• Include these codes as defined in http://terminology.hl7.org/CodeSystem/v3-ActCode version 📍8.0.0

  Code	Display	Definition
  COVGE	coverage problem	Insurance coverage problems have been encountered. Additional explanation information to be supplied.
  EFORM	electronic form to follow	Electronic form with supporting or additional information to follow.
  FAX	fax to follow	Fax with supporting or additional information to follow.
  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.
  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.
  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.
  OOJ	out of jurisdiction	The medical service and/or product was provided to a patient that has coverage in another jurisdiction.
  ORTHO	orthodontic service	The service provided is required for orthodontic purposes. If the covered party has orthodontic coverage, then the service may be paid.
  PAPER	paper documentation to follow	Paper documentation (or other physical format) with supporting or additional information to follow.
  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.
  PYRDELAY	delayed by a previous payor	Allows provider to explain lateness of invoice to a subsequent payor.
  REFNR	referral not required	Rules of practice do not require a physician's referral for the provider to perform a billable service.
  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.
  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.
  VERBAUTH	verbal authorization	The provider has received a verbal permission from an authoritative source to perform the service or supply the item being invoiced.

This value set expansion contains 15 concepts.