Extensions for Using Data Elements from FHIR R5 in FHIR R4
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Extensions for Using Data Elements from FHIR R5 in FHIR R4 - Downloaded Version null See the Directory of published versions

ValueSet: R5V3ClinicalResearchReasonForR4

Official URL: http://hl7.org/fhir/uv/xver/ValueSet/R5-v3-ClinicalResearchReason-for-R4 Version: 0.1.0
Standards status: Trial-use Maturity Level: 0 Computable Name: R5V3ClinicalResearchReasonForR4

This cross-version ValueSet represents content from http://terminology.hl7.org/ValueSet/v3-ClinicalResearchReason|2.0.0 for use in FHIR R4.

This value set is part of the cross-version definitions generated to enable use of the value set http://terminology.hl7.org/ValueSet/v3-ClinicalResearchReason|2.0.0 as defined in FHIR R5 in FHIR R4.

The source value set is bound to the following FHIR R5 elements:

Note that all concepts are included in this cross-version definition because no concepts have compatible representations

Following are the generation technical comments:

FHIR ValueSet http://terminology.hl7.org/ValueSet/v3-ClinicalResearchReason|2.0.0, defined in FHIR R5 does not have any mapping to FHIR R4

References

This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

Logical Definition (CLD)

  • Include these codes as defined in http://terminology.hl7.org/CodeSystem/v3-ActReason version 📍2.1.0
    CodeDisplayDefinition
    ACCREDaccreditation**Description:**Operational activities conducted for the purposes of meeting of criteria defined by an accrediting entity for an activity, product, or service
    ACCREQNAAccommodation Requested Not AvailableAccommodation requested is not available.
    ADMINERRORadministrative error in orderOrder was created with incorrect data and is changed to reflect the intended accuracy of the order.
    ADMREVadministrative review**Definition:** To evaluate for service authorization, payment, reporting, or performance/outcome measures.
    ADVSTORAGEadverse storage condition**Description:** Storage conditions caused the substance to be ineffective.
    AGEage eligibilityA 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.
    ALGINTallergy intolerance**Definition:** Patient has had a prior allergic intolerance response to alternate product or one of its components.
    ALREADYRXnew prescription exists**Definition:**Patient has already been given a new (renewal) prescription.
    ALTCHOICEtry 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.
    ALTDaltered 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.
    BIORCHbiomedical researchTo perform one or more operations on information for conducting scientific investigations to obtain health care knowledge. Use of the data must be related to specified biomedical basic or applied research. For example, research on rare plants to determine whether biologic properties may be useful for pharmaceutical development. May be used in combination with clinical trial and other healthcare research purposes of use.
    BLKUnexpected Block (of Schedule)The time slots previously allocated are now blocked and no longer available for booking Appointments
    BONUS
    BTGbreak the glassTo perform policy override operations on information for provision of immediately needed health care for an emergent condition affecting potential harm, death or patient safety by end users who are not provisioned for this purpose of use. Includes override of organizational provisioning policies and may include override of subject of care consent directive restricting access.

    *Map:* Partially Maps to ISO 14265 Classification Term "Emergency care provision to an individual subject of care" described as "To inform persons needing to provide health care services to the subject of care urgently, possibly needing to over-ride the policies and consents pertaining to Purpose 1 above." Purpose 1 is equivalent to HL7 treatment purpose of use: "Clinical care provision to an individual subject of care" described as "To inform persons or processes responsible for providing health care services to the subject of care." The ISO description conflates both of the proposed specializations of HL7 ETREAT: break the glass and the typically broader access to health information normally available to providers who are provisioned for emergency workflows on a regular basis, e.g., Emergency Room providers. Examples of greater access than is normally accessible by providers based on the need to know are access to sensitive information for which access typically requires a patient's consent. This is not an override of a patient's dissent to disclose sensitive information in cases where the applicable policy waives the need for that consent to access this information. In US, Title 38 Section 7332 and 42 CFR Part 2 both permit emergency access without the need to override a patient's consent directive; rather, this access is a limitation to the patient's right to dissent from disclosure.
    CAREMGTcare managementTo perform analytics, evaluation and other secondary uses of treatment and healthcare related information to manage the quality, efficacy, patient safety, population health, and cost effectiveness of healthcare delivery. Explicitly excludes the use of information to organize the delivery of health care for care coordination and case management, or to provide healthcare treatment.

    *Usage Note:* The concept of care management is narrower than the list of activities related to more general organizational objectives such as provider profiling, education of healthcare and non-healthcare professionals; insurance underwriting, premium rating, reinsurance; organizational legal, medical review, auditing, compliance and fraud and abuse detection; business planning, development, and restructuring; fund-raising; and customer service.

    *Map:* Maps to ISO 14265 Classification Term "Health service management and quality assurance" described as "To inform persons or processes responsible for determining the availability, quality, safety, equity and cost-effectiveness of health care services."

    There is a semantic gap in concepts. This classification term is described as activities, i.e., "to inform persons" or "to inform processes" rather than the rationale for performing actions/operations on information related to the activity.
    CHDChildren only**Description:**The level of coverage under the policy or program is available only to children
    CHGDATAinformation change**Description:**Information has changed since the record was created.
    CLARIFprescription requires clarification**Description:**Clarification is required before the order can be acted upon.
    CLINMODclinical modificationOrder is changed based on a clinical reason.
    CLINTRCHclinical trial researchTo perform one or more operations on information for conducting scientific investigations in accordance with clinical trial protocols to obtain health care knowledge.
    CLINTRCHNPCclinical trial research without patient careTo perform one or more operations on information for conducting scientific investigations in accordance with clinical trial protocols to obtain health care knowledge without provision of patient care. May be post-coordinated or used with other purposes of use such as disease, discipline, specialty, population origins or ancestry, translational healthcare research. For example, a clinical trial conducted on laboratory specimens collected from a specified patient population.
    CLINTRCHPCclinical trial research with patient careTo perform one or more operations on information for conducting scientific investigations with patient care in accordance with clinical trial protocols to obtain health care knowledge. May be post-coordinated or used with other purposes of use such as disease, discipline, specialty, population origins or ancestry, translational healthcare research. For example, an "off-label" drug used for cancer therapy administer to a specified patient population.
    CLINTRLclinical trialTo perform health care as part of the clinical trial protocol.
    CLMATTCHclaim attachmentTo 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.
    COCcoordination of careTo perform one or more actions on information in order to organize the provision and case management of an individual’s healthcare, including: Monitoring a person's goals, needs, and preferences; acting as the communication link between two or more participants concerned with a person's health and wellness; organizing and facilitating care activities and promoting self-management by advocating for, empowering, and educating a person; and ensuring safe, appropriate, non-duplicative, and effective integrated care.

    *Usage Note:* Use when describing these functions: 1. Monitoring a person’s goals, needs, and preferences. 2. Acting as the communication link between two or more participants concerned with a person's health and wellness. 3. Organizing and facilitating care activities and promoting self-management by advocating for, empowering, and educating a person. 4. Ensuring safe, appropriate, non-duplicative, and effective integrated care.

    The goal is to clearly differentiate this type of coordination of care from HIPAA Operations by specifying that these actions on information are undertaken in the provision of healthcare treatment.

    For similar uses of this concept, see SAMHSA Confidentiality of Substance Use Disorder Patient Records Supplemental notice of proposed rulemaking, which differentiates concepts of care coordination and case management for the provision of treatment as specifically distinct from activities related to health care delivery management and the operations of organizational entities involved in the delivery of healthcare.

    *Map:* Maps to ISO 14265 Classification Terms: "Support of care activities within the provider organisation for an individual subject of care" described as "To inform persons or processes enabling others to provide health care services to the subject of care." "Subject of Care Uses" described as "To inform the subject of care in support of his or her own interests."
    COLDCHNBRKcold chain break**Description:** Cold chain was not maintained for the substance.
    COMPCONcompliance concern**Definition:** Patient has compliance issues with medication such as differing appearance, flavor, size, shape or consistency.
    COMPLcompliance**Description:**Operational activities required to meet a mandate related to an activity, product, or service
    CONTRAcontraindication**Definition:**Contraindication identified
    COVAUTHcoverage authorizationTo perform one or more operations on information for conducting prior authorization or predetermination of coverage for services.
    COVERAGEcoverage under policy or programTo perform one or more operations on information for conducting activities related to coverage under a program or policy.
    COVSUScoverage suspendedWhen 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).
    CRIMEcrime victimA 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.
    CTcontinuing therapyIndicates 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.
    DECPatient DeceasedThe Patient is deceased
    DECSDdeceasedClient deceased.
    DEPDependents only**Description:**The level of coverage under the policy or program is available only to a subscriber's dependents.
    DISdisabilityA 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.
    DISASTERdisasterTo 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.
    DISCONTproduct discontinued**Description:**The medication is no longer being manufactured or is otherwise no longer available.
    DONATdonationTo perform one or more operations on information used for cadaveric organ, eye or tissue donation.
    DOSECHGchange in medication/dose**Description:**The medication is being re-prescribed at a different dosage.
    DRUGHIGHdrug 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.
    DSRCHdisease specific healthcare researchTo perform one or more operations on information for conducting scientific investigations to obtain health care knowledge. Use of the data must be related to specified conditions, diagnosis, or disease healthcare research. For example, conducting cancer research by testing reaction of tumor cells to certain biologics. May be used in combination with clinical trial and other healthcare research purposes of use.
    ECHEmployee and children**Description:**The level of coverage under the policy or program is available to an employee and his or her children.
    EDU
    EIEentered in error**Description:**The information was recorded incorrectly or was recorded in the wrong record.
    ELIGDTRMeligibility determinationTo 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.
    ELIGVEReligibility verificationTo 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.
    EMPEmployee only**Description:**The level of coverage under the policy or program is available only to an employee.
    EMPLOYemployment benefitA person becomes eligible for insurance provided as an employment benefit based on employment status.
    ENADMINentity administration**Description:**Operational activities conducted to administer information relating to entities involves with an activity, product, or service
    ENROLLMenrollmentTo 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.
    ERErrorMoved to an error in placing the patient in the original location.
    ERTREATemergency room treatmentTo perform one or more operations on information for provision of immediately needed health care for an emergent condition in an emergency room or similar emergent care context by end users provisioned for this purpose, which does not constitute as policy override such as in a "Break the Glass" purpose of use.

    Map:Partially Maps to ISO 14265 Classification Term "Emergency care provision to an individual subject of care" described as "To inform persons needing to provide health care services to the subject of care urgently, possibly needing to over-ride the policies and consents pertaining to Purpose 1 above." Purpose 1 is equivalent to HL7 treatment purpose of use: "Clinical care provision to an individual subject of care" described as "To inform persons or processes responsible for providing health care services to the subject of care."

    The ISO description conflates both of the proposed specializations of HL7 ETREAT: break the glass and the typically broader access to health information normally available to providers who are provisioned for emergency workflows on a regular basis, e.g., Emergency Room providers. Examples of greater access than is normally accessible by providers based on the need to know are access to sensitive information for which access typically requires a patient's consent. This is not an override of a patient's dissent to disclose sensitive information in cases where the applicable policy waives the need for that consent to access this information. In US, Title 38 Section 7332 and 42 CFR Part 2 both permit emergency access without the need to override a patient's consent directive; rather, this access is a limitation to the patient's right to dissent from disclosure.

    There is a semantic gap in concepts. This classification term is described as activities “to inform persons� rather than the rationale for performing actions/operations on information related to the activity.
    ESPEmployee and spouse**Description:**The level of coverage under the policy or program is available to an employee and his or her spouse.
    ETREATEmergency TreatmentTo perform one or more operations on information for provision of immediately needed health care for an emergent condition.
    EXPLOTexpired lot**Description:** The lot from which the substance was drawn was expired.
    FAMFamily**Description:**The level of coverage under the policy or program is available to a subscriber's family.
    FAMPHYSfamily physician must authorize further fills**Definition:**Request for further authorization must be done through patient's family physician.
    FAMRQTfamily requestedTo perform one or more operations on information in response to a request by a family member authorized by the patient.
    FILLEDfully filledOrdered quantity has already been completely fulfilled.
    FINNo Financial BackingPatient unable to pay and not covered by insurance
    FINANfinancial eligibilityA 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.
    FIXDATAerror correction**Description:**Previously recorded information was erroneous and is being corrected.
    FLRCNVFloor ConvenienceAccommodation is assigned for floor convenience.
    FLRSTCKfloor stock**Definition:**The bulk supply is issued to replenish a ward for local dispensing. (Includes both mobile and fixed-location ward stocks.)
    FOABORTorder aborted**Definition:**Order to be fulfilled was aborted
    FOSUSPorder suspended**Definition:**Order to be fulfilled was suspended
    FPformulary policyIndicates that the decision to substitute or to not substitute was driven by a policy expressed within the formulary.
    FRAUDfraudTo perform one or more operations on information used for fraud detection and prevention processes.
    FRR01order 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.
    FRR02stale-dated order**Definition:**Order has not been fulfilled within a reasonable amount of time, and may not be current.
    FRR03incomplete 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.
    FRR04product unavailable**Definition:**Product not available or manufactured. Cannot supply.
    FRR05ethical/religious**Definition:**The dispenser has ethical, religious or moral objections to fulfilling the order/dispensing the product.
    FRR06unable 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.
    GOVgovernmentTo perform one or more operations on information used within government processes.
    HACCREDhealth accreditationTo perform one or more operations on information for conducting activities related to meeting accreditation criteria.
    HCOMPLhealth complianceTo perform one or more operations on information used for conducting activities required to meet a mandate.
    HDECDdecedentTo perform one or more operations on information used for handling deceased patient matters.
    HDIRECTdirectoryTo perform one or more operation operations on information used to manage a patient directory.

    **Examples:**

    * facility
    * enterprise
    * payer
    * health information exchange patient directory
    HDMhealthcare delivery managementTo perform one or more actions on information used for conducting administrative and contractual activities by or on behalf of organizational entities responsible for delivery of an individual's benefits in a healthcare program, health plan or insurance. Explicitly excludes the use of information to organize the delivery of health care for care coordination and case management, or to provide healthcare treatment.

    *Usage Note:* Examples of activities conducted under this purpose of use: provider profiling, risk adjustment, underwriting, fraud and abuse, quality improvement population health and care management. Aligns with HIPAA Operation POU minus coordination of care or other treatment related activities. Similar to the description in SAMHSA Confidentiality of Substance Use Disorder Patient Records Supplemental notice of proposed rulemaking.

    *Map:* Maps to ISO 14265 Classification Term "Administration of care for an individual subject of care" described as "To inform persons or processes responsible for enabling the availability of resources or funding or permissions for providing health care services to the subject of care."

    However, this classification term is described as activities, i.e., "to inform persons" or "to inform processes" rather than the rationale for performing actions/operations on information related to the activity.
    HEALTHhealth statusA 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
    HLEGALlegalTo perform one or more operations on information for conducting activities required by legal proceeding.
    HMARKThealthcare marketingTo perform one or more operations on information for marketing services and products related to health care.
    HOLDDONEsuspend reason no longer applies**Definition:**The original reason for suspending the medication has ended.
    HOLDINAPsuspend reason inappropriate**Definition:**
    HOPERAThealthcare operationsTo perform one or more operations on information used for conducting administrative and contractual activities related to the provision of health care.
    HOSPADMadmission to hospital**Description:**The patient has been admitted to a care facility and their community medications are suspended until hospital discharge.
    HOUTCOMShealth outcome measureTo perform one or more operations on information used for assessing results and comparative effectiveness achieved by health care practices and interventions.
    HPAYMThealthcare paymentTo perform one or more operations on information for conducting financial or contractual activities related to payment for provision of health care.
    HPRGRPhealth program reportingTo perform one or more operations on information used for conducting activities to meet program accounting requirements.
    HQUALIMPhealth quality improvementTo perform one or more operations on information used for conducting administrative activities to improve health care quality.
    HRESCHhealthcare researchTo perform one or more operations on information for conducting scientific investigations to obtain health care knowledge. Use of the data iincludes basic and applied research such as biomedical, population origin or ancestry, translational research, and disease, discipline, specialty specific healthcare research and clinical trial research.
    HSYSADMINhealth system administrationTo perform one or more operations on information to administer the electronic systems used for the delivery of health care.
    HTESTtest health dataTo perform one or more operations on information that is simulated or synthetic health data used for testing system capabilities outside of a production or operational system environment.

    *Usage Note:* Data marked with a HTEST security label enables an access control system to permit interfacing systems or end users provisioned with a clearance, which includes a HTEST purpose of use attribute, to test, verify, or validate that a system or application will operate in production as intended based on design specifications.
    IMMUNEimmunity**Definition:**Testing has shown that the patient already has immunity to the agent targeted by the immunization.
    IMPROVcondition improved**Definition:**The patient's medical condition has nearly abated.
    INCCOVPTYincorrect covered party as patientThe covered party (patient) specified with the Invoice is not correct.
    INCINVOICEincorrect billingThe billing information, specified in the Invoice Elements, is not correct. This could include incorrect costing for items included in the Invoice.
    INCPOLICYincorrect policyThe policy specified with the Invoice is not correct. For example, it may belong to another Adjudicator or Covered Party.
    INCPROVincorrect providerThe provider specified with the Invoice is not correct.
    INDIndividual**Description:**The level of coverage under the policy or program is available to an individual.
    INEFFECTineffective**Description:**The therapy has been found to not have the desired therapeutic benefit on the patient.
    INRQSTATEin requested stateThe record is already in the requested state.
    INTOLintolerance**Description:**The patient has an intolerance to the medication.
    INVOICE
    LABELINGlabelingTo perform one or more operations on information to assign, persist, and manage labels to healthcare data to characterize various aspects, such as its security classification, sensitivity, compartment, integrity, and provenance; applicable privacy, consent, security, provenance, and trust policies; and handling caveats such as purpose of use, obligations, and refrain policies.

    Label management includes classification of target data by constructing and binding of a label set per applicable policies, security policy information file semantics, and classification guides. Label management also includes process and procedures for subsequent revision of a label for, e.g., reclassification, downgrading classification, and declassification.

    Label revisions may be triggered by, e.g., expiry of classification period; changes in applicable policy, e.g., revocation of a consent directive; or changes in the governing policy domain in which the data is relocated or a copy of the data is sent. If a label is revised, an audit log should be kept and the provenance of the label changes should be tracked.
    LABINTlab interference issues**Description:**The therapy would interfere with a planned lab test and the therapy is being withdrawn until the test is completed.
    LEGALsubpoena**Definition:**To provide information as a result of a subpoena.
    LOCKEDlocked**Definition:**The prescription may not be reassigned from the original pharmacy.
    LTClong term care use**Definition:**The bulk supply will be administered within a long term care facility.
    MARKTmarketing**Description:**
    MDATAmerge dataInformation is combined into the record.
    MEDMedical Status AlteredThe medical condition of the Patient has changed
    MEDNECMedical NecessityRequired for medical reasons(s).
    MEDPRECmedical precaution**Definition:**The patient currently has a medical condition for which the vaccine is contraindicated or for which precaution is warranted.
    MEMADMINmember administrationTo perform one or more operations on information to administer health care coverage to an enrollee under a policy or program.
    METAMGTmetadata managementTo perform one or more operations on information to assign, persist, and manage metadata to healthcare data to characterize various aspects used for its indexing, discovery, retrieval, and processing by systems, applications, and end users. For example, master index identifier, media type, and location.
    MILCDMmilitary commandTo perform one or more operations on information for conducting activities required by military processes, procedures, policies, or law.
    MILDCRGmilitary dischargeTo perform one or more operations on information for the process of releasing military personnel from their service obligations, which may include determining service merit, discharge benefits, and disability assessment.
    MODIFYmodified prescription exists**Definition:**Therapy has been changed and new prescription issued
    MONITresponse to monitoring**Description:**Monitoring the patient while taking the medication, the decision has been made that the therapy is no longer appropriate.
    MTGIn an outside meetingThe Physician is in a meeting. For example, he/she may request administrative time to talk to family after appointment
    MULTImultiple criteria eligibilityA 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.
    NEEDAPMTpatient must make appointment**Definition:**Patient must see prescriber prior to further fills.
    NEWDATAnew information**Description:**New information has become available to supplement the record.
    NEWSTRnew strength**Definition:**The current medication will be replaced by a new strength of the same medication.
    NEWTHERnew therapy**Definition:**A new therapy will be commenced when current supply exhausted.
    NOAGNTPERMno agent permission**Description:** The agent does not have permission.
    NOMATCHno match**Description:** There is no match.
    NON-AVAILpatient not-available**Description:**Patient not available for a period of time due to a scheduled therapy, leave of absence or other reason.
    NOPERMno permission**Description:** There is no permission.
    NOPICKnot picked up**Definition:**Patient did not come to get medication
    NOPRODMTCHno product match**Description:** There is no match for the product in the master file repository.
    NORECMTCHno record match**Description:** There is no match for the record in the database.
    NOREQno longer required for treatment**Description:**The underlying condition has been resolved or has evolved such that a different treatment is no longer needed.
    NOSERMTCHno service match**Description:** There is no match for the service in the master file repository.
    NOTAVAILprescriber not available**Definition:**Original prescriber is no longer available to prescribe and no other prescriber has taken responsibility for the patient.
    NOTCOVERnot covered**Description:**The product does not have (or no longer has) coverage under the patientaTMs insurance policy.
    NOTPATpatient no longer in this practice**Definition:**Patient no longer or has never been under this prescribers care.
    NOUSERPERMno user permission**Definition:**The user does not have permission
    NOUSRPERMno user permission**Description:** The user does not have permission.
    NOVERMTCHno version match**Description:** There is no match for the record and version.
    NPTnon-protocol**Definition:**The observation or test was neither defined or scheduled in the study protocol.
    OFFICEoffice use**Definition:**The bulk supply is intended for general clinician office use.
    ONHOLDmedication on hold**Definition:**This medication is on hold.
    OPERAToperations**Description:**Administrative and contractual processes required to support an activity, product, or service
    OSout of stockIn 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.
    OSTOCKproduct out of stock**Definition:**There was no supply of the product on hand to perform the service.
    OUTCOMSoutcome measure**Description:**Operational activities conducted for the purposes of assessing the results of an activity, product, or service
    OUTSIDESCHEDadministered outside recommended schedule or practiceThe substance was administered outside of the recommended schedule or practice.
    OVRERemergency treatment overrideTo 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.
    OVRINCOMPincompetency overrideTo perform one or more operations on information to which the patient has not consented because deemed incompetent to provide consent.

    *Usage Note:* Maps to v2 CON-16 Subject Competence Indicator (ID) 01791 Definition: Identifies whether the subject was deemed competent to provide consent. Refer to table HL7 Table 0136 - Yes/No Indicator and CON-23 Non-Subject Consenter Reason User-defined Table 0502 - Non-Subject Consenter Reason code NC "Subject is not competent to consent".
    OVRPJprofessional judgment overrideTo 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.
    OVRPSpublic safety overrideTo 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.
    OVRTPSthird party safety overrideTo 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.
    PATPatient requestThe Patient requested the action
    PATADMINpatient administrationTo perform one or more operations on information used for operational activities conducted to administer the delivery of health care to a patient.
    PATCARpatient care**Definition:**To obtain records as part of patient care.
    PATDECpatient changed mind**Definition:**Patient changed their mind regarding obtaining medication
    PATINELIGpatient not eligible**Definition:**Patient not eligible for drug
    PATOBJpatient objection**Definition:**The patient or their guardian objects to receiving the vaccine.
    PATREQpatient request query**Definition:**Patient requests information from their profile.
    PATRQTpatient requestedTo perform one or more operations on information in response to a patient's request.
    PATSFTYpatient safetyTo perform one or more operations on information in processes related to ensuring the safety of health care.
    PAYMTpayment**Description:**Administrative, financial, and contractual processes related to payment for an activity, product, or service
    PERFMSRperformance measureTo perform one or more operations on information used for monitoring performance of recommended health care practices and interventions.
    PHARMpharmacy transfer**Definition:**The bulk supply is being transferred to another dispensing facility to.

    **Example:**Alleviate a temporary shortage.
    PHILISOPphilosophical objection**Definition:**The patient or their guardian objects to receiving the vaccine because of philosophical beliefs.
    PHYPhysician requestThe Physician requested the action
    PNCproperty and casualty conditionA 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.
    POARCHpopulation origins or ancestry healthcare researchTo perform one or more operations on information, including genealogical pedigrees, historical records, surveys, family health data, health records, and genetic information, for conducting scientific investigations to obtain health care knowledge. Use of the data must be related to population origins and/or ancestry healthcare research. For example, gathering genetic specimens from a specific population in order to determine the ancestry and population origins of that group. May be used in combination with clinical trial and other healthcare research purposes of use.
    POPHLTHpopulation healthTo perform one or more operations on information for provision of health care to a population of living subjects, e.g., needle exchange program.
    PPTper 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.
    PRCREVpractice review**Definition:**To evaluate the provider's current practice for professional-improvement reasons.
    PRECLINTRCHpreclinical trial researchTo perform one or more operations on information in preparation for conducting scientific investigation to obtain health care knowledge, such as research on animals or review of patient health records, to determine the feasibility of a clinical trial study; assist with protocol design; or in preparation for institutional review board or ethics committee approval process. May be post-coordinated or used with other purposes of use such as disease, discipline, specialty, population origins or ancestry, translational healthcare research.
    PREFUSpatient refuse**Description:**The patient refused to take the product.
    PREGparent 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.
    PRGRPTprogram reporting**Description:**Operational activities conducted to meet program accounting requirements related to an activity, product, or service
    PRNAproduct not available**Description:**This product is not available or manufactured.
    PROA
    PRODRECALLproduct recall**Description:** The substance was recalled by the manufacturer.
    PROGprogram use**Definition:**The bulk supply is intended for dispensing according to a specific program.

    **Example:**Mass immunization.
    PROTUNMETprotocol not met**Definition:**Patient does not meet required protocol
    PROVUNAUTHprovider not authorized**Definition:**Provider is not authorized to prescribe or dispense
    PUBHLTHpublic healthTo perform one or more operations on information for conducting public health activities, such as the reporting of notifiable conditions.
    PWATRNYpower of attorneyTo perform one or more operations on information in response to a request by a person appointed as the patient's legal representative.
    PurposeOfUsepurpose of useReason 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.
    QUALIMPquality improvement**Description:**Operational activities conducted for the purposes of improving the quality of an activity, product, or service
    QUANTCHGchange supply quantity**Definition:**Patient requested a revised quantity of medication
    RECALLproduct recalled**Description:**The manufacturer or other agency has requested that stocks of a medication be removed from circulation.
    RECORDMGTrecords managementTo perform one or more operations on information used within the health records management process.
    RECOV
    REGERRregistered in errorClient was registered in error.
    REGULregulatory review**Description:**Review for the purpose of regulatory compliance.
    RELIGreligious objection**Definition:**The patient or their guardian objects to receiving the vaccine on religious grounds.
    REMITADVremittance adviceTo perform one or more operations on information about the amount remitted for a health care claim.
    REPLACEchange 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.
    REPLACEFIXerror in order**Description:**Current order was issued with incorrect data and a new order has/will be created to replace it.
    RESCHresearch**Description:**Investigative activities conducted for the purposes of obtaining knowledge
    RETretest**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.
    RETRO
    RQRequestMoved at the request of the patient.
    RRregulatory requirementIndicates that the decision to substitute or to not substitute was driven by a jurisdictional regulatory requirement mandating or prohibiting substitution.
    RSRCHresearch**Definition:**To provide research data, as authorized by the patient.
    SALGallergy**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.
    SCHscheduled**Definition:**The event occurred due to it being scheduled in the research protocol.
    SDDIdrug 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.
    SDUPTHERduplicate 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.
    SINTOLsuspected 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.
    SPCSpouse and children**Description:**The level of coverage under the policy or program is available to a subscriber's spouse and children
    SPOSpouse only**Description:**The level of coverage under the policy or program is available only to a subscribers spouse
    SRVCservice**Description:**Provision of a service, product, or capability to an individual or organization
    STATUTORYstatutory eligibilityA 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.
    STOPMEDprescriber stopped medication for patientRenewing or original prescriber informed patient to stop using the medication.
    SUPNWKsupport networkTo perform one or more operations on information in response to a request by a person authorized by the patient.
    SURGpatient 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.
    SYSADMNsystem administration**Description:**Operational activities conducted to administer the electronic systems used for an activity, product, or service
    SYSDEVsystem developmentTo perform one or more operations on information to design, develop, implement, test, or deploy a healthcare system or application.
    THERCHARtherapeutic characteristicsThe prescribed product has specific clinical release or other therapeutic characteristics not shared by other substitutable medications.
    THREATthreatTo perform one or more operations on information used to prevent injury or disease to living subjects who may be the target of violence.
    TOOEARLYtoo early**Definition:**The patient should have medication remaining.
    TRAINtrainingTo perform one or more operations on information used in training and education.
    TRAN
    TRANSRCHtranslational healthcare researchTo perform one or more operations on information for conducting scientific investigations to obtain health care knowledge related to evidence based medicine during the course of providing healthcare treatment. Sometimes referred to as "bench to bedside", which is the iterative feedback loop between healthcare research and clinical trials with input from information collected in the course of routine provision of healthcare. For example, by extending a patient encounter to conduct a survey related to a research topic such as attitudes about use of a wellness device that a patient agreed to use. May be used in combination with clinical trial and other healthcare research purposes of use.
    TREATtreatmentTo perform one or more operations on information for provision of health care.
    TRIALclinical trial drug**Definition:** The specific manufactured drug is part of a clinical trial.
    TRMtermination**Definition:**The event occurred in order to terminate the subject's participation in the study.
    UMDATAunmerge dataInformation is separated from the record.
    UNABLEunable to use**Description:**<The patient is not (or is no longer) able to use the medication in a manner prescribed.

    **Example:**CanaTMt swallow.
    UNKWNTARGETunknown target**Definition:**The target facility does not recognize the dispensing facility.
    UNSunscheduled**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.
    UPTper definition**:**The observation or test occurred as defined in the research protocol, but at a point in time not specified in the study protocol.
    VACEFFvaccine efficacy concerns**Definition:**The intended vaccine has expired or is otherwise believed to no longer be effective.

    **Example:**Due to temperature exposure.
    VACSAFvaccine safety concerns**Definition:**The patient or their guardian objects to receiving the vaccine because of concerns over its safety.
    VALIDATIONvalidation review**Description:**To validate the patient's record.

    **Example:**Merging or unmerging records.
    VEHICmotor vehicle accident victimA person becomes a claimant under a motor vehicle accident insurance because of a motor vehicle accident related health condition or injury.
    WASHOUTwaiting 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.
    WORKwork relatedA 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.
    WRNGVERwrong version**Description:** The record and version requested to update is not the current version.
    _ActAccommodationReasonActAccommodationReasonIdentifies the reason the patient is assigned to this accommodation type
    _ActAdjudicationReasonActAdjudicationReasonExplanatory codes that describe reasons why an Adjudicator has financially adjusted an invoice (claim).

    A companion domain (ActAdjudicationInformationCode) includes information reasons which do not have a financial impact on an invoice (claim).

    Example adjudication reason code is AA-CLAIM-0011 - Only Basic Procedure/Test Eligible.

    Codes from this domain further rationalizes ActAdjudicationCodes (e.g. AA - Adjudicated with Adjustment), which are used to describe the process of adjudicating an invoice. For AS - Adjudicated as Submitted, there should be no specification of ActAdjudicationReason codes, as there are no financial adjustments against the invoice.
    _ActBillableClinicalServiceReasonActBillableClinicalServiceReasonReason 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.
    _ActBillableServiceReasonActBillableServiceReason**Definition:** This domain is used to document reasons for providing a billable service; the billable services may include both clinical services and social services.
    _ActConsentInformationAccessOverrideReasonActConsentInformationAccessOverrideReasonTo 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.
    _ActCoverageLevelRasonCodeActCoverageLevelRasonCode**Description:**Represents the reason for the level of coverage provided under the policy or program in terms of the types of entities that may play covered parties based on their personal relationships or employment status.
    _ActCoverageProviderReasonActCoverageProviderReason**Description:**Identifies the reason or rationale for coverage of a service or product based on characteristics of the provider, e.g., contractual relationship to payor, such as in or out-of-network; relationship of the covered party to the provider.

    **Example:**In closed managed care plan, a covered party is assigned a primary care provider who provides primary care services and authorizes referrals and ancillary and non-primary care services.
    _ActCoverageReasonActCoverageReason**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.
    _ActCoverageServiceReasonActCoverageServiceReason**Description:**Identifies the reason or rationale for coverage of a service or product based on clinical efficacy criteria or practices prescribed by the payor.
    _ActHealthInformationManagementReasonActHealthInformationManagementReason**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.
    _ActHealthInformationPrivacyReasonActHealthInformationPrivacyReason**Description:**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.
    _ActImmunizationReasonActImmunizationReason**Description:**A coded description of the reason for why a patient was administered an immunization.

    **Examples:**Post Exposure - Reason, Universal Immunization Program, Outbreak Control, Universal School Program
    _ActIneligibilityReasonActIneligibilityReasonIdentifies 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.
    _ActInformationManagementReasonActInformationManagementReason**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.
    _ActInformationPrivacyReasonActInformationPrivacyReason**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.
    _ActInvalidReasonActInvalidReason**Description:** Types of reasons why a substance is invalid for use.
    _ActInvoiceCancelReasonActInvoiceCancelReasonDomain specifies the codes used to describe reasons why a Provider is cancelling an Invoice or Invoice Grouping.
    _ActNoImmunizationReasonActNoImmunizationReasonA coded description of the reason for why a patient did not receive a scheduled immunization.

    (important for public health strategy
    _ActSupplyFulfillmentRefusalReasonActSupplyFulfillmentRefusalReasonIndicates 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)
    _ClinicalResearchEventReasonClinicalResearchEventReason**Definition:**Specifies the reason that an event occurred in a clinical research study.
    _ClinicalResearchObservationReasonClinicalResearchObservationReason**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.
    _CombinedPharmacyOrderSuspendReasonCodeCombinedPharmacyOrderSuspendReasonCode**Description:**Indicates why the prescription should be suspended.
    _ConrolActNullificationReasonCodeConrolActNullificationReasonCode**Description:**Identifies reasons for nullifying (retracting) a particular control act.

    **Examples:**"Entered in error", "altered decision", etc.
    _ControlActNullificationReasonCodeControlActNullificationReasonCode**Description:**Identifies reasons for nullifying (retracting) a particular control act.
    _ControlActNullificationRefusalReasonTypeControlActNullificationRefusalReasonType**Description:** Reasons to refuse a transaction to be undone.
    _ControlActReasonControlActReasonIdentifies why a specific query, request, or other trigger event occurred.
    _ControlActReasonConditionNullifyControlActReasonConditionNullifyIndicates why the ConditionaTMs status was changed to Nullified. *Examples* administrative error, diagnostic error.
    _CoverageEligibilityReasonCoverageEligibilityReasonDefinition: 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.
    _CoverageExclusionReasonCoverageExclusionReason**Definition:** Identifies the reason or rationale for coverage of a service or product based on coverage exclusions related to the risk of adverse selection by covered parties.
    _CoverageFinancialParticipationReasonCoverageFinancialParticipationReason**Description:**Identifies the reason or rationale for coverage of a service or product based on financial participation responsibilities of the covered party.
    _CoverageLimitationReasonCoverageLimitationReason**Description:**Identifies the reason or rationale for limitations on the coverage of a service or product based on coverage contract provisions.

    **Example:**The maximum cost per unit; or the maximum number of units per period, which is typically the policy or program effective time.
    _EligibilityActReasonCodeEligibilityActReasonCodeIdentifies 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.
    _GenericUpdateReasonCodeGenericUpdateReasonCode**Description:**Identifies why a change is being made to a record.
    _MedicallyNecessaryDuplicateProcedureReasonMedicallyNecessaryDuplicateProcedureReason**Definition:** This domain is used to document why the procedure is a duplicate of one ordered/charged previously for the same patient within the same date of service and has been determined to be medically necessary.

    **Example:** A doctor needs a different view in a chest X-Ray.
    _MedicationOrderAbortReasonCodemedication order abort reason**Description:**Indicates the reason the medication order should be aborted.
    _MedicationOrderReleaseReasonCodemedication order release reason**Definition:**A collection of concepts that indicate why the prescription should be released from suspended state.
    _ModifyPrescriptionReasonTypeModifyPrescriptionReasonTypeTypes of reason why a prescription is being changed.
    _NonPerformanceReasonCodeNonPerformanceReasonCodeThe reason the action wasn't performed, e.g. why the medication was not taken. If an action wasn"t performed, it is often clinically important to know why the action wasn"t taken.

    *Examples:*Patient refused, clinically inappropriate, absolute contraindication etc.
    _PatientProfileQueryReasonCodepatient profile query reason**Definition:**A collection of concepts identifying why the patient's profile is being queried.
    _PharmacySupplyEventAbortReasonPharmacySupplyEventAbortReason**Definition:**Identifies why the dispense event was not completed.
    _PharmacySupplyEventStockReasonCodepharmacy supply event stock reason**Definition:**A collection of concepts that indicates the reason for a "bulk supply" of medication.
    _PharmacySupplyRequestFulfillerRevisionRefusalReasonCodePharmacySupplyRequestFulfillerRevisionRefusalReasonCode**Definition:**Indicates why the request to transfer a prescription from one dispensing facility to another has been refused.
    _PharmacySupplyRequestRenewalRefusalReasonCodepharmacy supply request renewal refusal reason**Definition:**A collection of concepts that identifies why a renewal prescription has been refused.
    _ReasonForNotEvaluatingDeviceReasonForNotEvaluatingDeviceCode assigned to indicate the rationale for not performing an evaluation investigation on a device for which a defect has been reported.

    Examples include: device received in a condition that made analysis impossible, device evaluation anticipated but not yet begun, device not made by company.
    _ReferralReasonCodeReferralReasonCodeThe reason a referral was made.

    *Examples:*Specialized Medical Assistance, Other Care Requirements.
    _RefusalReasonCodeRefusalReasonCode**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.
    _SchedulingActReasonSchedulingActReasonReasons for cancelling or rescheduling an Appointment
    _StatusRevisionRefusalReasonCodeStatusRevisionRefusalReasonCodeIndicates why the act revision (status update) is being refused.
    _SubstanceAdminSubstitutionNotAllowedReasonSubstanceAdminSubstitutionNotAllowedReasonReasons why substitution of a substance administration request is not permitted.
    _SubstanceAdminSubstitutionReasonSubstanceAdminSubstitutionReason
    _SubstanceAdministrationPermissionRefusalReasonCodeSubstanceAdministrationPermissionRefusalReasonCode**Definition:**Indicates why the requested authorization to prescribe or dispense a medication has been refused.
    _SupplyOrderAbortReasonCodesupply 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).
    _TransferActReasonTransferActReasonThe explanation for why a patient is moved from one location to another within the organization

 

Expansion

This value set expansion contains 295 concepts.

SystemVersionCodeDisplayDefinitionJSONXML
http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  ACCREDaccreditation

**Description:**Operational activities conducted for the purposes of meeting of criteria defined by an accrediting entity for an activity, product, or service

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  ACCREQNAAccommodation Requested Not Available

Accommodation requested is not available.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  ADMINERRORadministrative error in order

Order was created with incorrect data and is changed to reflect the intended accuracy of the order.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  ADMREVadministrative review

Definition: To evaluate for service authorization, payment, reporting, or performance/outcome measures.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  ADVSTORAGEadverse storage condition

Description: Storage conditions caused the substance to be ineffective.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  AGEage 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  ALGINTallergy intolerance

Definition: Patient has had a prior allergic intolerance response to alternate product or one of its components.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  ALREADYRXnew prescription exists

**Definition:**Patient has already been given a new (renewal) prescription.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  ALTCHOICEtry 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  ALTDaltered 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  BIORCHbiomedical research

To perform one or more operations on information for conducting scientific investigations to obtain health care knowledge. Use of the data must be related to specified biomedical basic or applied research. For example, research on rare plants to determine whether biologic properties may be useful for pharmaceutical development. May be used in combination with clinical trial and other healthcare research purposes of use.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  BLKUnexpected Block (of Schedule)

The time slots previously allocated are now blocked and no longer available for booking Appointments

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  BONUS
http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  BTGbreak the glass

To perform policy override operations on information for provision of immediately needed health care for an emergent condition affecting potential harm, death or patient safety by end users who are not provisioned for this purpose of use. Includes override of organizational provisioning policies and may include override of subject of care consent directive restricting access.

Map: Partially Maps to ISO 14265 Classification Term "Emergency care provision to an individual subject of care" described as "To inform persons needing to provide health care services to the subject of care urgently, possibly needing to over-ride the policies and consents pertaining to Purpose 1 above." Purpose 1 is equivalent to HL7 treatment purpose of use: "Clinical care provision to an individual subject of care" described as "To inform persons or processes responsible for providing health care services to the subject of care." The ISO description conflates both of the proposed specializations of HL7 ETREAT: break the glass and the typically broader access to health information normally available to providers who are provisioned for emergency workflows on a regular basis, e.g., Emergency Room providers. Examples of greater access than is normally accessible by providers based on the need to know are access to sensitive information for which access typically requires a patient's consent. This is not an override of a patient's dissent to disclose sensitive information in cases where the applicable policy waives the need for that consent to access this information. In US, Title 38 Section 7332 and 42 CFR Part 2 both permit emergency access without the need to override a patient's consent directive; rather, this access is a limitation to the patient's right to dissent from disclosure.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  CAREMGTcare management

To perform analytics, evaluation and other secondary uses of treatment and healthcare related information to manage the quality, efficacy, patient safety, population health, and cost effectiveness of healthcare delivery. Explicitly excludes the use of information to organize the delivery of health care for care coordination and case management, or to provide healthcare treatment.

Usage Note: The concept of care management is narrower than the list of activities related to more general organizational objectives such as provider profiling, education of healthcare and non-healthcare professionals; insurance underwriting, premium rating, reinsurance; organizational legal, medical review, auditing, compliance and fraud and abuse detection; business planning, development, and restructuring; fund-raising; and customer service.

Map: Maps to ISO 14265 Classification Term "Health service management and quality assurance" described as "To inform persons or processes responsible for determining the availability, quality, safety, equity and cost-effectiveness of health care services."

There is a semantic gap in concepts. This classification term is described as activities, i.e., "to inform persons" or "to inform processes" rather than the rationale for performing actions/operations on information related to the activity.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  CHDChildren only

**Description:**The level of coverage under the policy or program is available only to children

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  CHGDATAinformation change

**Description:**Information has changed since the record was created.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  CLARIFprescription requires clarification

**Description:**Clarification is required before the order can be acted upon.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  CLINMODclinical modification

Order is changed based on a clinical reason.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  CLINTRCHclinical 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  CLINTRCHNPCclinical trial research without patient care

To perform one or more operations on information for conducting scientific investigations in accordance with clinical trial protocols to obtain health care knowledge without provision of patient care. May be post-coordinated or used with other purposes of use such as disease, discipline, specialty, population origins or ancestry, translational healthcare research. For example, a clinical trial conducted on laboratory specimens collected from a specified patient population.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  CLINTRCHPCclinical trial research with patient care

To perform one or more operations on information for conducting scientific investigations with patient care in accordance with clinical trial protocols to obtain health care knowledge. May be post-coordinated or used with other purposes of use such as disease, discipline, specialty, population origins or ancestry, translational healthcare research. For example, an "off-label" drug used for cancer therapy administer to a specified patient population.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  CLINTRLclinical trial

To perform health care as part of the clinical trial protocol.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  CLMATTCHclaim 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  COCcoordination of care

To perform one or more actions on information in order to organize the provision and case management of an individual’s healthcare, including: Monitoring a person's goals, needs, and preferences; acting as the communication link between two or more participants concerned with a person's health and wellness; organizing and facilitating care activities and promoting self-management by advocating for, empowering, and educating a person; and ensuring safe, appropriate, non-duplicative, and effective integrated care.

Usage Note: Use when describing these functions: 1. Monitoring a person’s goals, needs, and preferences. 2. Acting as the communication link between two or more participants concerned with a person's health and wellness. 3. Organizing and facilitating care activities and promoting self-management by advocating for, empowering, and educating a person. 4. Ensuring safe, appropriate, non-duplicative, and effective integrated care.

The goal is to clearly differentiate this type of coordination of care from HIPAA Operations by specifying that these actions on information are undertaken in the provision of healthcare treatment.

For similar uses of this concept, see SAMHSA Confidentiality of Substance Use Disorder Patient Records Supplemental notice of proposed rulemaking, which differentiates concepts of care coordination and case management for the provision of treatment as specifically distinct from activities related to health care delivery management and the operations of organizational entities involved in the delivery of healthcare.

Map: Maps to ISO 14265 Classification Terms: "Support of care activities within the provider organisation for an individual subject of care" described as "To inform persons or processes enabling others to provide health care services to the subject of care." "Subject of Care Uses" described as "To inform the subject of care in support of his or her own interests."

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  COLDCHNBRKcold chain break

Description: Cold chain was not maintained for the substance.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  COMPCONcompliance concern

Definition: Patient has compliance issues with medication such as differing appearance, flavor, size, shape or consistency.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  COMPLcompliance

**Description:**Operational activities required to meet a mandate related to an activity, product, or service

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  CONTRAcontraindication

**Definition:**Contraindication identified

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  COVAUTHcoverage authorization

To perform one or more operations on information for conducting prior authorization or predetermination of coverage for services.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  COVERAGEcoverage under policy or program

To perform one or more operations on information for conducting activities related to coverage under a program or policy.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  COVSUScoverage 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).

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  CRIMEcrime 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  CTcontinuing 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  DECPatient Deceased

The Patient is deceased

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  DECSDdeceased

Client deceased.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  DEPDependents only

**Description:**The level of coverage under the policy or program is available only to a subscriber's dependents.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  DISdisability

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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  DISASTERdisaster

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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  DISCONTproduct discontinued

**Description:**The medication is no longer being manufactured or is otherwise no longer available.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  DONATdonation

To perform one or more operations on information used for cadaveric organ, eye or tissue donation.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  DOSECHGchange in medication/dose

**Description:**The medication is being re-prescribed at a different dosage.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  DRUGHIGHdrug 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  DSRCHdisease specific healthcare research

To perform one or more operations on information for conducting scientific investigations to obtain health care knowledge. Use of the data must be related to specified conditions, diagnosis, or disease healthcare research. For example, conducting cancer research by testing reaction of tumor cells to certain biologics. May be used in combination with clinical trial and other healthcare research purposes of use.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  ECHEmployee and children

**Description:**The level of coverage under the policy or program is available to an employee and his or her children.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  EDU
http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  EIEentered in error

**Description:**The information was recorded incorrectly or was recorded in the wrong record.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  ELIGDTRMeligibility 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  ELIGVEReligibility 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  EMPEmployee only

**Description:**The level of coverage under the policy or program is available only to an employee.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  EMPLOYemployment benefit

A person becomes eligible for insurance provided as an employment benefit based on employment status.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  ENADMINentity administration

**Description:**Operational activities conducted to administer information relating to entities involves with an activity, product, or service

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  ENROLLMenrollment

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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  ERError

Moved to an error in placing the patient in the original location.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  ERTREATemergency room treatment

To perform one or more operations on information for provision of immediately needed health care for an emergent condition in an emergency room or similar emergent care context by end users provisioned for this purpose, which does not constitute as policy override such as in a "Break the Glass" purpose of use.

Map:Partially Maps to ISO 14265 Classification Term "Emergency care provision to an individual subject of care" described as "To inform persons needing to provide health care services to the subject of care urgently, possibly needing to over-ride the policies and consents pertaining to Purpose 1 above." Purpose 1 is equivalent to HL7 treatment purpose of use: "Clinical care provision to an individual subject of care" described as "To inform persons or processes responsible for providing health care services to the subject of care."

The ISO description conflates both of the proposed specializations of HL7 ETREAT: break the glass and the typically broader access to health information normally available to providers who are provisioned for emergency workflows on a regular basis, e.g., Emergency Room providers. Examples of greater access than is normally accessible by providers based on the need to know are access to sensitive information for which access typically requires a patient's consent. This is not an override of a patient's dissent to disclose sensitive information in cases where the applicable policy waives the need for that consent to access this information. In US, Title 38 Section 7332 and 42 CFR Part 2 both permit emergency access without the need to override a patient's consent directive; rather, this access is a limitation to the patient's right to dissent from disclosure.

There is a semantic gap in concepts. This classification term is described as activities “to inform persons� rather than the rationale for performing actions/operations on information related to the activity.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  ESPEmployee and spouse

**Description:**The level of coverage under the policy or program is available to an employee and his or her spouse.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  ETREATEmergency Treatment

To perform one or more operations on information for provision of immediately needed health care for an emergent condition.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  EXPLOTexpired lot

Description: The lot from which the substance was drawn was expired.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  FAMFamily

**Description:**The level of coverage under the policy or program is available to a subscriber's family.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  FAMPHYSfamily physician must authorize further fills

**Definition:**Request for further authorization must be done through patient's family physician.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  FAMRQTfamily requested

To perform one or more operations on information in response to a request by a family member authorized by the patient.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  FILLEDfully filled

Ordered quantity has already been completely fulfilled.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  FINNo Financial Backing

Patient unable to pay and not covered by insurance

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  FINANfinancial 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  FIXDATAerror correction

**Description:**Previously recorded information was erroneous and is being corrected.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  FLRCNVFloor Convenience

Accommodation is assigned for floor convenience.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  FLRSTCKfloor stock

**Definition:**The bulk supply is issued to replenish a ward for local dispensing. (Includes both mobile and fixed-location ward stocks.)

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  FOABORTorder aborted

**Definition:**Order to be fulfilled was aborted

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  FOSUSPorder suspended

**Definition:**Order to be fulfilled was suspended

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  FPformulary policy

Indicates that the decision to substitute or to not substitute was driven by a policy expressed within the formulary.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  FRAUDfraud

To perform one or more operations on information used for fraud detection and prevention processes.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  FRR01order 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  FRR02stale-dated order

**Definition:**Order has not been fulfilled within a reasonable amount of time, and may not be current.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  FRR03incomplete 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  FRR04product unavailable

**Definition:**Product not available or manufactured. Cannot supply.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  FRR05ethical/religious

**Definition:**The dispenser has ethical, religious or moral objections to fulfilling the order/dispensing the product.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  FRR06unable 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  GOVgovernment

To perform one or more operations on information used within government processes.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  HACCREDhealth accreditation

To perform one or more operations on information for conducting activities related to meeting accreditation criteria.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  HCOMPLhealth compliance

To perform one or more operations on information used for conducting activities required to meet a mandate.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  HDECDdecedent

To perform one or more operations on information used for handling deceased patient matters.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  HDIRECTdirectory

To perform one or more operation operations on information used to manage a patient directory.

Examples:

  • facility
  • enterprise
  • payer
  • health information exchange patient directory
http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  HDMhealthcare delivery management

To perform one or more actions on information used for conducting administrative and contractual activities by or on behalf of organizational entities responsible for delivery of an individual's benefits in a healthcare program, health plan or insurance. Explicitly excludes the use of information to organize the delivery of health care for care coordination and case management, or to provide healthcare treatment.

Usage Note: Examples of activities conducted under this purpose of use: provider profiling, risk adjustment, underwriting, fraud and abuse, quality improvement population health and care management. Aligns with HIPAA Operation POU minus coordination of care or other treatment related activities. Similar to the description in SAMHSA Confidentiality of Substance Use Disorder Patient Records Supplemental notice of proposed rulemaking.

Map: Maps to ISO 14265 Classification Term "Administration of care for an individual subject of care" described as "To inform persons or processes responsible for enabling the availability of resources or funding or permissions for providing health care services to the subject of care."

However, this classification term is described as activities, i.e., "to inform persons" or "to inform processes" rather than the rationale for performing actions/operations on information related to the activity.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  HEALTHhealth 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

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  HLEGALlegal

To perform one or more operations on information for conducting activities required by legal proceeding.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  HMARKThealthcare marketing

To perform one or more operations on information for marketing services and products related to health care.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  HOLDDONEsuspend reason no longer applies

**Definition:**The original reason for suspending the medication has ended.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  HOLDINAPsuspend reason inappropriate

Definition:

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  HOPERAThealthcare operations

To perform one or more operations on information used for conducting administrative and contractual activities related to the provision of health care.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  HOSPADMadmission to hospital

**Description:**The patient has been admitted to a care facility and their community medications are suspended until hospital discharge.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  HOUTCOMShealth outcome measure

To perform one or more operations on information used for assessing results and comparative effectiveness achieved by health care practices and interventions.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  HPAYMThealthcare payment

To perform one or more operations on information for conducting financial or contractual activities related to payment for provision of health care.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  HPRGRPhealth program reporting

To perform one or more operations on information used for conducting activities to meet program accounting requirements.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  HQUALIMPhealth quality improvement

To perform one or more operations on information used for conducting administrative activities to improve health care quality.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  HRESCHhealthcare research

To perform one or more operations on information for conducting scientific investigations to obtain health care knowledge. Use of the data iincludes basic and applied research such as biomedical, population origin or ancestry, translational research, and disease, discipline, specialty specific healthcare research and clinical trial research.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  HSYSADMINhealth system administration

To perform one or more operations on information to administer the electronic systems used for the delivery of health care.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  HTESTtest health data

To perform one or more operations on information that is simulated or synthetic health data used for testing system capabilities outside of a production or operational system environment.

Usage Note: Data marked with a HTEST security label enables an access control system to permit interfacing systems or end users provisioned with a clearance, which includes a HTEST purpose of use attribute, to test, verify, or validate that a system or application will operate in production as intended based on design specifications.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  IMMUNEimmunity

**Definition:**Testing has shown that the patient already has immunity to the agent targeted by the immunization.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  IMPROVcondition improved

**Definition:**The patient's medical condition has nearly abated.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  INCCOVPTYincorrect covered party as patient

The covered party (patient) specified with the Invoice is not correct.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  INCINVOICEincorrect billing

The billing information, specified in the Invoice Elements, is not correct. This could include incorrect costing for items included in the Invoice.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  INCPOLICYincorrect policy

The policy specified with the Invoice is not correct. For example, it may belong to another Adjudicator or Covered Party.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  INCPROVincorrect provider

The provider specified with the Invoice is not correct.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  INDIndividual

**Description:**The level of coverage under the policy or program is available to an individual.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  INEFFECTineffective

**Description:**The therapy has been found to not have the desired therapeutic benefit on the patient.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  INRQSTATEin requested state

The record is already in the requested state.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  INTOLintolerance

**Description:**The patient has an intolerance to the medication.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  INVOICE
http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  LABELINGlabeling

To perform one or more operations on information to assign, persist, and manage labels to healthcare data to characterize various aspects, such as its security classification, sensitivity, compartment, integrity, and provenance; applicable privacy, consent, security, provenance, and trust policies; and handling caveats such as purpose of use, obligations, and refrain policies.

Label management includes classification of target data by constructing and binding of a label set per applicable policies, security policy information file semantics, and classification guides. Label management also includes process and procedures for subsequent revision of a label for, e.g., reclassification, downgrading classification, and declassification.

Label revisions may be triggered by, e.g., expiry of classification period; changes in applicable policy, e.g., revocation of a consent directive; or changes in the governing policy domain in which the data is relocated or a copy of the data is sent. If a label is revised, an audit log should be kept and the provenance of the label changes should be tracked.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  LABINTlab interference issues

**Description:**The therapy would interfere with a planned lab test and the therapy is being withdrawn until the test is completed.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  LEGALsubpoena

**Definition:**To provide information as a result of a subpoena.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  LOCKEDlocked

**Definition:**The prescription may not be reassigned from the original pharmacy.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  LTClong term care use

**Definition:**The bulk supply will be administered within a long term care facility.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  MARKTmarketing

Description:

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  MDATAmerge data

Information is combined into the record.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  MEDMedical Status Altered

The medical condition of the Patient has changed

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  MEDNECMedical Necessity

Required for medical reasons(s).

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  MEDPRECmedical precaution

**Definition:**The patient currently has a medical condition for which the vaccine is contraindicated or for which precaution is warranted.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  MEMADMINmember administration

To perform one or more operations on information to administer health care coverage to an enrollee under a policy or program.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  METAMGTmetadata management

To perform one or more operations on information to assign, persist, and manage metadata to healthcare data to characterize various aspects used for its indexing, discovery, retrieval, and processing by systems, applications, and end users. For example, master index identifier, media type, and location.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  MILCDMmilitary command

To perform one or more operations on information for conducting activities required by military processes, procedures, policies, or law.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  MILDCRGmilitary discharge

To perform one or more operations on information for the process of releasing military personnel from their service obligations, which may include determining service merit, discharge benefits, and disability assessment.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  MODIFYmodified prescription exists

**Definition:**Therapy has been changed and new prescription issued

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  MONITresponse to monitoring

**Description:**Monitoring the patient while taking the medication, the decision has been made that the therapy is no longer appropriate.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  MTGIn an outside meeting

The Physician is in a meeting. For example, he/she may request administrative time to talk to family after appointment

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  MULTImultiple 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  NEEDAPMTpatient must make appointment

**Definition:**Patient must see prescriber prior to further fills.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  NEWDATAnew information

**Description:**New information has become available to supplement the record.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  NEWSTRnew strength

**Definition:**The current medication will be replaced by a new strength of the same medication.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  NEWTHERnew therapy

**Definition:**A new therapy will be commenced when current supply exhausted.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  NOAGNTPERMno agent permission

Description: The agent does not have permission.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  NOMATCHno match

Description: There is no match.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  NON-AVAILpatient not-available

**Description:**Patient not available for a period of time due to a scheduled therapy, leave of absence or other reason.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  NOPERMno permission

Description: There is no permission.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  NOPICKnot picked up

**Definition:**Patient did not come to get medication

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  NOPRODMTCHno product match

Description: There is no match for the product in the master file repository.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  NORECMTCHno record match

Description: There is no match for the record in the database.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  NOREQno longer required for treatment

**Description:**The underlying condition has been resolved or has evolved such that a different treatment is no longer needed.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  NOSERMTCHno service match

Description: There is no match for the service in the master file repository.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  NOTAVAILprescriber not available

**Definition:**Original prescriber is no longer available to prescribe and no other prescriber has taken responsibility for the patient.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  NOTCOVERnot covered

**Description:**The product does not have (or no longer has) coverage under the patientaTMs insurance policy.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  NOTPATpatient no longer in this practice

**Definition:**Patient no longer or has never been under this prescribers care.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  NOUSERPERMno user permission

**Definition:**The user does not have permission

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  NOUSRPERMno user permission

Description: The user does not have permission.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  NOVERMTCHno version match

Description: There is no match for the record and version.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  NPTnon-protocol

**Definition:**The observation or test was neither defined or scheduled in the study protocol.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  OFFICEoffice use

**Definition:**The bulk supply is intended for general clinician office use.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  ONHOLDmedication on hold

**Definition:**This medication is on hold.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  OPERAToperations

**Description:**Administrative and contractual processes required to support an activity, product, or service

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  OSout 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  OSTOCKproduct out of stock

**Definition:**There was no supply of the product on hand to perform the service.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  OUTCOMSoutcome measure

**Description:**Operational activities conducted for the purposes of assessing the results of an activity, product, or service

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  OUTSIDESCHEDadministered outside recommended schedule or practice

The substance was administered outside of the recommended schedule or practice.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  OVRERemergency 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  OVRINCOMPincompetency override

To perform one or more operations on information to which the patient has not consented because deemed incompetent to provide consent.

Usage Note: Maps to v2 CON-16 Subject Competence Indicator (ID) 01791 Definition: Identifies whether the subject was deemed competent to provide consent. Refer to table HL7 Table 0136 - Yes/No Indicator and CON-23 Non-Subject Consenter Reason User-defined Table 0502 - Non-Subject Consenter Reason code NC "Subject is not competent to consent".

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  OVRPJprofessional 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  OVRPSpublic 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  OVRTPSthird 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PATPatient request

The Patient requested the action

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PATADMINpatient administration

To perform one or more operations on information used for operational activities conducted to administer the delivery of health care to a patient.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PATCARpatient care

**Definition:**To obtain records as part of patient care.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PATDECpatient changed mind

**Definition:**Patient changed their mind regarding obtaining medication

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PATINELIGpatient not eligible

**Definition:**Patient not eligible for drug

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PATOBJpatient objection

**Definition:**The patient or their guardian objects to receiving the vaccine.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PATREQpatient request query

**Definition:**Patient requests information from their profile.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PATRQTpatient requested

To perform one or more operations on information in response to a patient's request.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PATSFTYpatient safety

To perform one or more operations on information in processes related to ensuring the safety of health care.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PAYMTpayment

**Description:**Administrative, financial, and contractual processes related to payment for an activity, product, or service

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PERFMSRperformance measure

To perform one or more operations on information used for monitoring performance of recommended health care practices and interventions.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PHARMpharmacy transfer

**Definition:**The bulk supply is being transferred to another dispensing facility to.

**Example:**Alleviate a temporary shortage.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PHILISOPphilosophical objection

**Definition:**The patient or their guardian objects to receiving the vaccine because of philosophical beliefs.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PHYPhysician request

The Physician requested the action

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PNCproperty 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  POARCHpopulation origins or ancestry healthcare research

To perform one or more operations on information, including genealogical pedigrees, historical records, surveys, family health data, health records, and genetic information, for conducting scientific investigations to obtain health care knowledge. Use of the data must be related to population origins and/or ancestry healthcare research. For example, gathering genetic specimens from a specific population in order to determine the ancestry and population origins of that group. May be used in combination with clinical trial and other healthcare research purposes of use.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  POPHLTHpopulation 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PPTper 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PRCREVpractice review

**Definition:**To evaluate the provider's current practice for professional-improvement reasons.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PRECLINTRCHpreclinical trial research

To perform one or more operations on information in preparation for conducting scientific investigation to obtain health care knowledge, such as research on animals or review of patient health records, to determine the feasibility of a clinical trial study; assist with protocol design; or in preparation for institutional review board or ethics committee approval process. May be post-coordinated or used with other purposes of use such as disease, discipline, specialty, population origins or ancestry, translational healthcare research.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PREFUSpatient refuse

**Description:**The patient refused to take the product.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PREGparent 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PRGRPTprogram reporting

**Description:**Operational activities conducted to meet program accounting requirements related to an activity, product, or service

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PRNAproduct not available

**Description:**This product is not available or manufactured.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PROA
http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PRODRECALLproduct recall

Description: The substance was recalled by the manufacturer.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PROGprogram use

**Definition:**The bulk supply is intended for dispensing according to a specific program.

**Example:**Mass immunization.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PROTUNMETprotocol not met

**Definition:**Patient does not meet required protocol

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PROVUNAUTHprovider not authorized

**Definition:**Provider is not authorized to prescribe or dispense

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PUBHLTHpublic health

To perform one or more operations on information for conducting public health activities, such as the reporting of notifiable conditions.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PWATRNYpower 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  PurposeOfUsepurpose 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  QUALIMPquality improvement

**Description:**Operational activities conducted for the purposes of improving the quality of an activity, product, or service

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  QUANTCHGchange supply quantity

**Definition:**Patient requested a revised quantity of medication

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  RECALLproduct recalled

**Description:**The manufacturer or other agency has requested that stocks of a medication be removed from circulation.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  RECORDMGTrecords management

To perform one or more operations on information used within the health records management process.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  RECOV
http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  REGERRregistered in error

Client was registered in error.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  REGULregulatory review

**Description:**Review for the purpose of regulatory compliance.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  RELIGreligious objection

**Definition:**The patient or their guardian objects to receiving the vaccine on religious grounds.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  REMITADVremittance advice

To perform one or more operations on information about the amount remitted for a health care claim.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  REPLACEchange 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  REPLACEFIXerror in order

**Description:**Current order was issued with incorrect data and a new order has/will be created to replace it.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  RESCHresearch

**Description:**Investigative activities conducted for the purposes of obtaining knowledge

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  RETretest

**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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  RETRO
http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  RQRequest

Moved at the request of the patient.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  RRregulatory requirement

Indicates that the decision to substitute or to not substitute was driven by a jurisdictional regulatory requirement mandating or prohibiting substitution.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  RSRCHresearch

**Definition:**To provide research data, as authorized by the patient.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  SALGallergy

**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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  SCHscheduled

**Definition:**The event occurred due to it being scheduled in the research protocol.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  SDDIdrug 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  SDUPTHERduplicate 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  SINTOLsuspected 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  SPCSpouse and children

**Description:**The level of coverage under the policy or program is available to a subscriber's spouse and children

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  SPOSpouse only

**Description:**The level of coverage under the policy or program is available only to a subscribers spouse

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  SRVCservice

**Description:**Provision of a service, product, or capability to an individual or organization

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  STATUTORYstatutory 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  STOPMEDprescriber stopped medication for patient

Renewing or original prescriber informed patient to stop using the medication.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  SUPNWKsupport network

To perform one or more operations on information in response to a request by a person authorized by the patient.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  SURGpatient 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  SYSADMNsystem administration

**Description:**Operational activities conducted to administer the electronic systems used for an activity, product, or service

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  SYSDEVsystem development

To perform one or more operations on information to design, develop, implement, test, or deploy a healthcare system or application.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  THERCHARtherapeutic characteristics

The prescribed product has specific clinical release or other therapeutic characteristics not shared by other substitutable medications.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  THREATthreat

To perform one or more operations on information used to prevent injury or disease to living subjects who may be the target of violence.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  TOOEARLYtoo early

**Definition:**The patient should have medication remaining.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  TRAINtraining

To perform one or more operations on information used in training and education.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  TRAN
http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  TRANSRCHtranslational healthcare research

To perform one or more operations on information for conducting scientific investigations to obtain health care knowledge related to evidence based medicine during the course of providing healthcare treatment. Sometimes referred to as "bench to bedside", which is the iterative feedback loop between healthcare research and clinical trials with input from information collected in the course of routine provision of healthcare. For example, by extending a patient encounter to conduct a survey related to a research topic such as attitudes about use of a wellness device that a patient agreed to use. May be used in combination with clinical trial and other healthcare research purposes of use.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  TREATtreatment

To perform one or more operations on information for provision of health care.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  TRIALclinical trial drug

Definition: The specific manufactured drug is part of a clinical trial.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  TRMtermination

**Definition:**The event occurred in order to terminate the subject's participation in the study.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  UMDATAunmerge data

Information is separated from the record.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  UNABLEunable to use

Description:<The patient is not (or is no longer) able to use the medication in a manner prescribed.

**Example:**CanaTMt swallow.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  UNKWNTARGETunknown target

**Definition:**The target facility does not recognize the dispensing facility.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  UNSunscheduled

**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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  UPTper definition

**:**The observation or test occurred as defined in the research protocol, but at a point in time not specified in the study protocol.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  VACEFFvaccine efficacy concerns

**Definition:**The intended vaccine has expired or is otherwise believed to no longer be effective.

**Example:**Due to temperature exposure.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  VACSAFvaccine safety concerns

**Definition:**The patient or their guardian objects to receiving the vaccine because of concerns over its safety.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  VALIDATIONvalidation review

**Description:**To validate the patient's record.

**Example:**Merging or unmerging records.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  VEHICmotor 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  WASHOUTwaiting 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  WORKwork 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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  WRNGVERwrong version

Description: The record and version requested to update is not the current version.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ActAccommodationReasonActAccommodationReason

Identifies the reason the patient is assigned to this accommodation type

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ActAdjudicationReasonActAdjudicationReason

Explanatory codes that describe reasons why an Adjudicator has financially adjusted an invoice (claim).

A companion domain (ActAdjudicationInformationCode) includes information reasons which do not have a financial impact on an invoice (claim).

Example adjudication reason code is AA-CLAIM-0011 - Only Basic Procedure/Test Eligible.

Codes from this domain further rationalizes ActAdjudicationCodes (e.g. AA - Adjudicated with Adjustment), which are used to describe the process of adjudicating an invoice. For AS - Adjudicated as Submitted, there should be no specification of ActAdjudicationReason codes, as there are no financial adjustments against the invoice.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ActBillableClinicalServiceReasonActBillableClinicalServiceReason

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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ActBillableServiceReasonActBillableServiceReason

Definition: This domain is used to document reasons for providing a billable service; the billable services may include both clinical services and social services.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ActConsentInformationAccessOverrideReasonActConsentInformationAccessOverrideReason

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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ActCoverageLevelRasonCodeActCoverageLevelRasonCode

**Description:**Represents the reason for the level of coverage provided under the policy or program in terms of the types of entities that may play covered parties based on their personal relationships or employment status.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ActCoverageProviderReasonActCoverageProviderReason

**Description:**Identifies the reason or rationale for coverage of a service or product based on characteristics of the provider, e.g., contractual relationship to payor, such as in or out-of-network; relationship of the covered party to the provider.

**Example:**In closed managed care plan, a covered party is assigned a primary care provider who provides primary care services and authorizes referrals and ancillary and non-primary care services.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ActCoverageReasonActCoverageReason

**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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ActCoverageServiceReasonActCoverageServiceReason

**Description:**Identifies the reason or rationale for coverage of a service or product based on clinical efficacy criteria or practices prescribed by the payor.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ActHealthInformationManagementReasonActHealthInformationManagementReason

**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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ActHealthInformationPrivacyReasonActHealthInformationPrivacyReason

**Description:**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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ActImmunizationReasonActImmunizationReason

**Description:**A coded description of the reason for why a patient was administered an immunization.

**Examples:**Post Exposure - Reason, Universal Immunization Program, Outbreak Control, Universal School Program

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ActIneligibilityReasonActIneligibilityReason

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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ActInformationManagementReasonActInformationManagementReason

**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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ActInformationPrivacyReasonActInformationPrivacyReason

**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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ActInvalidReasonActInvalidReason

Description: Types of reasons why a substance is invalid for use.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ActInvoiceCancelReasonActInvoiceCancelReason

Domain specifies the codes used to describe reasons why a Provider is cancelling an Invoice or Invoice Grouping.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ActNoImmunizationReasonActNoImmunizationReason

A coded description of the reason for why a patient did not receive a scheduled immunization.

(important for public health strategy

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ActSupplyFulfillmentRefusalReasonActSupplyFulfillmentRefusalReason

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)

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ClinicalResearchEventReasonClinicalResearchEventReason

**Definition:**Specifies the reason that an event occurred in a clinical research study.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ClinicalResearchObservationReasonClinicalResearchObservationReason

**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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _CombinedPharmacyOrderSuspendReasonCodeCombinedPharmacyOrderSuspendReasonCode

**Description:**Indicates why the prescription should be suspended.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ConrolActNullificationReasonCodeConrolActNullificationReasonCode

**Description:**Identifies reasons for nullifying (retracting) a particular control act.

Examples:"Entered in error", "altered decision", etc.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ControlActNullificationReasonCodeControlActNullificationReasonCode

**Description:**Identifies reasons for nullifying (retracting) a particular control act.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ControlActNullificationRefusalReasonTypeControlActNullificationRefusalReasonType

Description: Reasons to refuse a transaction to be undone.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ControlActReasonControlActReason

Identifies why a specific query, request, or other trigger event occurred.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ControlActReasonConditionNullifyControlActReasonConditionNullify

Indicates why the ConditionaTMs status was changed to Nullified. Examples administrative error, diagnostic error.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _CoverageEligibilityReasonCoverageEligibilityReason

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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _CoverageExclusionReasonCoverageExclusionReason

Definition: Identifies the reason or rationale for coverage of a service or product based on coverage exclusions related to the risk of adverse selection by covered parties.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _CoverageFinancialParticipationReasonCoverageFinancialParticipationReason

**Description:**Identifies the reason or rationale for coverage of a service or product based on financial participation responsibilities of the covered party.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _CoverageLimitationReasonCoverageLimitationReason

**Description:**Identifies the reason or rationale for limitations on the coverage of a service or product based on coverage contract provisions.

**Example:**The maximum cost per unit; or the maximum number of units per period, which is typically the policy or program effective time.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _EligibilityActReasonCodeEligibilityActReasonCode

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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _GenericUpdateReasonCodeGenericUpdateReasonCode

**Description:**Identifies why a change is being made to a record.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _MedicallyNecessaryDuplicateProcedureReasonMedicallyNecessaryDuplicateProcedureReason

Definition: This domain is used to document why the procedure is a duplicate of one ordered/charged previously for the same patient within the same date of service and has been determined to be medically necessary.

Example: A doctor needs a different view in a chest X-Ray.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _MedicationOrderAbortReasonCodemedication order abort reason

**Description:**Indicates the reason the medication order should be aborted.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _MedicationOrderReleaseReasonCodemedication order release reason

**Definition:**A collection of concepts that indicate why the prescription should be released from suspended state.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ModifyPrescriptionReasonTypeModifyPrescriptionReasonType

Types of reason why a prescription is being changed.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _NonPerformanceReasonCodeNonPerformanceReasonCode

The reason the action wasn't performed, e.g. why the medication was not taken. If an action wasn"t performed, it is often clinically important to know why the action wasn"t taken.

*Examples:*Patient refused, clinically inappropriate, absolute contraindication etc.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _PatientProfileQueryReasonCodepatient profile query reason

**Definition:**A collection of concepts identifying why the patient's profile is being queried.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _PharmacySupplyEventAbortReasonPharmacySupplyEventAbortReason

**Definition:**Identifies why the dispense event was not completed.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _PharmacySupplyEventStockReasonCodepharmacy supply event stock reason

**Definition:**A collection of concepts that indicates the reason for a "bulk supply" of medication.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _PharmacySupplyRequestFulfillerRevisionRefusalReasonCodePharmacySupplyRequestFulfillerRevisionRefusalReasonCode

**Definition:**Indicates why the request to transfer a prescription from one dispensing facility to another has been refused.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _PharmacySupplyRequestRenewalRefusalReasonCodepharmacy supply request renewal refusal reason

**Definition:**A collection of concepts that identifies why a renewal prescription has been refused.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ReasonForNotEvaluatingDeviceReasonForNotEvaluatingDevice

Code assigned to indicate the rationale for not performing an evaluation investigation on a device for which a defect has been reported.

Examples include: device received in a condition that made analysis impossible, device evaluation anticipated but not yet begun, device not made by company.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _ReferralReasonCodeReferralReasonCode

The reason a referral was made.

*Examples:*Specialized Medical Assistance, Other Care Requirements.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _RefusalReasonCodeRefusalReasonCode

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.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _SchedulingActReasonSchedulingActReason

Reasons for cancelling or rescheduling an Appointment

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _StatusRevisionRefusalReasonCodeStatusRevisionRefusalReasonCode

Indicates why the act revision (status update) is being refused.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _SubstanceAdminSubstitutionNotAllowedReasonSubstanceAdminSubstitutionNotAllowedReason

Reasons why substitution of a substance administration request is not permitted.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _SubstanceAdminSubstitutionReasonSubstanceAdminSubstitutionReason
http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _SubstanceAdministrationPermissionRefusalReasonCodeSubstanceAdministrationPermissionRefusalReasonCode

**Definition:**Indicates why the requested authorization to prescribe or dispense a medication has been refused.

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _SupplyOrderAbortReasonCodesupply 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).

http://terminology.hl7.org/CodeSystem/v3-ActReason2.1.0  _TransferActReasonTransferActReason

The explanation for why a patient is moved from one location to another within the organization


Explanation of the columns that may appear on this page:

Level A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
System The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code The code (used as the code in the resource instance)
Display The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition An explanation of the meaning of the concept
Comments Additional notes about how to use the code