Generated Narrative: CodeSystem v3-ActReason 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/ActReason defines the following codes in an undefined hierarchy: Lvl Code Display Definition Not Selectable 1 _ActAccommodationReason ActAccommodationReason Identifies the reason the patient is assigned to this accommodation type true 2 ACCREQNA Accommodation Requested Not Available Accommodation requested is not available. false 2 FLRCNV Floor Convenience Accommodation is assigned for floor convenience. false 2 MEDNEC Medical Necessity Required for medical reasons(s). false 2 PAT Patient request The Patient requested the action false 1 _ActCoverageReason ActCoverageReason Description:Codes used to specify reasons or criteria relating to coverage provided under a policy or program. May be used to convey reasons pertaining to coverage contractual provisions, including criteria for eligibility, coverage limitations, coverage maximums, or financial participation required of covered parties. true 2 _EligibilityActReasonCode EligibilityActReasonCode Identifies the reason or rational for why a person is eligibile for benefits under an insurance policy or progam. Examples: A person is a claimant under an automobile insurance policy are client deceased & adopted client has been given a new policy identifier. A new employee is eligible for health insurance as an employment benefit. A person meets a government program eligibility criteria for financial, age or health status. true 3 _ActIneligibilityReason ActIneligibilityReason Identifies the reason or rational for why a person is not eligibile for benefits under an insurance policy. Examples are client deceased & adopted client has been given a new policy identifier. true 4 COVSUS coverage suspended When a client has no contact with the health system for an extended period, coverage is suspended. Client will be reinstated to original start date upon proof of identification, residency etc. Example: Coverage may be suspended during a strike situation, when employer benefits for employees are not covered (i.e. not in effect). false 4 DECSD deceased Client deceased. false 4 REGERR registered in error Client was registered in error. false 3 _CoverageEligibilityReason CoverageEligibilityReason Definition: Identifies the reason or rational for why a person is eligibile for benefits under an insurance policy or progam. Examples: A person is a claimant under an automobile insurance policy are client deceased & adopted client has been given a new policy identifier. A new employee is eligible for health insurance as an employment benefit. A person meets a government program eligibility criteria for financial, age or health status. true 4 AGE age eligibility A person becomes eligible for a program based on age. Example: In the U.S., a person who is 65 years of age or older is eligible for Medicare. false 4 CRIME crime victim A person becomes eligible for insurance or a program because of crime related health condition or injury. Example: A person is a claimant under the U.S. Crime Victims Compensation program. false 4 DIS disability A person becomes a claimant under a disability income insurance policy or a disability rehabilitation program because of a health condition or injury which limits the person's ability to earn an income or function without institutionalization. false 4 EMPLOY employment benefit A person becomes eligible for insurance provided as an employment benefit based on employment status. false 4 FINAN financial eligibility A person becomes eligible for a program based on financial criteria. Example: A person whose family income is below a financial threshold for eligibility for Medicaid or SCHIP. false 4 HEALTH health status A person becomes eligible for a program because of a qualifying health condition or injury. Examples: A person is determined to have a qualifying health conditions include pregnancy, HIV/AIDs, tuberculosis, end stage renal disease, breast or cervical cancer, or other condition requiring specialized health services, hospice, institutional or community based care provided under a program false 4 MULTI multiple criteria eligibility A person becomes eligible for a program based on more than one criterion. Examples: In the U.S., a child whose familiy income meets Medicaid financial thresholds and whose age is less than 18 is eligible for the Early and Periodic Screening, Diagnostic, and Treatment program (EPSDT). A person whose family income meets Medicaid financial thresholds and whose age is 65 years or older is eligible for Medicaid and Medicare, and are referred to as dual eligibles. false 4 PNC property and casualty condition A person becomes a claimant under a property and casualty insurance policy because of a related health condition or injury resulting from a circumstance covered under the terms of the policy. Example: A person is a claimant under a homeowners insurance policy because of an injury sustained on the policyholderaTMs premises. false 4 STATUTORY statutory eligibility A person becomes eligible for a program based on statutory criteria. Examples: A person is a member of an indigenous group, a veteran of military service, or in the U.S., a recipient of adoption assistance and foster care under Title IV-E of the Social Security. false 4 VEHIC motor vehicle accident victim A person becomes a claimant under a motor vehicle accident insurance because of a motor vehicle accident related health condition or injury. false 4 WORK work related A person becomes eligible for insurance or a program because of a work related health condition or injury. Example: A person is a claimant under the U.S. Black Lung Program. false 1 _ActInformationManagementReason ActInformationManagementReason Description:The rationale or purpose for an act relating to information management, such as archiving information for the purpose of complying with an enterprise data retention policy. true 2 _ActHealthInformationManagementReason ActHealthInformationManagementReason Description:The rationale or purpose for an act relating to health information management, such as archiving information for the purpose of complying with an organization policy or jurisdictional law relating to data retention. true 3 _ActConsentInformationAccessOverrideReason ActConsentInformationAccessOverrideReason To perform one or more operations on information to which the patient has not consented as deemed necessary by authorized entities for providing care in the best interest of the patient; providing immediately needed health care for an emergent condition; or for protecting public or third party safety. Usage Notes: Used to convey the reason that a provider or other entity may or has accessed personal healthcare information. Typically, this involves overriding the subject's consent directives. true 4 OVRER emergency treatment override To perform one or more operations on information to which the patient has not consented by authorized entities for treating a condition which poses an immediate threat to the patient's health and which requires immediate medical intervention. Usage Notes: The patient is unable to provide consent, but the provider determines they have an urgent healthcare related reason to access the record. false 4 OVRPJ professional judgment override To perform one or more operations on information to which the patient declined to consent for providing health care. Usage Notes: The patient, while able to give consent, has not. However the provider believes it is in the patient's interest to access the record without patient consent. false 4 OVRPS public safety override To perform one or more operations on information to which the patient has not consented for public safety reasons. Usage Notes: The patient, while able to give consent, has not. However, the provider believes that access to masked patient information is justified because of concerns related to public safety. false 4 OVRTPS third party safety override To perform one or more operations on information to which the patient has not consented for third party safety. Usage Notes: The patient, while able to give consent, has not. However, the provider believes that access to masked patient information is justified because of concerns related to the health and safety of one or more third parties. false 3 PurposeOfUse purpose of use Reason for performing one or more operations on information, which may be permitted by source system's security policy in accordance with one or more privacy policies and consent directives. Usage Notes: The rationale or purpose for an act relating to the management of personal health information, such as collecting personal health information for research or public health purposes. false 4 HMARKT healthcare marketing To perform one or more operations on information for marketing services and products related to health care. false 4 HOPERAT healthcare operations To perform one or more operations on information used for conducting administrative and contractual activities related to the provision of health care. false 5 DONAT donation To perform one or more operations on information used for cadaveric organ, eye or tissue donation. false 5 FRAUD fraud To perform one or more operations on information used for fraud detection and prevention processes. false 5 GOV government To perform one or more operations on information used within government processes. false 5 HACCRED health accreditation To perform one or more operations on information for conducting activities related to meeting accreditation criteria. false 5 HCOMPL health compliance To perform one or more operations on information used for conducting activities required to meet a mandate. false 5 HDECD decedent To perform one or more operations on information used for handling deceased patient matters. false 5 HDIRECT directory To perform one or more operation operations on information used to manage a patient directory. Examples: facility enterprise payer health information exchange patient directory false 5 HLEGAL legal To perform one or more operations on information for conducting activities required by legal proceeding. false 5 HOUTCOMS health outcome measure To perform one or more operations on information used for assessing results and comparative effectiveness achieved by health care practices and interventions. false 5 HPRGRP health program reporting To perform one or more operations on information used for conducting activities to meet program accounting requirements. false 5 HQUALIMP health quality improvement To perform one or more operations on information used for conducting administrative activities to improve health care quality. false 5 HSYSADMIN health system administration To perform one or more operations on information to administer the electronic systems used for the delivery of health care. false 5 MEMADMIN member administration To perform one or more operations on information to administer health care coverage to an enrollee under a policy or program. false 5 PATADMIN patient administration To perform one or more operations on information used for operational activities conducted to administer the delivery of health care to a patient. false 5 PATSFTY patient safety To perform one or more operations on information in processes related to ensuring the safety of health care. false 5 PERFMSR performance measure To perform one or more operations on information used for monitoring performance of recommended health care practices and interventions. false 5 RECORDMGT records management To perform one or more operations on information used within the health records management process. false 5 TRAIN training To perform one or more operations on information used in training and education. false 4 HPAYMT healthcare payment To perform one or more operations on information for conducting financial or contractual activities related to payment for provision of health care. false 5 CLMATTCH claim attachment To perform one or more operations on information for provision of additional clinical evidence in support of a request for coverage or payment for health services. false 5 COVAUTH coverage authorization To perform one or more operations on information for conducting prior authorization or predetermination of coverage for services. false 5 COVERAGE coverage under policy or program To perform one or more operations on information for conducting activities related to coverage under a program or policy. false 6 ELIGDTRM eligibility determination To perform one or more operations on information used for conducting eligibility determination for coverage in a program or policy. May entail review of financial status or disability assessment. false 6 ELIGVER eligibility verification To perform one or more operations on information used for conducting eligibility verification of coverage in a program or policy. May entail provider contacting coverage source (e.g. government health program such as workers compensation or health plan) for confirmation of enrollment, eligibility for specific services, and any applicable copays. false 6 ENROLLM enrollment To perform one or more operations on information used for enrolling a covered party in a program or policy. May entail recording of covered party's and any dependent's demographic information and benefit choices. false 5 REMITADV remittance advice To perform one or more operations on information about the amount remitted for a health care claim. false 4 HRESCH healthcare research To perform one or more operations on information for conducting scientific investigations to obtain health care knowledge. false 5 CLINTRCH clinical trial research To perform one or more operations on information for conducting scientific investigations in accordance with clinical trial protocols to obtain health care knowledge. false 4 PATRQT patient requested To perform one or more operations on information in response to a patient's request. false 5 FAMRQT family requested To perform one or more operations on information in response to a request by a family member authorized by the patient. false 5 PWATRNY power of attorney To perform one or more operations on information in response to a request by a person appointed as the patient's legal representative. false 5 SUPNWK support network To perform one or more operations on information in response to a request by a person authorized by the patient. false 4 PUBHLTH public health To perform one or more operations on information for conducting public health activities, such as the reporting of notifiable conditions. false 5 DISASTER disaster To perform one or more operations on information used for provision of immediately needed health care to a population of living subjects located in a disaster zone. false 5 THREAT threat To perform one or more operations on information used to prevent injury or disease to living subjects who may be the target of violence. false 4 TREAT treatment To perform one or more operations on information for provision of health care. false 5 CAREMGT Care Management To perform one or more operations on information for provision of health care coordination. false 5 CLINTRL clinical trial To perform health care as part of the clinical trial protocol. false 5 ETREAT Emergency Treatment To perform one or more operations on information for provision of immediately needed health care for an emergent condition. false 5 POPHLTH population health To perform one or more operations on information for provision of health care to a population of living subjects, e.g. needle exchange program. false 2 _ActInformationPrivacyReason ActInformationPrivacyReason Description:The rationale or purpose for an act relating to the management of personal information, such as disclosing personal tax information for the purpose of complying with a court order. true 3 MARKT marketing Description: false 3 OPERAT operations Description:Administrative and contractual processes required to support an activity, product, or service false 4 LEGAL subpoena Definition:To provide information as a result of a subpoena. false 4 ACCRED accreditation Description:Operational activities conducted for the purposes of meeting of criteria defined by an accrediting entity for an activity, product, or service false 4 COMPL compliance Description:Operational activities required to meet a mandate related to an activity, product, or service false 4 ENADMIN entity administration Description:Operational activities conducted to administer information relating to entities involves with an activity, product, or service false 4 OUTCOMS outcome measure Description:Operational activities conducted for the purposes of assessing the results of an activity, product, or service false 4 PRGRPT program reporting Description:Operational activities conducted to meet program accounting requirements related to an activity, product, or service false 4 QUALIMP quality improvement Description:Operational activities conducted for the purposes of improving the quality of an activity, product, or service false 4 SYSADMN system administration Description:Operational activities conducted to administer the electronic systems used for an activity, product, or service false 3 PAYMT payment Description:Administrative, financial, and contractual processes related to payment for an activity, product, or service false 3 RESCH research Description:Investigative activities conducted for the purposes of obtaining knowledge false 3 SRVC service Description:Provision of a service, product, or capability to an individual or organization false 1 _ActInvalidReason ActInvalidReason Description: Types of reasons why a substance is invalid for use. false 2 ADVSTORAGE adverse storage condition Description: Storage conditions caused the substance to be ineffective. false 3 COLDCHNBRK cold chain break Description: Cold chain was not maintained for the substance. false 2 EXPLOT expired lot Description: The lot from which the substance was drawn was expired. false 2 OUTSIDESCHED administered outside recommended schedule or practice The substance was administered outside of the recommended schedule or practice. false 2 PRODRECALL product recall Description: The substance was recalled by the manufacturer. false 1 _ActInvoiceCancelReason ActInvoiceCancelReason Domain specifies the codes used to describe reasons why a Provider is cancelling an Invoice or Invoice Grouping. true 2 INCCOVPTY incorrect covered party as patient The covered party (patient) specified with the Invoice is not correct. false 2 INCINVOICE incorrect billing The billing information, specified in the Invoice Elements, is not correct. This could include incorrect costing for items included in the Invoice. false 2 INCPOLICY incorrect policy The policy specified with the Invoice is not correct. For example, it may belong to another Adjudicator or Covered Party. false 2 INCPROV incorrect provider The provider specified with the Invoice is not correct. false 1 _ActNoImmunizationReason ActNoImmunizationReason A coded description of the reason for why a patient did not receive a scheduled immunization. (important for public health strategy true 2 IMMUNE immunity Definition:Testing has shown that the patient already has immunity to the agent targeted by the immunization. false 2 MEDPREC medical precaution Definition:The patient currently has a medical condition for which the vaccine is contraindicated or for which precaution is warranted. false 2 OSTOCK product out of stock Definition:There was no supply of the product on hand to perform the service. false 2 PATOBJ patient objection Definition:The patient or their guardian objects to receiving the vaccine. false 2 PHILISOP philosophical objection Definition:The patient or their guardian objects to receiving the vaccine because of philosophical beliefs. false 2 RELIG religious objection Definition:The patient or their guardian objects to receiving the vaccine on religious grounds. false 2 VACEFF vaccine efficacy concerns Definition:The intended vaccine has expired or is otherwise believed to no longer be effective. Example:Due to temperature exposure. false 2 VACSAF vaccine safety concerns Definition:The patient or their guardian objects to receiving the vaccine because of concerns over its safety. false 1 _ActSupplyFulfillmentRefusalReason ActSupplyFulfillmentRefusalReason Indicates why a fulfiller refused to fulfill a supply order, and considered it important to notify other providers of their decision; e.g. "Suspect fraud", "Possible abuse", "Contraindicated". (used when capturing 'refusal to fill' annotations) true 2 FRR01 order stopped Definition:The order has been stopped by the prescriber but this fact has not necessarily captured electronically. Example:A verbal stop, a fax, etc. false 2 FRR02 stale-dated order Definition:Order has not been fulfilled within a reasonable amount of time, and may not be current. false 2 FRR03 incomplete data Definition:Data needed to safely act on the order which was expected to become available independent of the order is not yet available Example:Lab results, diagnostic imaging, etc. false 2 FRR04 product unavailable Definition:Product not available or manufactured. Cannot supply. false 2 FRR05 ethical/religious Definition:The dispenser has ethical, religious or moral objections to fulfilling the order/dispensing the product. false 2 FRR06 unable to provide care Definition:Fulfiller not able to provide appropriate care associated with fulfilling the order. Example:Therapy requires ongoing monitoring by fulfiller and fulfiller will be ending practice, leaving town, unable to schedule necessary time, etc. false 1 _ClinicalResearchEventReason ClinicalResearchEventReason Definition:Specifies the reason that an event occurred in a clinical research study. true 2 RET retest Definition:The event occurred so that a test or observation performed at a prior event could be performed again due to conditions set forth in the protocol. false 2 SCH scheduled Definition:The event occurred due to it being scheduled in the research protocol. false 2 TRM termination Definition:The event occurred in order to terminate the subject's participation in the study. false 2 UNS unscheduled Definition:The event that occurred was initiated by a study participant (e.g. the subject or the investigator), and did not occur for protocol reasons. false 1 _ClinicalResearchObservationReason ClinicalResearchObservationReason Definition:SSpecifies the reason that a test was performed or observation collected in a clinical research study. Note:This set of codes are not strictly reasons, but are used in the currently Normative standard. Future revisions of the specification will model these as ActRelationships and thes codes may subsequently be retired. Thus, these codes should not be used for new specifications. true 2 NPT non-protocol Definition:The observation or test was neither defined or scheduled in the study protocol. false 2 PPT per protocol Definition:The observation or test occurred due to it being defined in the research protocol, and during an activity or event that was scheduled in the protocol. false 2 UPT per definition :The observation or test occurred as defined in the research protocol, but at a point in time not specified in the study protocol. false 1 _CombinedPharmacyOrderSuspendReasonCode CombinedPharmacyOrderSuspendReasonCode Description:Indicates why the prescription should be suspended. true 2 ALTCHOICE try another treatment first Description:This therapy has been ordered as a backup to a preferred therapy. This order will be released when and if the preferred therapy is unsuccessful. false 2 CLARIF prescription requires clarification Description:Clarification is required before the order can be acted upon. false 2 DRUGHIGH drug level too high Description:The current level of the medication in the patient's system is too high. The medication is suspended to allow the level to subside to a safer level. false 2 HOSPADM admission to hospital Description:The patient has been admitted to a care facility and their community medications are suspended until hospital discharge. false 2 LABINT lab interference issues Description:The therapy would interfere with a planned lab test and the therapy is being withdrawn until the test is completed. false 2 NON-AVAIL patient not-available Description:Patient not available for a period of time due to a scheduled therapy, leave of absence or other reason. false 2 PREG parent is pregnant/breast feeding Description:The patient is pregnant or breast feeding. The therapy will be resumed when the pregnancy is complete and the patient is no longer breastfeeding. false 2 SALG allergy Description:The patient is believed to be allergic to a substance that is part of the therapy and the therapy is being temporarily withdrawn to confirm. false 2 SDDI drug interacts with another drug Description:The drug interacts with a short-term treatment that is more urgently required. This order will be resumed when the short-term treatment is complete. false 2 SDUPTHER duplicate therapy Description:Another short-term co-occurring therapy fulfills the same purpose as this therapy. This therapy will be resumed when the co-occuring therapy is complete. false 2 SINTOL suspected intolerance Description:The patient is believed to have an intolerance to a substance that is part of the therapy and the therapy is being temporarily withdrawn to confirm. false 2 SURG patient scheduled for surgery Description:The drug is contraindicated for patients receiving surgery and the patient is scheduled to be admitted for surgery in the near future. The drug will be resumed when the patient has sufficiently recovered from the surgery. false 2 WASHOUT waiting for old drug to wash out Description:The patient was previously receiving a medication contraindicated with the current medication. The current medication will remain on hold until the prior medication has been cleansed from their system. false 1 _ControlActNullificationReasonCode ControlActNullificationReasonCode Description:Identifies reasons for nullifying (retracting) a particular control act. false 2 ALTD altered decision Description:The decision on which the recorded information was based was changed before the decision had an effect. Example:Aborted prescription before patient left office, released prescription before suspend took effect. false 2 EIE entered in error Description:The information was recorded incorrectly or was recorded in the wrong record. false 2 NORECMTCH no record match Description: There is no match for the record in the database. false 1 _ControlActNullificationRefusalReasonType ControlActNullificationRefusalReasonType Description: Reasons to refuse a transaction to be undone. true 2 INRQSTATE in requested state The record is already in the requested state. false 2 NOMATCH no match Description: There is no match. false 3 NOPRODMTCH no product match Description: There is no match for the product in the master file repository. false 3 NOSERMTCH no service match Description: There is no match for the service in the master file repository. false 3 NOVERMTCH no version match Description: There is no match for the record and version. false 2 NOPERM no permission Description: There is no permission. false 3 NOUSERPERM no user permission Definition:The user does not have permission false 3 NOAGNTPERM no agent permission Description: The agent does not have permission. false 3 NOUSRPERM no user permission Description: The user does not have permission. false 2 WRNGVER wrong version Description: The record and version requested to update is not the current version. false 1 _ControlActReason ControlActReason Identifies why a specific query, request, or other trigger event occurred. true 2 _MedicationOrderAbortReasonCode medication order abort reason Description:Indicates the reason the medication order should be aborted. true 3 DISCONT product discontinued Description:The medication is no longer being manufactured or is otherwise no longer available. false 3 INEFFECT ineffective Description:The therapy has been found to not have the desired therapeutic benefit on the patient. false 3 MONIT response to monitoring Description:Monitoring the patient while taking the medication, the decision has been made that the therapy is no longer appropriate. false 3 NOREQ no longer required for treatment Description:The underlying condition has been resolved or has evolved such that a different treatment is no longer needed. false 3 NOTCOVER not covered Description:The product does not have (or no longer has) coverage under the patientaTMs insurance policy. false 3 PREFUS patient refuse Description:The patient refused to take the product. false 3 RECALL product recalled Description:The manufacturer or other agency has requested that stocks of a medication be removed from circulation. false 3 REPLACE change in order Description:Item in current order is no longer in use as requested and a new one has/will be created to replace it. false 4 DOSECHG change in medication/dose Description:The medication is being re-prescribed at a different dosage. false 3 REPLACEFIX error in order Description:Current order was issued with incorrect data and a new order has/will be created to replace it. false 3 UNABLE unable to use Description:<The patient is not (or is no longer) able to use the medication in a manner prescribed. Example:CanaTMt swallow. false 2 _MedicationOrderReleaseReasonCode medication order release reason Definition:A collection of concepts that indicate why the prescription should be released from suspended state. true 3 HOLDDONE suspend reason no longer applies Definition:The original reason for suspending the medication has ended. false 3 HOLDINAP suspend reason inappropriate Definition: false 2 _ModifyPrescriptionReasonType ModifyPrescriptionReasonType Types of reason why a prescription is being changed. true 3 ADMINERROR administrative error in order Order was created with incorrect data and is changed to reflect the intended accuracy of the order. false 3 CLINMOD clinical modification Order is changed based on a clinical reason. false 2 _PharmacySupplyEventAbortReason PharmacySupplyEventAbortReason Definition:Identifies why the dispense event was not completed. false 3 CONTRA contraindication Definition:Contraindication identified false 3 FOABORT order aborted Definition:Order to be fulfilled was aborted false 3 FOSUSP order suspended Definition:Order to be fulfilled was suspended false 3 NOPICK not picked up Definition:Patient did not come to get medication false 3 PATDEC patient changed mind Definition:Patient changed their mind regarding obtaining medication false 3 QUANTCHG change supply quantity Definition:Patient requested a revised quantity of medication false 2 _PharmacySupplyEventStockReasonCode pharmacy supply event stock reason Definition:A collection of concepts that indicates the reason for a "bulk supply" of medication. true 3 FLRSTCK floor stock Definition:The bulk supply is issued to replenish a ward for local dispensing. (Includes both mobile and fixed-location ward stocks.) false 3 LTC long term care use Definition:The bulk supply will be administered within a long term care facility. false 3 OFFICE office use Definition:The bulk supply is intended for general clinician office use. false 3 PHARM pharmacy transfer Definition:The bulk supply is being transferred to another dispensing facility to. Example:Alleviate a temporary shortage. false 3 PROG program use Definition:The bulk supply is intended for dispensing according to a specific program. Example:Mass immunization. false 2 _PharmacySupplyRequestRenewalRefusalReasonCode pharmacy supply request renewal refusal reason Definition:A collection of concepts that identifies why a renewal prescription has been refused. true 3 ALREADYRX new prescription exists Definition:Patient has already been given a new (renewal) prescription. false 3 FAMPHYS family physician must authorize further fills Definition:Request for further authorization must be done through patient's family physician. false 3 MODIFY modified prescription exists Definition:Therapy has been changed and new prescription issued false 3 NEEDAPMT patient must make appointment Definition:Patient must see prescriber prior to further fills. false 3 NOTAVAIL prescriber not available Definition:Original prescriber is no longer available to prescribe and no other prescriber has taken responsibility for the patient. false 3 NOTPAT patient no longer in this practice Definition:Patient no longer or has never been under this prescribers care. false 3 ONHOLD medication on hold Definition:This medication is on hold. false 3 PRNA product not available Description:This product is not available or manufactured. false 3 STOPMED prescriber stopped medication for patient Renewing or original prescriber informed patient to stop using the medication. false 3 TOOEARLY too early Definition:The patient should have medication remaining. false 2 _SupplyOrderAbortReasonCode supply order abort reason Definition:A collection of concepts that indicates why the prescription should no longer be allowed to be dispensed (but can still administer what is already being dispensed). true 3 IMPROV condition improved Definition:The patient's medical condition has nearly abated. false 3 INTOL intolerance Description:The patient has an intolerance to the medication. false 3 NEWSTR new strength Definition:The current medication will be replaced by a new strength of the same medication. false 3 NEWTHER new therapy Definition:A new therapy will be commenced when current supply exhausted. false 1 _GenericUpdateReasonCode GenericUpdateReasonCode Description:Identifies why a change is being made to a record. true 2 CHGDATA information change Description:Information has changed since the record was created. false 2 FIXDATA error correction Description:Previously recorded information was erroneous and is being corrected. false 2 MDATA merge data Information is combined into the record. false 2 NEWDATA new information Description:New information has become available to supplement the record. false 2 UMDATA unmerge data Information is separated from the record. false 1 _PatientProfileQueryReasonCode patient profile query reason Definition:A collection of concepts identifying why the patient's profile is being queried. true 2 ADMREV administrative review Definition: To evaluate for service authorization, payment, reporting, or performance/outcome measures. false 2 PATCAR patient care Definition:To obtain records as part of patient care. false 2 PATREQ patient request query Definition:Patient requests information from their profile. false 2 PRCREV practice review Definition:To evaluate the provider's current practice for professional-improvement reasons. false 2 REGUL regulatory review Description:Review for the purpose of regulatory compliance. false 2 RSRCH research Definition:To provide research data, as authorized by the patient. false 2 VALIDATION validation review Description:To validate the patient's record. Example:Merging or unmerging records. false 1 _PharmacySupplyRequestFulfillerRevisionRefusalReasonCode PharmacySupplyRequestFulfillerRevisionRefusalReasonCode Definition:Indicates why the request to transfer a prescription from one dispensing facility to another has been refused. false 2 LOCKED locked Definition:The prescription may not be reassigned from the original pharmacy. false 2 UNKWNTARGET unknown target Definition:The target facility does not recognize the dispensing facility. false 1 _RefusalReasonCode RefusalReasonCode Description: Identifies why a request to add (or activate) a record is being refused. Examples include the receiving system not able to match the identifier and find that record in the receiving system, having no permission, or a detected issue exists which precludes the requested action. true 1 _SchedulingActReason SchedulingActReason Reasons for cancelling or rescheduling an Appointment true 2 BLK Unexpected Block (of Schedule) The time slots previously allocated are now blocked and no longer available for booking Appointments false 2 DEC Patient Deceased The Patient is deceased false 2 FIN No Financial Backing Patient unable to pay and not covered by insurance false 2 MED Medical Status Altered The medical condition of the Patient has changed false 2 MTG In an outside meeting The Physician is in a meeting. For example, he/she may request administrative time to talk to family after appointment false 2 PHY Physician request The Physician requested the action false 1 _StatusRevisionRefusalReasonCode StatusRevisionRefusalReasonCode Indicates why the act revision (status update) is being refused. false 2 FILLED fully filled Ordered quantity has already been completely fulfilled. false 1 _SubstanceAdministrationPermissionRefusalReasonCode SubstanceAdministrationPermissionRefusalReasonCode Definition:Indicates why the requested authorization to prescribe or dispense a medication has been refused. false 2 PATINELIG patient not eligible Definition:Patient not eligible for drug false 2 PROTUNMET protocol not met Definition:Patient does not meet required protocol false 2 PROVUNAUTH provider not authorized Definition:Provider is not authorized to prescribe or dispense false 1 _SubstanceAdminSubstitutionNotAllowedReason SubstanceAdminSubstitutionNotAllowedReason Reasons why substitution of a substance administration request is not permitted. true 2 ALGINT allergy intolerance Definition: Patient has had a prior allergic intolerance response to alternate product or one of its components. false 2 COMPCON compliance concern Definition: Patient has compliance issues with medication such as differing appearance, flavor, size, shape or consistency. false 2 THERCHAR therapeutic characteristics The prescribed product has specific clinical release or other therapeutic characteristics not shared by other substitutable medications. false 2 TRIAL clinical trial drug Definition: The specific manufactured drug is part of a clinical trial. false 1 _SubstanceAdminSubstitutionReason SubstanceAdminSubstitutionReason SubstanceAdminSubstitutionReason true 2 CT continuing therapy Indicates that the decision to substitute or to not substitute was driven by a desire to maintain consistency with a pre-existing therapy. I.e. The performer provided the same item/service as had been previously provided rather than providing exactly what was ordered, or rather than substituting with a lower-cost equivalent. false 2 FP formulary policy Indicates that the decision to substitute or to not substitute was driven by a policy expressed within the formulary. false 2 OS out of stock In the case of 'substitution', indicates that the substitution occurred because the ordered item was not in stock. In the case of 'no substitution', indicates that a cheaper equivalent was not substituted because it was not in stock. false 2 RR regulatory requirement Indicates that the decision to substitute or to not substitute was driven by a jurisdictional regulatory requirement mandating or prohibiting substitution. false 1 _TransferActReason TransferActReason The explanation for why a patient is moved from one location to another within the organization true 2 ER Error Moved to an error in placing the patient in the original location. false 2 RQ Request Moved at the request of the patient. false 1 _ActBillableServiceReason ActBillableServiceReason Definition: This domain is used to document reasons for providing a billable service; the billable services may include both clinical services and social services. true 2 _ActBillableClinicalServiceReason ActBillableClinicalServiceReason Reason for Clinical Service being performed. This domain excludes reasons specified by diagnosed conditions. Examples of values from this domain include duplicate therapy and fraudulent prescription. true 1 BONUS false 1 CHD Children only Description:The level of coverage under the policy or program is available only to children false 1 DEP Dependents only Description:The level of coverage under the policy or program is available only to a subscriber's dependents. false 1 ECH Employee and children Description:The level of coverage under the policy or program is available to an employee and his or her children. false 1 EDU false 1 EMP Employee only Description:The level of coverage under the policy or program is available only to an employee. false 1 ESP Employee and spouse Description:The level of coverage under the policy or program is available to an employee and his or her spouse. false 1 FAM Family Description:The level of coverage under the policy or program is available to a subscriber's family. false 1 IND Individual Description:The level of coverage under the policy or program is available to an individual. false 1 INVOICE false 1 PROA false 1 RECOV false 1 RETRO false 1 SPC Spouse and children Description:The level of coverage under the policy or program is available to a subscriber's spouse and children false 1 SPO Spouse only Description:The level of coverage under the policy or program is available only to a subscribers spouse false 1 TRAN false
Identifies the reason the patient is assigned to this accommodation type
Accommodation requested is not available.
Accommodation is assigned for floor convenience.
Description:Codes used to specify reasons or criteria relating to coverage provided under a policy or program. May be used to convey reasons pertaining to coverage contractual provisions, including criteria for eligibility, coverage limitations, coverage maximums, or financial participation required of covered parties.
Identifies the reason or rational for why a person is eligibile for benefits under an insurance policy or progam. Examples: A person is a claimant under an automobile insurance policy are client deceased & adopted client has been given a new policy identifier. A new employee is eligible for health insurance as an employment benefit. A person meets a government program eligibility criteria for financial, age or health status.
Identifies the reason or rational for why a person is not eligibile for benefits under an insurance policy. Examples are client deceased & adopted client has been given a new policy identifier.
When a client has no contact with the health system for an extended period, coverage is suspended. Client will be reinstated to original start date upon proof of identification, residency etc. Example: Coverage may be suspended during a strike situation, when employer benefits for employees are not covered (i.e. not in effect).
Definition: Identifies the reason or rational for why a person is eligibile for benefits under an insurance policy or progam. Examples: A person is a claimant under an automobile insurance policy are client deceased & adopted client has been given a new policy identifier. A new employee is eligible for health insurance as an employment benefit. A person meets a government program eligibility criteria for financial, age or health status.
A person becomes eligible for a program based on age. Example: In the U.S., a person who is 65 years of age or older is eligible for Medicare.
A person becomes eligible for insurance or a program because of crime related health condition or injury. Example: A person is a claimant under the U.S. Crime Victims Compensation program.
A person becomes a claimant under a disability income insurance policy or a disability rehabilitation program because of a health condition or injury which limits the person's ability to earn an income or function without institutionalization.
A person becomes eligible for insurance provided as an employment benefit based on employment status.
A person becomes eligible for a program based on financial criteria. Example: A person whose family income is below a financial threshold for eligibility for Medicaid or SCHIP.
A person becomes eligible for a program because of a qualifying health condition or injury. Examples: A person is determined to have a qualifying health conditions include pregnancy, HIV/AIDs, tuberculosis, end stage renal disease, breast or cervical cancer, or other condition requiring specialized health services, hospice, institutional or community based care provided under a program
A person becomes eligible for a program based on more than one criterion. Examples: In the U.S., a child whose familiy income meets Medicaid financial thresholds and whose age is less than 18 is eligible for the Early and Periodic Screening, Diagnostic, and Treatment program (EPSDT). A person whose family income meets Medicaid financial thresholds and whose age is 65 years or older is eligible for Medicaid and Medicare, and are referred to as dual eligibles.
A person becomes a claimant under a property and casualty insurance policy because of a related health condition or injury resulting from a circumstance covered under the terms of the policy. Example: A person is a claimant under a homeowners insurance policy because of an injury sustained on the policyholderaTMs premises.
A person becomes eligible for a program based on statutory criteria. Examples: A person is a member of an indigenous group, a veteran of military service, or in the U.S., a recipient of adoption assistance and foster care under Title IV-E of the Social Security.
A person becomes a claimant under a motor vehicle accident insurance because of a motor vehicle accident related health condition or injury.
A person becomes eligible for insurance or a program because of a work related health condition or injury. Example: A person is a claimant under the U.S. Black Lung Program.
Description:The rationale or purpose for an act relating to information management, such as archiving information for the purpose of complying with an enterprise data retention policy.
Description:The rationale or purpose for an act relating to health information management, such as archiving information for the purpose of complying with an organization policy or jurisdictional law relating to data retention.
To perform one or more operations on information to which the patient has not consented as deemed necessary by authorized entities for providing care in the best interest of the patient; providing immediately needed health care for an emergent condition; or for protecting public or third party safety. Usage Notes: Used to convey the reason that a provider or other entity may or has accessed personal healthcare information. Typically, this involves overriding the subject's consent directives.
To perform one or more operations on information to which the patient has not consented by authorized entities for treating a condition which poses an immediate threat to the patient's health and which requires immediate medical intervention. Usage Notes: The patient is unable to provide consent, but the provider determines they have an urgent healthcare related reason to access the record.
To perform one or more operations on information to which the patient declined to consent for providing health care. Usage Notes: The patient, while able to give consent, has not. However the provider believes it is in the patient's interest to access the record without patient consent.
To perform one or more operations on information to which the patient has not consented for public safety reasons. Usage Notes: The patient, while able to give consent, has not. However, the provider believes that access to masked patient information is justified because of concerns related to public safety.
To perform one or more operations on information to which the patient has not consented for third party safety. Usage Notes: The patient, while able to give consent, has not. However, the provider believes that access to masked patient information is justified because of concerns related to the health and safety of one or more third parties.
Reason for performing one or more operations on information, which may be permitted by source system's security policy in accordance with one or more privacy policies and consent directives. Usage Notes: The rationale or purpose for an act relating to the management of personal health information, such as collecting personal health information for research or public health purposes.
To perform one or more operations on information for marketing services and products related to health care.
To perform one or more operations on information used for conducting administrative and contractual activities related to the provision of health care.
To perform one or more operations on information used for cadaveric organ, eye or tissue donation.
To perform one or more operations on information used for fraud detection and prevention processes.
To perform one or more operations on information used within government processes.
To perform one or more operations on information for conducting activities related to meeting accreditation criteria.
To perform one or more operations on information used for conducting activities required to meet a mandate.
To perform one or more operations on information used for handling deceased patient matters.
To perform one or more operation operations on information used to manage a patient directory. Examples: facility enterprise payer health information exchange patient directory
To perform one or more operations on information for conducting activities required by legal proceeding.
To perform one or more operations on information used for assessing results and comparative effectiveness achieved by health care practices and interventions.
To perform one or more operations on information used for conducting activities to meet program accounting requirements.
To perform one or more operations on information used for conducting administrative activities to improve health care quality.
To perform one or more operations on information to administer the electronic systems used for the delivery of health care.
To perform one or more operations on information to administer health care coverage to an enrollee under a policy or program.
To perform one or more operations on information used for operational activities conducted to administer the delivery of health care to a patient.
To perform one or more operations on information in processes related to ensuring the safety of health care.
To perform one or more operations on information used for monitoring performance of recommended health care practices and interventions.
To perform one or more operations on information used within the health records management process.
To perform one or more operations on information used in training and education.
To perform one or more operations on information for conducting financial or contractual activities related to payment for provision of health care.
To perform one or more operations on information for provision of additional clinical evidence in support of a request for coverage or payment for health services.
To perform one or more operations on information for conducting prior authorization or predetermination of coverage for services.
To perform one or more operations on information for conducting activities related to coverage under a program or policy.
To perform one or more operations on information used for conducting eligibility determination for coverage in a program or policy. May entail review of financial status or disability assessment.
To perform one or more operations on information used for conducting eligibility verification of coverage in a program or policy. May entail provider contacting coverage source (e.g. government health program such as workers compensation or health plan) for confirmation of enrollment, eligibility for specific services, and any applicable copays.
To perform one or more operations on information used for enrolling a covered party in a program or policy. May entail recording of covered party's and any dependent's demographic information and benefit choices.
To perform one or more operations on information about the amount remitted for a health care claim.
To perform one or more operations on information for conducting scientific investigations to obtain health care knowledge.
To perform one or more operations on information for conducting scientific investigations in accordance with clinical trial protocols to obtain health care knowledge.
To perform one or more operations on information in response to a patient's request.
To perform one or more operations on information in response to a request by a family member authorized by the patient.
To perform one or more operations on information in response to a request by a person appointed as the patient's legal representative.
To perform one or more operations on information in response to a request by a person authorized by the patient.
To perform one or more operations on information for conducting public health activities, such as the reporting of notifiable conditions.
To perform one or more operations on information used for provision of immediately needed health care to a population of living subjects located in a disaster zone.
To perform one or more operations on information used to prevent injury or disease to living subjects who may be the target of violence.
To perform one or more operations on information for provision of health care.
To perform one or more operations on information for provision of health care coordination.
To perform health care as part of the clinical trial protocol.
To perform one or more operations on information for provision of immediately needed health care for an emergent condition.
To perform one or more operations on information for provision of health care to a population of living subjects, e.g. needle exchange program.
Description:The rationale or purpose for an act relating to the management of personal information, such as disclosing personal tax information for the purpose of complying with a court order.
Description:Administrative and contractual processes required to support an activity, product, or service
Definition:To provide information as a result of a subpoena.
Description:Operational activities conducted for the purposes of meeting of criteria defined by an accrediting entity for an activity, product, or service
Description:Operational activities required to meet a mandate related to an activity, product, or service
Description:Operational activities conducted to administer information relating to entities involves with an activity, product, or service
Description:Operational activities conducted for the purposes of assessing the results of an activity, product, or service
Description:Operational activities conducted to meet program accounting requirements related to an activity, product, or service
Description:Operational activities conducted for the purposes of improving the quality of an activity, product, or service
Description:Operational activities conducted to administer the electronic systems used for an activity, product, or service
Description:Administrative, financial, and contractual processes related to payment for an activity, product, or service
Description:Investigative activities conducted for the purposes of obtaining knowledge
Description:Provision of a service, product, or capability to an individual or organization
Description: Types of reasons why a substance is invalid for use.
Description: Storage conditions caused the substance to be ineffective.
Description: Cold chain was not maintained for the substance.
Description: The lot from which the substance was drawn was expired.
administered outside recommended schedule or practice
The substance was administered outside of the recommended schedule or practice.
Description: The substance was recalled by the manufacturer.
Domain specifies the codes used to describe reasons why a Provider is cancelling an Invoice or Invoice Grouping.
The covered party (patient) specified with the Invoice is not correct.
The billing information, specified in the Invoice Elements, is not correct. This could include incorrect costing for items included in the Invoice.
The policy specified with the Invoice is not correct. For example, it may belong to another Adjudicator or Covered Party.
The provider specified with the Invoice is not correct.
A coded description of the reason for why a patient did not receive a scheduled immunization. (important for public health strategy
Definition:Testing has shown that the patient already has immunity to the agent targeted by the immunization.
Definition:The patient currently has a medical condition for which the vaccine is contraindicated or for which precaution is warranted.
Definition:There was no supply of the product on hand to perform the service.
Definition:The patient or their guardian objects to receiving the vaccine.
Definition:The patient or their guardian objects to receiving the vaccine because of philosophical beliefs.
Definition:The patient or their guardian objects to receiving the vaccine on religious grounds.
Definition:The intended vaccine has expired or is otherwise believed to no longer be effective. Example:Due to temperature exposure.
Definition:The patient or their guardian objects to receiving the vaccine because of concerns over its safety.
Indicates why a fulfiller refused to fulfill a supply order, and considered it important to notify other providers of their decision; e.g. "Suspect fraud", "Possible abuse", "Contraindicated". (used when capturing 'refusal to fill' annotations)
Definition:The order has been stopped by the prescriber but this fact has not necessarily captured electronically. Example:A verbal stop, a fax, etc.
Definition:Order has not been fulfilled within a reasonable amount of time, and may not be current.
Definition:Data needed to safely act on the order which was expected to become available independent of the order is not yet available Example:Lab results, diagnostic imaging, etc.
Definition:Product not available or manufactured. Cannot supply.
Definition:The dispenser has ethical, religious or moral objections to fulfilling the order/dispensing the product.
Definition:Fulfiller not able to provide appropriate care associated with fulfilling the order. Example:Therapy requires ongoing monitoring by fulfiller and fulfiller will be ending practice, leaving town, unable to schedule necessary time, etc.
Definition:Specifies the reason that an event occurred in a clinical research study.
Definition:The event occurred so that a test or observation performed at a prior event could be performed again due to conditions set forth in the protocol.
Definition:The event occurred due to it being scheduled in the research protocol.
Definition:The event occurred in order to terminate the subject's participation in the study.
Definition:The event that occurred was initiated by a study participant (e.g. the subject or the investigator), and did not occur for protocol reasons.
Definition:SSpecifies the reason that a test was performed or observation collected in a clinical research study. Note:This set of codes are not strictly reasons, but are used in the currently Normative standard. Future revisions of the specification will model these as ActRelationships and thes codes may subsequently be retired. Thus, these codes should not be used for new specifications.
Definition:The observation or test was neither defined or scheduled in the study protocol.
Definition:The observation or test occurred due to it being defined in the research protocol, and during an activity or event that was scheduled in the protocol.
:The observation or test occurred as defined in the research protocol, but at a point in time not specified in the study protocol.
Description:Indicates why the prescription should be suspended.
Description:This therapy has been ordered as a backup to a preferred therapy. This order will be released when and if the preferred therapy is unsuccessful.
Description:Clarification is required before the order can be acted upon.
Description:The current level of the medication in the patient's system is too high. The medication is suspended to allow the level to subside to a safer level.
Description:The patient has been admitted to a care facility and their community medications are suspended until hospital discharge.
Description:The therapy would interfere with a planned lab test and the therapy is being withdrawn until the test is completed.
Description:Patient not available for a period of time due to a scheduled therapy, leave of absence or other reason.
Description:The patient is pregnant or breast feeding. The therapy will be resumed when the pregnancy is complete and the patient is no longer breastfeeding.
Description:The patient is believed to be allergic to a substance that is part of the therapy and the therapy is being temporarily withdrawn to confirm.
Description:The drug interacts with a short-term treatment that is more urgently required. This order will be resumed when the short-term treatment is complete.
Description:Another short-term co-occurring therapy fulfills the same purpose as this therapy. This therapy will be resumed when the co-occuring therapy is complete.
Description:The patient is believed to have an intolerance to a substance that is part of the therapy and the therapy is being temporarily withdrawn to confirm.
Description:The drug is contraindicated for patients receiving surgery and the patient is scheduled to be admitted for surgery in the near future. The drug will be resumed when the patient has sufficiently recovered from the surgery.
Description:The patient was previously receiving a medication contraindicated with the current medication. The current medication will remain on hold until the prior medication has been cleansed from their system.
Description:Identifies reasons for nullifying (retracting) a particular control act.
Description:The decision on which the recorded information was based was changed before the decision had an effect. Example:Aborted prescription before patient left office, released prescription before suspend took effect.
Description:The information was recorded incorrectly or was recorded in the wrong record.
Description: There is no match for the record in the database.
Description: Reasons to refuse a transaction to be undone.
The record is already in the requested state.
Description: There is no match for the product in the master file repository.
Description: There is no match for the service in the master file repository.
Description: There is no match for the record and version.
Definition:The user does not have permission
Description: The agent does not have permission.
Description: The user does not have permission.
Description: The record and version requested to update is not the current version.
Identifies why a specific query, request, or other trigger event occurred.
Description:Indicates the reason the medication order should be aborted.
Description:The medication is no longer being manufactured or is otherwise no longer available.
Description:The therapy has been found to not have the desired therapeutic benefit on the patient.
Description:Monitoring the patient while taking the medication, the decision has been made that the therapy is no longer appropriate.
Description:The underlying condition has been resolved or has evolved such that a different treatment is no longer needed.
Description:The product does not have (or no longer has) coverage under the patientaTMs insurance policy.
Description:The patient refused to take the product.
Description:The manufacturer or other agency has requested that stocks of a medication be removed from circulation.
Description:Item in current order is no longer in use as requested and a new one has/will be created to replace it.
Description:The medication is being re-prescribed at a different dosage.
Description:Current order was issued with incorrect data and a new order has/will be created to replace it.
Description:<The patient is not (or is no longer) able to use the medication in a manner prescribed. Example:CanaTMt swallow.
Definition:A collection of concepts that indicate why the prescription should be released from suspended state.
Definition:The original reason for suspending the medication has ended.
Types of reason why a prescription is being changed.
Order was created with incorrect data and is changed to reflect the intended accuracy of the order.
Order is changed based on a clinical reason.
Definition:Identifies why the dispense event was not completed.
Definition:Order to be fulfilled was aborted
Definition:Order to be fulfilled was suspended
Definition:Patient did not come to get medication
Definition:Patient changed their mind regarding obtaining medication
Definition:Patient requested a revised quantity of medication
Definition:A collection of concepts that indicates the reason for a "bulk supply" of medication.
Definition:The bulk supply is issued to replenish a ward for local dispensing. (Includes both mobile and fixed-location ward stocks.)
Definition:The bulk supply will be administered within a long term care facility.
Definition:The bulk supply is intended for general clinician office use.
Definition:The bulk supply is being transferred to another dispensing facility to. Example:Alleviate a temporary shortage.
Definition:The bulk supply is intended for dispensing according to a specific program. Example:Mass immunization.
pharmacy supply request renewal refusal reason
Definition:A collection of concepts that identifies why a renewal prescription has been refused.
Definition:Patient has already been given a new (renewal) prescription.
family physician must authorize further fills
Definition:Request for further authorization must be done through patient's family physician.
Definition:Therapy has been changed and new prescription issued
Definition:Patient must see prescriber prior to further fills.
Definition:Original prescriber is no longer available to prescribe and no other prescriber has taken responsibility for the patient.
Definition:Patient no longer or has never been under this prescribers care.
Description:This product is not available or manufactured.
prescriber stopped medication for patient
Renewing or original prescriber informed patient to stop using the medication.
Definition:The patient should have medication remaining.
Definition:A collection of concepts that indicates why the prescription should no longer be allowed to be dispensed (but can still administer what is already being dispensed).
Definition:The patient's medical condition has nearly abated.
Description:The patient has an intolerance to the medication.
Definition:The current medication will be replaced by a new strength of the same medication.
Definition:A new therapy will be commenced when current supply exhausted.
Description:Identifies why a change is being made to a record.
Description:Information has changed since the record was created.
Description:Previously recorded information was erroneous and is being corrected.
Information is combined into the record.
Description:New information has become available to supplement the record.
Information is separated from the record.
Definition:A collection of concepts identifying why the patient's profile is being queried.
Definition: To evaluate for service authorization, payment, reporting, or performance/outcome measures.
Definition:To obtain records as part of patient care.
Definition:Patient requests information from their profile.
Definition:To evaluate the provider's current practice for professional-improvement reasons.
Description:Review for the purpose of regulatory compliance.
Definition:To provide research data, as authorized by the patient.
Description:To validate the patient's record. Example:Merging or unmerging records.
Definition:Indicates why the request to transfer a prescription from one dispensing facility to another has been refused.
Definition:The prescription may not be reassigned from the original pharmacy.
Definition:The target facility does not recognize the dispensing facility.
Description: Identifies why a request to add (or activate) a record is being refused. Examples include the receiving system not able to match the identifier and find that record in the receiving system, having no permission, or a detected issue exists which precludes the requested action.
Reasons for cancelling or rescheduling an Appointment
The time slots previously allocated are now blocked and no longer available for booking Appointments
Patient unable to pay and not covered by insurance
The medical condition of the Patient has changed
The Physician is in a meeting. For example, he/she may request administrative time to talk to family after appointment
Indicates why the act revision (status update) is being refused.
Ordered quantity has already been completely fulfilled.
Definition:Indicates why the requested authorization to prescribe or dispense a medication has been refused.
Definition:Patient not eligible for drug
Definition:Patient does not meet required protocol
Definition:Provider is not authorized to prescribe or dispense
Reasons why substitution of a substance administration request is not permitted.
Definition: Patient has had a prior allergic intolerance response to alternate product or one of its components.
Definition: Patient has compliance issues with medication such as differing appearance, flavor, size, shape or consistency.
The prescribed product has specific clinical release or other therapeutic characteristics not shared by other substitutable medications.
Definition: The specific manufactured drug is part of a clinical trial.
Indicates that the decision to substitute or to not substitute was driven by a desire to maintain consistency with a pre-existing therapy. I.e. The performer provided the same item/service as had been previously provided rather than providing exactly what was ordered, or rather than substituting with a lower-cost equivalent.
Indicates that the decision to substitute or to not substitute was driven by a policy expressed within the formulary.
In the case of 'substitution', indicates that the substitution occurred because the ordered item was not in stock. In the case of 'no substitution', indicates that a cheaper equivalent was not substituted because it was not in stock.
Indicates that the decision to substitute or to not substitute was driven by a jurisdictional regulatory requirement mandating or prohibiting substitution.
The explanation for why a patient is moved from one location to another within the organization
Moved to an error in placing the patient in the original location.
Definition: This domain is used to document reasons for providing a billable service; the billable services may include both clinical services and social services.
Reason for Clinical Service being performed. This domain excludes reasons specified by diagnosed conditions. Examples of values from this domain include duplicate therapy and fraudulent prescription.
Description:The level of coverage under the policy or program is available only to children
Description:The level of coverage under the policy or program is available only to a subscriber's dependents.
Description:The level of coverage under the policy or program is available to an employee and his or her children.
Description:The level of coverage under the policy or program is available only to an employee.
Description:The level of coverage under the policy or program is available to an employee and his or her spouse.
Description:The level of coverage under the policy or program is available to a subscriber's family.
Description:The level of coverage under the policy or program is available to an individual.
Description:The level of coverage under the policy or program is available to a subscriber's spouse and children
Description:The level of coverage under the policy or program is available only to a subscribers spouse