This value set includes codes based on the following rules:

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

  Code	Display	Definition
  ABUSE	commonly abused/misused alert	**Description:**The proposed therapy is frequently misused or abused and therefore should be used with caution and/or monitoring.
  ADALRT	adult alert	Proposed therapy is outside of the standard practice for an adult patient.
  AGE	Age Alert	Proposed therapy may be inappropriate or contraindicated due to patient age
  ALGY	Allergy Alert	Proposed therapy may be inappropriate or contraindicated because of a recorded patient allergy to the proposed product. (Allergies are immune based reactions.)
  ALLDONE	already performed	**Definition:**The requested action has already been performed and so this request has no effect
  ALRTENDLATE	end too late alert	**Definition:**Proposed therapy may be inappropriate or ineffective because the end of administration is too close to another planned therapy.
  ALRTSTRTLATE	start too late alert	**Definition:**Proposed therapy may be inappropriate or ineffective because the start of administration is too late after the onset of the condition.
  BUS	business constraint violation	**Description:**A local business rule relating multiple elements has been violated.
  CAREGAP	Caregap	Identifies the type of detected issue is a care gap
  CODE_DEPREC	code has been deprecated	**Description:**The specified code has been deprecated and should no longer be used. Select another code from the code system.
  CODE_INVAL	code is not valid	**Description:**The specified code is not valid against the list of codes allowed for the element.
  CODINGGAP	Codinggap	Identifies the type of detected issue is a risk adjustment coding gap
  COMPLY	Compliance Alert	There may be an issue with the patient complying with the intentions of the proposed therapy
  COND	Condition Alert	Proposed therapy may be inappropriate or contraindicated due to an existing/recent patient condition or diagnosis
  CREACT	common reaction alert	**Description:**Proposed therapy may be inappropriate or contraindicated because of a common but non-patient specific reaction to the product. **Example:**There is no record of a specific sensitivity for the patient, but the presence of the sensitivity is common and therefore caution is warranted.
  DACT	drug action detected issue	**Description:**Proposed therapy may be contraindicated or ineffective based on an existing or recent drug therapy.
  DOSE	Dosage problem	Proposed dosage instructions for therapy differ from standard practice.
  DOSECOND	dosage-condition alert	**Description:**Proposed dosage is inappropriate due to patient's medical condition.
  DOSEDUR	Dose-Duration Alert	Proposed length of therapy differs from standard practice.
  DOSEDURH	Dose-Duration High Alert	Proposed length of therapy is longer than standard practice
  DOSEDURHIND	Dose-Duration High for Indication Alert	Proposed length of therapy is longer than standard practice for the identified indication or diagnosis
  DOSEDURL	Dose-Duration Low Alert	Proposed length of therapy is shorter than that necessary for therapeutic effect
  DOSEDURLIND	Dose-Duration Low for Indication Alert	Proposed length of therapy is shorter than standard practice for the identified indication or diagnosis
  DOSEH	High Dose Alert	Proposed dosage exceeds standard practice
  DOSEHIND	High Dose for Indication Alert
  DOSEHINDA	High Dose for Age Alert	Proposed dosage exceeds standard practice for the patient's age
  DOSEHINDSA	High Dose for Height/Surface Area Alert	Proposed dosage exceeds standard practice for the patient's height or body surface area
  DOSEHINDW	High Dose for Weight Alert	Proposed dosage exceeds standard practice for the patient's weight
  DOSEIVL	Dose-Interval Alert	Proposed dosage interval/timing differs from standard practice
  DOSEIVLIND	Dose-Interval for Indication Alert	Proposed dosage interval/timing differs from standard practice for the identified indication or diagnosis
  DOSEL	Low Dose Alert	Proposed dosage is below suggested therapeutic levels
  DOSELIND	Low Dose for Indication Alert
  DOSELINDA	Low Dose for Age Alert	Proposed dosage is below suggested therapeutic levels for the patient's age
  DOSELINDSA	Low Dose for Height/Surface Area Alert	Proposed dosage is below suggested therapeutic levels for the patient's height or body surface area
  DOSELINDW	Low Dose for Weight Alert	Proposed dosage is below suggested therapeutic levels for the patient's weight
  DRG	Drug Interaction Alert	Proposed therapy may interact with an existing or recent drug therapy
  DUPTHPCLS	duplicate therapeutic alass alert	**Description:**The proposed therapy appears to have the same intended therapeutic benefit as an existing therapy, though the specific mechanisms of action vary.
  DUPTHPGEN	duplicate generic alert	**Description:**The proposed therapy appears to have the same intended therapeutic benefit as an existing therapy and uses the same mechanisms of action as the existing therapy.
  DUPTHPY	Duplicate Therapy Alert	The proposed therapy appears to duplicate an existing therapy
  ENDLATE	End Too Late Alert	Proposed therapy may be inappropriate or ineffective because the end of administration is too close to another planned therapy
  FOOD	Food Interaction Alert	Proposed therapy may interact with certain foods
  FORMAT	invalid format	**Description:**The element does not follow the formatting or type rules defined for the field.
  FRAUD	potential fraud	**Description:**The request is suspected to have a fraudulent basis.
  FULFIL	fulfillment alert	**Definition:**The therapy being performed is in some way out of alignment with the requested therapy.
  GEALRT	geriatric alert	Proposed therapy is outside of standard practice for a geriatric patient.
  GEN	Genetic Alert	Proposed therapy may be inappropriate or contraindicated due to patient genetic indicators.
  GEND	Gender Alert	Proposed therapy may be inappropriate or contraindicated due to patient gender.
  HELD	held/suspended alert	**Definition:**There should be no actions taken in fulfillment of a request that has been held or suspended.
  HGHT
  HISTORIC	record recorded as historical	**Description:** While the record was accepted in the repository, there is a more recent version of a record of this type.
  ILLEGAL	illegal	**Description:**The request is missing elements or contains elements which cause it to not meet the legal standards for actioning.
  INT	Intolerance Alert	Proposed therapy may be inappropriate or contraindicated because of a recorded patient intolerance to the proposed product. (Intolerances are non-immune based sensitivities.)
  INTERVAL	outside requested time	**Definition:**The therapy action is being performed outside the bounds of the time period requested
  ISSUE	detected issue	There is a clinical issue for the therapy that makes continuation of the therapy inappropriate. *Open Issue:* The definition of this code does not correctly represent the concept space of its specializations (children)
  KEY204	Unknown key identifier	The ID of the patient, order, etc., was not found. Used for transactions other than additions, e.g. transfer of a non-existent patient.
  KEY205	Duplicate key identifier	The ID of the patient, order, etc., already exists. Used in response to addition transactions (Admit, New Order, etc.).
  KEY206	non-matching identification	**Description:** Metadata associated with the identification (e.g. name or gender) does not match the identification being verified.
  LAB	Lab Alert	Proposed therapy may be inappropriate or contraindicated due to recent lab test results
  LACT	Lactation Alert	Proposed therapy may be inappropriate or contraindicated when breast-feeding
  LEN_LONG	length is too long	**Description:**The length of the data specified is greater than the maximum length defined for the element.
  LEN_RANGE	length out of range	**Description:**The length of the data specified falls out of the range defined for the element.
  LEN_SHORT	length is too short	**Description:**The length of the data specified is less than the minimum length defined for the element.
  MAXOCCURS	repetitions above maximum	**Description:**The number of repeating elements is above the maximum number of repetitions allowed.
  MDOSE	maximum dosage reached	**Description:**The maximum quantity of this drug allowed to be administered within a particular time-range (month, year, lifetime) has been reached or exceeded.
  MINFREQ	too soon within frequency based on the usage	**Definition:**The therapy action is being performed too soon after the previous occurrence based on the requested frequency
  MINOCCURS	repetitions below minimum	**Description:**The number of repeating elements is below the minimum number of repetitions allowed.
  MISSCOND	conditional element missing	**Description:**The specified element must be specified with a non-null value under certain conditions. In this case, the conditions are true but the element is still missing or null.
  MISSMAND	mandatory element missing	**Description:**The specified element is mandatory and was not included in the instance.
  NAT	Insufficient authorization	The requesting party has insufficient authorization to invoke the interaction.
  NHP	Natural Health Product Alert	Proposed therapy may interact with existing or recent natural health product therapy
  NODUPS	duplicate values are not permitted	**Description:**More than one element with the same value exists in the set. Duplicates not permission in this set in a set.
  NONRX	Non-Prescription Interaction Alert	Proposed therapy may interact with a non-prescription drug (e.g. alcohol, tobacco, Aspirin)
  NOPERSIST	element will not be persisted	**Description:** Element in submitted message will not persist in data storage based on detected issue.
  NOTACTN	no longer actionable	**Definition:**The status of the request being fulfilled has changed such that it is no longer actionable. This may be because the request has expired, has already been completely fulfilled or has been otherwise stopped or disabled. (Not used for 'suspended' orders.)
  NOTEQUIV	not equivalent alert	**Definition:**The therapy being performed is not sufficiently equivalent to the therapy which was requested.
  NOTEQUIVGEN	not generically equivalent alert	**Definition:**The therapy being performed is not generically equivalent (having the identical biological action) to the therapy which was requested.
  NOTEQUIVTHER	not therapeutically equivalent alert	**Definition:**The therapy being performed is not therapeutically equivalent (having the same overall patient effect) to the therapy which was requested.
  OBSA	Observation Alert	Proposed therapy may be inappropriate or contraindicated due to conditions or characteristics of the patient
  OBSOLETE	obsolete record returned	**Description:** One or more records in the query response have a status of 'obsolete'.
  PATPREF	violates stated preferences	**Definition:**The proposed therapy goes against preferences or consent constraints recorded in the patient's record.
  PATPREFALT	violates stated preferences, alternate available	**Definition:**The proposed therapy goes against preferences or consent constraints recorded in the patient's record. An alternate therapy meeting those constraints is available.
  PEALRT	pediatric alert	Proposed therapy is outside of the standard practice for a pediatric patient.
  PLYDOC	Poly-orderer Alert	A similar or identical therapy was recently ordered by a different practitioner.
  PLYPHRM	Poly-supplier Alert	This patient was recently supplied a similar or identical therapy from a different pharmacy or supplier.
  PREG	Pregnancy Alert	Proposed therapy may be inappropriate or contraindicated during pregnancy
  PREVINEF	previously ineffective	**Definition:**The same or similar treatment has previously been attempted with the patient without achieving a positive effect.
  RALG	Related Allergy Alert	Proposed therapy may be inappropriate or contraindicated because of a recorded patient allergy to a cross-sensitivity related product. (Allergies are immune based reactions.)
  RAR	Related Prior Reaction Alert	Proposed therapy may be inappropriate or contraindicated because of a recorded prior adverse reaction to a cross-sensitivity related product.
  REACT	Reaction Alert	Proposed therapy may be inappropriate or contraindicated based on the potential for a patient reaction to the proposed product
  REP_RANGE	repetitions out of range	**Description:**The number of repeating elements falls outside the range of the allowed number of repetitions.
  RINT	Related Intolerance Alert	Proposed therapy may be inappropriate or contraindicated because of a recorded patient intolerance to a cross-sensitivity related product. (Intolerances are non-immune based sensitivities.)
  RREACT	Related Reaction Alert	Proposed therapy may be inappropriate or contraindicated because of a potential patient reaction to a cross-sensitivity related product.
  STRTLATE	Start Too Late Alert	Proposed therapy may be inappropriate or ineffective because the start of administration is too late after the onset of the condition
  SUPPRESSED	record suppressed	**Description:** One or more records in the query response have been suppressed due to consent or privacy restrictions.
  TIME	timing detected issue	**Description:**Proposed therapy may be inappropriate or ineffective based on the proposed start or end time.
  TIMING	event timing incorrect alert	**Definition:**The therapy is being performed at a time which diverges from the time the therapy was requested
  TOOLATE	Refill Too Late Alert	The patient is receiving a subsequent fill significantly later than would be expected based on the amount previously supplied and the therapy dosage instructions
  TOOSOON	Refill Too Soon Alert	The patient is receiving a subsequent fill significantly earlier than would be expected based on the amount previously supplied and the therapy dosage instructions
  TPROD	Therapeutic Product Alert	Proposed therapy may interact with an existing or recent therapeutic product
  VALIDAT	validation issue	**Description:**The specified element did not pass business-rule validation.
  WGHT
  _ActAdministrativeAuthorizationDetectedIssueCode	ActAdministrativeAuthorizationDetectedIssueCode
  _ActAdministrativeDetectedIssueCode	ActAdministrativeDetectedIssueCode	Identifies types of detectyed issues for Act class "ALRT" for the administrative and patient administrative acts domains.
  _ActAdministrativeRuleDetectedIssueCode	ActAdministrativeRuleDetectedIssueCode
  _ActFinancialDetectedIssueCode	ActFinancialDetectedIssueCode	Identifies types of detected issues for Act class "ALRT" for the financial acts domain.
  _ActSuppliedItemDetectedIssueCode	ActSuppliedItemDetectedIssueCode	Identifies types of detected issues regarding the administration or supply of an item to a patient.
  _AdministrationDetectedIssueCode	AdministrationDetectedIssueCode	Administration of the proposed therapy may be inappropriate or contraindicated as proposed
  _AppropriatenessDetectedIssueCode	AppropriatenessDetectedIssueCode
  _ClinicalActionDetectedIssueCode	ClinicalActionDetectedIssueCode	Identifies types of issues detected regarding the performance of a clinical action on a patient.
  _DrugActionDetectedIssueCode	DrugActionDetectedIssueCode	Proposed therapy may be contraindicated or ineffective based on an existing or recent drug therapy
  _InteractionDetectedIssueCode	InteractionDetectedIssueCode
  _SupplyDetectedIssueCode	SupplyDetectedIssueCode	Supplying the product at this time may be inappropriate or indicate compliance issues with the associated therapy
  _TimingDetectedIssueCode	TimingDetectedIssueCode	Proposed therapy may be inappropriate or ineffective based on the proposed start or end time.

• Include these codes as defined in http://terminology.hl7.org/CodeSystem/v3-ActReason version 📍2.1.0

  Code	Display	Definition
  NOAGNTPERM	no agent permission	**Description:** The agent does not have permission.
  NOMATCH	no match	**Description:** There is no match.
  NOPERM	no permission	**Description:** There is no permission.
  NOPRODMTCH	no product match	**Description:** There is no match for the product in the master file repository.
  NORECMTCH	no record match	**Description:** There is no match for the record in the database.
  NOSERMTCH	no service match	**Description:** There is no match for the service in the master file repository.
  NOUSERPERM	no user permission	**Definition:**The user does not have permission
  NOUSRPERM	no user permission	**Description:** The user does not have permission.
  NOVERMTCH	no version match	**Description:** There is no match for the record and version.
  _RefusalReasonCode	RefusalReasonCode	**Description:** Identifies why a request to add (or activate) a record is being refused. Examples include the receiving system not able to match the identifier and find that record in the receiving system, having no permission, or a detected issue exists which precludes the requested action.

This value set expansion contains 123 concepts.