean (BL) with true for the presence or false for the absence of one or more coatings on a solid dosage form.
Definition: A characteristic of an oral solid dosage form of a medicinal product, specifying the color or colors that most predominantly define the appearance of the dose form. SPLCOLOR is not an FDA specification for the actual color of solid dosage forms or the names of colors that can appear in labeling. Constraints: The Observation.value must be a single coded value or a list of multiple coded values, specifying one or more distinct colors that approximate of the color(s) of distinct areas of the solid dosage form, such as the different sides of a tablet or one-part capsule, or the different halves of a two-part capsule. Bands on banded capsules, regardless of the color, are not considered when assigning an SPLCOLOR. Imprints on the dosage form, regardless of their color are not considered when assigning an SPLCOLOR. If more than one color exists on a particular side or half, then the most predominant color on that side or half is recorded. If the gelatin capsule shell is colorless and transparent, use the predominant color of the contents that appears through the colorless and transparent capsule shell. Colors can include: Black;Gray;White;Red;Pink;Purple;Green;Yellow;Orange;Brown;Blue;Turquoise.
Description: A characteristic representing a single file reference that contains two or more views of the same dosage form of the product; in most cases this should represent front and back views of the dosage form, but occasionally additional views might be needed in order to capture all of the important physical characteristics of the dosage form. Any imprint and/or symbol should be clearly identifiable, and the viewer should not normally need to rotate the image in order to read it. Images that are submitted with SPL should be included in the same directory as the SPL file.
Definition: A characteristic of an oral solid dosage form of a medicinal product, specifying the alphanumeric text that appears on the solid dosage form, including text that is embossed, debossed, engraved or printed with ink. The presence of other non-textual distinguishing marks or symbols is recorded by SPLSYMBOL. Examples: Included in SPLIMPRINT are alphanumeric text that appears on the bands of banded capsules and logos and other symbols that can be interpreted as letters or numbers. Constraints: The Observation.value must be of type Character String (ST). Excluded from SPLIMPRINT are internal and external cut-outs in the form of alphanumeric text and the letter 'R' with a circle around it (when referring to a registered trademark) and the letters 'TM' (when referring to a 'trade mark'). To record text, begin on either side or part of the dosage form. Start at the top left and progress as one would normally read a book. Enter a semicolon to show separation between words or line divisions.
Definition: A characteristic of an oral solid dosage form of a medicinal product, specifying the number of equal pieces that the solid dosage form can be divided into using score line(s). Example: One score line creating two equal pieces is given a value of 2, two parallel score lines creating three equal pieces is given a value of 3. Constraints: Whether three parallel score lines create four equal pieces or two intersecting score lines create two equal pieces using one score line and four equal pieces using both score lines, both have the scoring value of 4. Solid dosage forms that are not scored are given a value of 1. Solid dosage forms that can only be divided into unequal pieces are given a null-value with nullFlavor other (OTH).
Description: A characteristic of an oral solid dosage form of a medicinal product, specifying the two dimensional representation of the solid dose form, in terms of the outside perimeter of a solid dosage form when the dosage form, resting on a flat surface, is viewed from directly above, including slight rounding of corners. SPLSHAPE does not include embossing, scoring, debossing, or internal cut-outs. SPLSHAPE is independent of the orientation of the imprint and logo. Shapes can include: Triangle (3 sided); Square; Round; Semicircle; Pentagon (5 sided); Diamond; Double circle; Bullet; Hexagon (6 sided); Rectangle; Gear; Capsule; Heptagon (7 sided); Trapezoid; Oval; Clover; Octagon (8 sided); Tear; Freeform.
Definition: A characteristic of an oral solid dosage form of a medicinal product, specifying the longest single dimension of the solid dosage form as a physical quantity in the dimension of length (e.g. 3 mm). The length is should be specified in millimeters and should be rounded to the nearest whole millimeter. Example: SPLSIZE for a rectangular shaped tablet is the length and SPLSIZE for a round shaped tablet is the diameter.
Definition: A characteristic of an oral solid dosage form of a medicinal product, to describe whether or not the medicinal product has a mark or symbol appearing on it for easy and definite recognition. Score lines, letters, numbers, and internal and external cut-outs are not considered marks or symbols. See SPLSCORING and SPLIMPRINT for these characteristics. Constraints: The Observation.value must be a Boolean (BL) with true indicating the presence and false for the absence of marks or symbols. Example:
Distinguishes the kinds of coded observations that could be the trigger for clinical issue detection. These are observations that are not measurable, but instead can be defined with codes. Coded observation types include: Allergy, Intolerance, Medical Condition, Pregnancy status, etc.
Code for the mechanism by which disease was acquired by the living subject involved in the public health case. Includes sexually transmitted, airborne, bloodborne, vectorborne, foodborne, zoonotic, nosocomial, mechanical, dermal, congenital, environmental exposure, indeterminate.
Communication of an agent from a living subject or environmental source to a living subject through indirect contact via oral or nasal inhalation.
Communication of an agent from one animal to another proximate animal.
Communication of an agent from an animal to a proximate person.
Communication of an agent from one living subject to another living subject through direct contact with any body fluid.
Communication of an agent to a living subject through direct contact with blood or blood products whether the contact with blood is part of a therapeutic procedure or not.
Communication of an agent from a living subject or environmental source to a living subject via agent migration through intact skin.
Communication of an agent from an environmental surface or source to a living subject by direct contact.
Communication of an agent from a living subject or environmental source to a living subject through oral contact with material contaminated by person or animal fecal material.
Communication of an agent from an non-living material to a living subject through direct contact.
Communication of an agent from a food source to a living subject via oral consumption.
Communication of an agent from a person to a proximate person.
Communication of an agent to a living subject via an undetermined route.
Communication of an agent from one living subject to another living subject through direct contact with mammalian milk or colostrum.
Communication of an agent from any entity to a living subject while the living subject is in the patient role in a healthcare facility.
Communication of an agent from a living subject or environmental source to a living subject where the acquisition of the agent is not via the alimentary canal.
Communication of an agent from a living subject to the progeny of that living subject via agent migration across the maternal-fetal placental membranes while in utero.
Communication of an agent from one living subject to another living subject through direct contact with genital or oral tissues as part of a sexual act.
Communication of an agent from one living subject to another living subject through direct contact with blood or blood products where the contact with blood is part of a therapeutic procedure.
Communication of an agent from a living subject acting as a required intermediary in the agent transmission process to a recipient living subject via direct contact.
Communication of an agent from a contaminated water source to a living subject whether the water is ingested as a food or not. The route of entry of the water may be through any bodily orifice.
Codes used to define various metadata aspects of a health quality measure.
Indicates that the observation is carrying out an aggregation calculation, contained in the value element.
Identifies the organization(s) who own the intellectual property represented by the eMeasure.
Summary of relevant clinical guidelines or other clinical recommendations supporting this eMeasure.
Description of individual terms, provided as needed.
Disclaimer information for the eMeasure.
The timestamp when the eMeasure was last packaged in the Measure Authoring Tool.
Used to allow measure developers to provide additional guidance for implementers to understand greater specificity than could be provided in the logic for data criteria.
Information on whether an increase or decrease in score is the preferred result (e.g. a higher score indicates better quality OR a lower score indicates better quality OR quality is within a range).
Describes the items counted by the measure (e.g. patients, encounters, procedures, etc.)
A significant word that aids in discoverability.
The start date of the measurement period.
The method of adjusting for clinical severity and conditions present at the start of care that can influence patient outcomes for making valid comparisons of outcome measures across providers. Indicates whether an eMeasure is subject to the statistical process for reducing, removing, or clarifying the influences of confounding factors to allow more useful comparisons.
Describes how to combine information calculated based on logic in each of several populations into one summarized result. It can also be used to describe how to risk adjust the data based on supplemental data elements described in the eMeasure. (e.g. pneumonia hospital measures antibiotic selection in the ICU versus non-ICU and then the roll-up of the two). Open Issue: The description does NOT align well with the definition used in the HQMF specfication; correct the MSGAGG definition, and the possible distinction of MSRAGG as a child of AGGREGATE.
health quality measure improvement notation
Information on whether an increase or decrease in score is the preferred result. This should reflect information on which way is better, an increase or decrease in score.
The list of jurisdiction(s) for which the measure applies.
Type of person or organization that is expected to report the issue.
The maximum time that may elapse following completion of the measure until the measure report must be sent to the receiver.
Indicates how the calculation is performed for the eMeasure (e.g. proportion, continuous variable, ratio)
Location(s) in which care being measured is rendered Usage Note: MSRSET is used rather than RoleCode because the setting applies to what is being measured, as opposed to participating directly in the health quality measure documantion itself).
The time period for which the eMeasure applies.
Indicates whether the eMeasure is used to examine a process or an outcome over time (e.g. Structure, Process, Outcome).
Succinct statement of the need for the measure. Usually includes statements pertaining to Importance criterion: impact, gap in care and evidence.
Identifies bibliographic citations or references to clinical practice guidelines, sources of evidence, or other relevant materials supporting the intent and rationale of the eMeasure.
Comparison of results across strata can be used to show where disparities exist or where there is a need to expose differences in results. For example, Centers for Medicare & Medicaid Services (CMS) in the U.S. defines four required Supplemental Data Elements (payer, ethnicity, race, and gender), which are variables used to aggregate data into various subgroups. Additional supplemental data elements required for risk adjustment or other purposes of data aggregation can be included in the Supplemental Data Element section.
Describes the strata for which the measure is to be evaluated. There are three examples of reasons for stratification based on existing work. These include: (1) evaluate the measure based on different age groupings within the population described in the measure (e.g. evaluate the whole [age 14-25] and each sub-stratum [14-19] and [20-25]); (2) evaluate the eMeasure based on either a specific condition, a specific discharge location, or both; (3) evaluate the eMeasure based on different locations within a facility (e.g. evaluate the overall rate for all intensive care units and also some strata include additional findings [specific birth weights for neonatal intensive care units]).
Can be a URL or hyperlinks that link to the transmission formats that are specified for a particular reporting program.
A sequence of values in the "absolute" time domain. This is the same time domain that all HL7 timestamps use. It is time as measured by the Gregorian calendar
A sequence of values in a "relative" time domain. The time is measured relative to the earliest effective time in the Observation Series containing this sequence.
This Observation Series type contains waveforms of a "representative beat" (a.k.a. "median beat" or "average beat"). The waveform samples are measured in relative time, relative to the beginning of the beat as defined by the Observation Series effective time. The waveforms are not directly acquired from the subject, but rather algorithmically derived from the "rhythm" waveforms.
This Observation type contains ECG "rhythm" waveforms. The waveform samples are measured in absolute time (a.k.a. "subject time" or "effective time"). These waveforms are usually "raw" with some minimal amount of noise reduction and baseline filtering applied.
Description: Reporting codes that are related to an immunization event.
Description: The class room associated with the patient during the immunization event.
Description: The school grade or level the patient was in when immunized.
Description: The school the patient attended when immunized.
Description: The school division or district associated with the patient during the immunization event.
Description: The patient's teacher when immunized.
Observation types for specifying criteria used to assert that a subject is included in a particular population.
Criteria which specify subjects who should be removed from the eMeasure population and denominator before determining if numerator criteria are met. Denominator exclusions are used in proportion and ratio measures to help narrow the denominator.
Criteria which specify the removal of a subject, procedure or unit of measurement from the denominator, only if the numerator criteria are not met. Denominator exceptions allow for adjustment of the calculated score for those providers with higher risk populations. Denominator exceptions are used only in proportion eMeasures. They are not appropriate for ratio or continuous variable eMeasures. Denominator exceptions allow for the exercise of clinical judgment and should be specifically defined where capturing the information in a structured manner fits the clinical workflow. Generic denominator exception reasons used in proportion eMeasures fall into three general categories: Medical reasons Patient (or subject) reasons System reasons
Criteria for specifying the entities to be evaluated by a specific quality measure, based on a shared common set of characteristics (within a specific measurement set to which a given measure belongs). The denominator can be the same as the initial population, or it may be a subset of the initial population to further constrain it for the purpose of the eMeasure. Different measures within an eMeasure set may have different denominators. Continuous Variable eMeasures do not have a denominator, but instead define a measure population.
Criteria for specifying the entities to be evaluated by a specific quality measure, based on a shared common set of characteristics (within a specific measurement set to which a given measure belongs).
Criteria for specifying the patients to be evaluated by a specific quality measure, based on a shared common set of characteristics (within a specific measurement set to which a given measure belongs). Details often include information based upon specific age groups, diagnoses, diagnostic and procedure codes, and enrollment periods.
Criteria for specifying the measure population as a narrative description (e.g. all patients seen in the Emergency Department during the measurement period). This is used only in continuous variable eMeasures.
Criteria for specifying subjects who should be removed from the eMeasure's Initial Population and Measure Population. Measure Population Exclusions are used in Continuous Variable measures to help narrow the Measure Population before determining the value(s) of the continuous variable(s).
Criteria for specifying the processes or outcomes expected for each patient, procedure, or other unit of measurement defined in the denominator for proportion measures, or related to (but not directly derived from) the denominator for ratio measures (e.g. a numerator listing the number of central line blood stream infections and a denominator indicating the days per thousand of central line usage in a specific time period).
Criteria for specifying instances that should not be included in the numerator data. (e.g. if the number of central line blood stream infections per 1000 catheter days were to exclude infections with a specific bacterium, that bacterium would be listed as a numerator exclusion). Numerator Exclusions are used only in ratio eMeasures.
Types of observations that can be made about Preferences.
An observation about how important a preference is to the target of the preference.
Indicates that the observation is of an unexpected negative occurrence in the subject suspected to result from the subject's exposure to one or more agents. Observation values would be the symptom resulting from the reaction.
Description:Refines classCode OBS to indicate an observation in which observation.value contains a finding or other nominalized statement, where the encoded information in Observation.value is not altered by Observation.code. For instance, observation.code="ASSERTION" and observation.value="fracture of femur present" is an assertion of a clinical finding of femur fracture.
Definition:An observation that provides a characterization of the level of harm to an investigation subject as a result of a reaction or event.
An observation that states whether the disease was likely acquired outside the jurisdiction of observation, and if so, the nature of the inter-jurisdictional relationship. OpenIssue: This code could be moved to LOINC if it can be done before there are significant implemenations using it.
A clinical judgment as to the worst case result of a future exposure (including substance administration). When the worst case result is assessed to have a life-threatening or organ system threatening potential, it is considered to be of high criticality.
An observation that states the mechanism by which disease was acquired by the living subject involved in the public health case. OpenIssue: This code could be moved to LOINC if it can be done before there are significant implemenations using it.
Includes all codes defining types of indications such as diagnosis, symptom and other indications such as contrast agents for lab tests.
Admitting diagnosis are the diagnoses documented for administrative purposes as the basis for a hospital admission.
Discharge diagnosis are the diagnoses documented for administrative purposes as the time of hospital discharge.
Intermediate diagnoses are those diagnoses documented for administrative purposes during the course of a hospital stay.
The type of injury that the injury coding specifies.
Description: Accuracy determined as per the GIS tier code system.
Indicates that the observation is of a person’s living situation in a household including the household composition and circumstances.
There is a clinical issue for the therapy that makes continuation of the therapy inappropriate. Open Issue: The definition of this code does not correctly represent the concept space of its specializations (children)
Identifies types of detectyed issues for Act class "ALRT" for the administrative and patient administrative acts domains.
The requesting party has insufficient authorization to invoke the interaction.
Description: One or more records in the query response have been suppressed due to consent or privacy restrictions.
Description:The specified element did not pass business-rule validation.
The ID of the patient, order, etc., was not found. Used for transactions other than additions, e.g. transfer of a non-existent patient.
The ID of the patient, order, etc., already exists. Used in response to addition transactions (Admit, New Order, etc.).
There may be an issue with the patient complying with the intentions of the proposed therapy
The proposed therapy appears to duplicate an existing therapy
Description:The proposed therapy appears to have the same intended therapeutic benefit as an existing therapy, though the specific mechanisms of action vary.
Description:The proposed therapy appears to have the same intended therapeutic benefit as an existing therapy and uses the same mechanisms of action as the existing therapy.
Description:The proposed therapy is frequently misused or abused and therefore should be used with caution and/or monitoring.
Description:The request is suspected to have a fraudulent basis.
A similar or identical therapy was recently ordered by a different practitioner.
This patient was recently supplied a similar or identical therapy from a different pharmacy or supplier.
Proposed dosage instructions for therapy differ from standard practice.
Description:Proposed dosage is inappropriate due to patient's medical condition.
Proposed length of therapy differs from standard practice.
Proposed length of therapy is longer than standard practice
Proposed length of therapy is longer than standard practice for the identified indication or diagnosis
Proposed length of therapy is shorter than that necessary for therapeutic effect
Proposed length of therapy is shorter than standard practice for the identified indication or diagnosis
Proposed dosage exceeds standard practice
Proposed dosage exceeds standard practice for the patient's age
Proposed dosage exceeds standard practice for the patient's height or body surface area
Proposed dosage exceeds standard practice for the patient's weight
Proposed dosage interval/timing differs from standard practice
Proposed dosage interval/timing differs from standard practice for the identified indication or diagnosis
Proposed dosage is below suggested therapeutic levels
Proposed dosage is below suggested therapeutic levels for the patient's age
Proposed dosage is below suggested therapeutic levels for the patient's height or body surface area
Proposed dosage is below suggested therapeutic levels for the patient's weight
Description:The maximum quantity of this drug allowed to be administered within a particular time-range (month, year, lifetime) has been reached or exceeded.
Proposed therapy may be inappropriate or contraindicated due to conditions or characteristics of the patient
Proposed therapy may be inappropriate or contraindicated due to patient age
Proposed therapy is outside of the standard practice for an adult patient.
Proposed therapy is outside of standard practice for a geriatric patient.
Proposed therapy is outside of the standard practice for a pediatric patient.
Proposed therapy may be inappropriate or contraindicated due to an existing/recent patient condition or diagnosis
Proposed therapy may be inappropriate or contraindicated when breast-feeding
Proposed therapy may be inappropriate or contraindicated during pregnancy
Description:Proposed therapy may be inappropriate or contraindicated because of a common but non-patient specific reaction to the product. Example:There is no record of a specific sensitivity for the patient, but the presence of the sensitivity is common and therefore caution is warranted.
Proposed therapy may be inappropriate or contraindicated due to patient genetic indicators.
Proposed therapy may be inappropriate or contraindicated due to patient gender.
Proposed therapy may be inappropriate or contraindicated due to recent lab test results
Proposed therapy may be inappropriate or contraindicated based on the potential for a patient reaction to the proposed product
Proposed therapy may be inappropriate or contraindicated because of a recorded patient allergy to the proposed product. (Allergies are immune based reactions.)
Proposed therapy may be inappropriate or contraindicated because of a recorded patient intolerance to the proposed product. (Intolerances are non-immune based sensitivities.)
Proposed therapy may be inappropriate or contraindicated because of a potential patient reaction to a cross-sensitivity related product.
Proposed therapy may be inappropriate or contraindicated because of a recorded patient allergy to a cross-sensitivity related product. (Allergies are immune based reactions.)
Proposed therapy may be inappropriate or contraindicated because of a recorded prior adverse reaction to a cross-sensitivity related product.
Proposed therapy may be inappropriate or contraindicated because of a recorded patient intolerance to a cross-sensitivity related product. (Intolerances are non-immune based sensitivities.)
Description:A local business rule relating multiple elements has been violated.
Description:The specified code is not valid against the list of codes allowed for the element.
Description:The specified code has been deprecated and should no longer be used. Select another code from the code system.
Description:The element does not follow the formatting or type rules defined for the field.
Description:The request is missing elements or contains elements which cause it to not meet the legal standards for actioning.
Description:The length of the data specified falls out of the range defined for the element.
Description:The length of the data specified is greater than the maximum length defined for the element.
Description:The length of the data specified is less than the minimum length defined for the element.
Description:The specified element must be specified with a non-null value under certain conditions. In this case, the conditions are true but the element is still missing or null.
Description:The specified element is mandatory and was not included in the instance.
Description:More than one element with the same value exists in the set. Duplicates not permission in this set in a set.
Description: Element in submitted message will not persist in data storage based on detected issue.
Description:The number of repeating elements falls outside the range of the allowed number of repetitions.
Description:The number of repeating elements is above the maximum number of repetitions allowed.
Description:The number of repeating elements is below the minimum number of repetitions allowed.
Description: Metadata associated with the identification (e.g. name or gender) does not match the identification being verified.
Description: One or more records in the query response have a status of 'obsolete'.
Identifies types of detected issues regarding the administration or supply of an item to a patient.
Administration of the proposed therapy may be inappropriate or contraindicated as proposed
Proposed therapy may interact with certain foods
Proposed therapy may interact with an existing or recent therapeutic product
Proposed therapy may interact with an existing or recent drug therapy
Proposed therapy may interact with existing or recent natural health product therapy
Proposed therapy may interact with a non-prescription drug (e.g. alcohol, tobacco, Aspirin)
Definition:The same or similar treatment has previously been attempted with the patient without achieving a positive effect.
Description:Proposed therapy may be contraindicated or ineffective based on an existing or recent drug therapy.
Description:Proposed therapy may be inappropriate or ineffective based on the proposed start or end time.
Definition:Proposed therapy may be inappropriate or ineffective because the end of administration is too close to another planned therapy.
Definition:Proposed therapy may be inappropriate or ineffective because the start of administration is too late after the onset of the condition.
Proposed therapy may be inappropriate or ineffective based on the proposed start or end time.
Proposed therapy may be inappropriate or ineffective because the end of administration is too close to another planned therapy
Proposed therapy may be inappropriate or ineffective because the start of administration is too late after the onset of the condition
Supplying the product at this time may be inappropriate or indicate compliance issues with the associated therapy
Definition:The requested action has already been performed and so this request has no effect
Definition:The therapy being performed is in some way out of alignment with the requested therapy.
Definition:The status of the request being fulfilled has changed such that it is no longer actionable. This may be because the request has expired, has already been completely fulfilled or has been otherwise stopped or disabled. (Not used for 'suspended' orders.)
Definition:The therapy being performed is not sufficiently equivalent to the therapy which was requested.
Definition:The therapy being performed is not generically equivalent (having the identical biological action) to the therapy which was requested.
Definition:The therapy being performed is not therapeutically equivalent (having the same overall patient effect) to the therapy which was requested.
Definition:The therapy is being performed at a time which diverges from the time the therapy was requested
Definition:The therapy action is being performed outside the bounds of the time period requested
too soon within frequency based on the usage
Definition:The therapy action is being performed too soon after the previous occurrence based on the requested frequency
Definition:There should be no actions taken in fulfillment of a request that has been held or suspended.
The patient is receiving a subsequent fill significantly later than would be expected based on the amount previously supplied and the therapy dosage instructions
The patient is receiving a subsequent fill significantly earlier than would be expected based on the amount previously supplied and the therapy dosage instructions
Description: While the record was accepted in the repository, there is a more recent version of a record of this type.
Definition:The proposed therapy goes against preferences or consent constraints recorded in the patient's record.
violates stated preferences, alternate available
Definition:The proposed therapy goes against preferences or consent constraints recorded in the patient's record. An alternate therapy meeting those constraints is available.
Categorization of types of observation that capture the main clinical knowledge subject which may be a medication, a laboratory test, a disease.
Categorization of types of observation that capture a knowledge subtopic which might be treatment, etiology, or prognosis.
Hypersensitivity resulting in an adverse reaction upon exposure to an agent.
Hypersensitivity to an agent caused by an immunologic response to an initial exposure
An allergy to a substance other than a drug or a food; e.g. Latex, pollen, etc.
An allergy to a substance generally consumed for nutritional purposes.
Hypersensitivity resulting in an adverse reaction upon exposure to a drug.
Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure
Hypersensitivity resulting in an adverse reaction upon exposure to environmental conditions.
Hypersensitivity resulting in an adverse reaction upon exposure to food.
A subjective evaluation of the seriousness or intensity associated with another observation.
Shape of the region on the object being referenced
A circle defined by two (column,row) pairs. The first point is the center of the circle and the second point is a point on the perimeter of the circle.
An ellipse defined by four (column,row) pairs, the first two points specifying the endpoints of the major axis and the second two points specifying the endpoints of the minor axis.
A single point denoted by a single (column,row) pair, or multiple points each denoted by a (column,row) pair.
A series of connected line segments with ordered vertices denoted by (column,row) pairs; if the first and last vertices are the same, it is a closed polygon.
Description:Indicates that result data has been corrected.
Code set to define specialized/allowed diets
A diet exclusively composed of oatmeal, semolina, or rice, to be extremely easy to eat and digest.
A diet that uses carbohydrates sparingly. Typically with a restriction in daily energy content (e.g. 1600-2000 kcal).
No enteral intake of foot or liquids whatsoever, no smoking. Typically 6 to 8 hours before anesthesia.
A diet consisting of a formula feeding, either for an infant or an adult, to provide nutrition either orally or through the gastrointestinal tract via tube, catheter or stoma.
A diet low in fat, particularly to patients with hepatic diseases.
A low protein diet for patients with renal failure.
A strictly liquid diet, that can be fully absorbed in the intestine, and therefore may not contain fiber. Used before enteral surgeries.
A diet low in sodium for patients with congestive heart failure and/or renal failure.
A normal diet, i.e. no special preparations or restrictions for medical reasons. This is notwithstanding any preferences the patient might have regarding special foods, such as vegetarian, kosher, etc.
A no fat diet for acute hepatic diseases.
Patient is supplied with parenteral nutrition, typically described in terms of i.v. medications.
A diet that seeks to reduce body fat, typically low energy content (800-1600 kcal).
A diet that avoids ingredients that might cause digestion problems, e.g. avoid excessive fat, avoid too much fiber (cabbage, peas, beans).
A diet that is not intended to be complete but is added to other diets.
This is not really a diet, since it contains little nutritional value, but is essentially just water. Used before coloscopy examinations.
Diet with low content of the amino-acids valin, leucin, and isoleucin, for "maple syrup disease."
Definition: A public or government health program that administers and funds coverage for prescription drugs to assist program eligible who meet financial and health status criteria.
Description:Indicates that a result is complete. No further results are to come. This maps to the 'complete' state in the observation result status code.
Description:Indicates that a result is incomplete. There are further results to come. This maps to the 'active' state in the observation result status code.
An observation identifying security metadata about an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security metadata are used to name security labels. Rationale: According to ISO/TS 22600-3:2009(E) A.9.1.7 SECURITY LABEL MATCHING, Security label matching compares the initiator's clearance to the target's security label. All of the following must be true for authorization to be granted: The security policy identifiers shall be identical The classification level of the initiator shall be greater than or equal to that of the target (that is, there shall be at least one value in the classification list of the clearance greater than or equal to the classification of the target), and For each security category in the target label, there shall be a security category of the same type in the initiator's clearance and the initiator's classification level shall dominate that of the target. Examples: SecurityObservationType security label fields include: Confidentiality classification Compartment category Sensitivity category Security mechanisms used to ensure data integrity or to perform authorized data transformation Indicators of an IT resource completeness, veracity, reliability, trustworthiness, or provenance. Usage Note: SecurityObservationType codes designate security label field types, which are valued with an applicable SecurityObservationValue code as the "security label tag".
Type of security metadata observation made about the category of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security category metadata is defined by ISO/IEC 2382-8:1998(E/F)/ T-REC-X.812-1995 as: "A nonhierarchical grouping of sensitive information used to control access to data more finely than with hierarchical security classification alone." Rationale: A security category observation supports requirement to specify the type of IT resource to facilitate application of appropriate levels of information security according to a range of levels of impact or consequences that might result from the unauthorized disclosure, modification, or use of the information or information system. A resource is assigned to a specific category of information (e.g. privacy, medical, proprietary, financial, investigative, contractor sensitive, security management) defined by an organization or in some instances, by a specific law, Executive Order, directive, policy, or regulation. [FIPS 199] Examples: Types of security categories include: Compartment: A division of data into isolated blocks with separate security controls for the purpose of reducing risk. (ISO 2382-8). A security label tag that "segments" an IT resource by indicating that access and use is restricted to members of a defined community or project. (HL7 Healthcare Classification System) Sensitivity: The characteristic of an IT resource which implies its value or importance and may include its vulnerability. (ISO 7492-2) Privacy metadata for information perceived as undesirable to share. (HL7 Healthcare Classification System)
Type of security metadata observation made about the classification of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security classification is defined by ISO/IEC 2382-8:1998(E/F)/ T-REC-X.812-1995 as: "The determination of which specific degree of protection against access the data or information requires, together with a designation of that degree of protection." Security classification metadata is based on an analysis of applicable policies and the risk of financial, reputational, or other harm that could result from unauthorized disclosure. Rationale: A security classification observation may indicate that the confidentiality level indicated by an Act or Role confidentiality attribute has been overridden by the entity responsible for ascribing the SecurityClassificationObservationValue. This supports the business requirement for increasing or decreasing the level of confidentiality (classification or declassification) based on parameters beyond the original assignment of an Act or Role confidentiality. Examples: Types of security classification include: HL7 Confidentiality Codes such as very restricted, unrestricted, and normal. Intelligence community examples include top secret, secret, and confidential. Usage Note: Security classification observation type codes designate security label field types, which are valued with an applicable SecurityClassificationObservationValue code as the "security label tag".
Type of security metadata observation made about the control of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security control metadata convey instructions to users and receivers for secure distribution, transmission, and storage; dictate obligations or mandated actions; specify any action prohibited by refrain policy such as dissemination controls; and stipulate the permissible purpose of use of an IT resource. Rationale: A security control observation supports requirement to specify applicable management, operational, and technical controls (i.e., safeguards or countermeasures) prescribed for an information system to protect the confidentiality, integrity, and availability of the system and its information. [FIPS 199] Examples: Types of security control metadata include: handling caveats dissemination controls obligations refrain policies purpose of use constraints
Type of security metadata observation made about the integrity of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Rationale: A security integrity observation supports the requirement to guard against improper information modification or destruction, and includes ensuring information non-repudiation and authenticity. (44 U.S.C., SEC. 3542) Examples: Types of security integrity metadata include: Integrity status, which indicates the completeness or workflow status of an IT resource (data, information object, service, or system capability) Integrity confidence, which indicates the reliability and trustworthiness of an IT resource Integrity control, which indicates pertinent handling caveats, obligations, refrain policies, and purpose of use for the resource Data integrity, which indicate the security mechanisms used to ensure that the accuracy and consistency are preserved regardless of changes made (ISO/IEC DIS 2382-8) Alteration integrity, which indicate the security mechanisms used for authorized transformations of the resource Integrity provenance, which indicates the entity responsible for a report or assertion relayed "second-hand" about an IT resource
security alteration integrity observation
Type of security metadata observation made about the alteration integrity of an IT resource (data, information object, service, or system capability), which indicates the mechanism used for authorized transformations of the resource. Examples: Types of security alteration integrity observation metadata, which may value the observation with a code used to indicate the mechanism used for authorized transformation of an IT resource, including: translation syntactic transformation semantic mapping redaction masking pseudonymization anonymization
Type of security metadata observation made about the data integrity of an IT resource (data, information object, service, or system capability), which indicates the security mechanism used to preserve resource accuracy and consistency. Data integrity is defined by ISO 22600-23.3.21 as: "The property that data has not been altered or destroyed in an unauthorized manner", and by ISO/IEC 2382-8: The property of data whose accuracy and consistency are preserved regardless of changes made." Examples: Types of security data integrity observation metadata, which may value the observation, include cryptographic hash function and digital signature.
security integrity confidence observation
Type of security metadata observation made about the integrity confidence of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Examples: Types of security integrity confidence observation metadata, which may value the observation, include highly reliable, uncertain reliability, and not reliable. Usage Note: A security integrity confidence observation on an Act may indicate that a valued Act.uncertaintycode attribute has been overridden by the entity responsible for ascribing the SecurityIntegrityConfidenceObservationValue. This supports the business requirements for increasing or decreasing the assessment of the reliability or trustworthiness of an IT resource based on parameters beyond the original assignment of an Act statement level of uncertainty.
security integrity provenance observation
Type of security metadata observation made about the provenance integrity of an IT resource (data, information object, service, or system capability), which indicates the lifecycle completeness of an IT resource in terms of workflow status such as its creation, modification, suspension, and deletion; locations in which the resource has been collected or archived, from which it may be retrieved, and the history of its distribution and disclosure. Integrity provenance metadata about an IT resource may be used to assess its veracity, reliability, and trustworthiness. Examples: Types of security integrity provenance observation metadata, which may value the observation about an IT resource, include: completeness or workflow status, such as authentication the entity responsible for original authoring or informing about an IT resource the entity responsible for a report or assertion about an IT resource relayed “second-handâ€? the entity responsible for excerpting, transforming, or compiling an IT resource
security integrity provenance asserted by observation
Type of security metadata observation made about the integrity provenance of an IT resource (data, information object, service, or system capability), which indicates the entity that made assertions about the resource. The asserting entity may not be the original informant about the resource. Examples: Types of security integrity provenance asserted by observation metadata, which may value the observation, including: assertions about an IT resource by a patient assertions about an IT resource by a clinician assertions about an IT resource by a device
security integrity provenance reported by observation
Type of security metadata observation made about the integrity provenance of an IT resource (data, information object, service, or system capability), which indicates the entity that reported the existence of the resource. The reporting entity may not be the original author of the resource. Examples: Types of security integrity provenance reported by observation metadata, which may value the observation, include: reports about an IT resource by a patient reports about an IT resource by a clinician reports about an IT resource by a device
Type of security metadata observation made about the integrity status of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Indicates the completeness of an IT resource in terms of workflow status, which may impact users that are authorized to access and use the resource. Examples: Types of security integrity status observation metadata, which may value the observation, include codes from the HL7 DocumentCompletion code system such as legally authenticated, in progress, and incomplete.
An observation identifying trust metadata about an IT resource (data, information object, service, or system capability), which may be used as a trust attribute to populate a computable trust policy, trust credential, trust assertion, or trust label field in a security label or trust policy, which are principally used for authentication, authorization, and access control decisions.
Type of security metadata observation made about the formal declaration by an authority or neutral third party that validates the technical, security, trust, and business practice conformance of Trust Agents to facilitate security, interoperability, and trust among participants within a security domain or trust framework.
Type of security metadata observation made about privacy and security requirements with which a security domain must comply. [ISO IEC 10181-1]
Type of security metadata observation made about a set of security-relevant data issued by a security authority or trusted third party, together with security information which is used to provide the integrity and data origin authentication services for an IT resource (data, information object, service, or system capability). [Based on ISO IEC 10181-1] For example, A Certificate Policy (CP), which is a named set of rules that indicates the applicability of a certificate to a particular community and/or class of application with common security requirements. For example, a particular Certificate Policy might indicate the applicability of a type of certificate to the authentication of electronic data interchange transactions for the trading of goods within a given price range. [Trust Service Principles and Criteria for Certification Authorities Version 2.0 March 2011 Copyright 2011 by Canadian Institute of Chartered Accountants. A Certificate Practice Statement (CSP), which is a statement of the practices which an Authority employs in issuing and managing certificates. [Trust Service Principles and Criteria for Certification Authorities Version 2.0 March 2011 Copyright 2011 by Canadian Institute of Chartered Accountants.]
Type of security metadata observation made about a complete set of contracts, regulations or commitments that enable participating actors to rely on certain assertions by other actors to fulfill their information security requirements. [Kantara Initiative]
Type of security metadata observation made about the digital quality or reliability of a trust assertion, activity, capability, information exchange, mechanism, process, or protocol.
Type of security metadata observation made about a security architecture system component that supports enforcement of security policies.
Definition: A government health program that provides coverage on a fee for service basis for health services to persons meeting eligibility criteria such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds. Discussion: The structure and business processes for underwriting and administering a subsidized fee for service program is further specified by the Underwriter and Payer Role.class and Role.code.
Definition: Government mandated program providing coverage, disability income, and vocational rehabilitation for injuries sustained in the work place or in the course of employment. Employers may either self-fund the program, purchase commercial coverage, or pay a premium to a government entity that administers the program. Employees may be required to pay premiums toward the cost of coverage as well.
An identifying code for healthcare interventions/procedures.
Definition: An identifying code for billable services, as opposed to codes for similar services used to identify them for functional purposes.
Domain provides the root for HL7-defined detailed or rich codes for the Act classes.
The act of putting something away for safe keeping. The "something" may be physical object such as a specimen, or information, such as observations regarding a specimen.