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4.4.1.201 ValueSet http://hl7.org/fhir/ValueSet/ex-benefitcategory

Financial Management Work Group

Maturity Level: 1

Draft

Use Context: Country: World, Not Intended for Production use

• Narrative
• XML
• JSON
• TTL

This value set is used in the following places:

• Resource: CoverageEligibilityResponse.insurance.item.category (CodeableConcept / Example)
• Resource: ExplanationOfBenefit.item.category (CodeableConcept / Example)
• Resource: ExplanationOfBenefit.item.detail.category (CodeableConcept / Example)
• Resource: ExplanationOfBenefit.item.detail.subDetail.category (CodeableConcept / Example)
• Resource: ExplanationOfBenefit.benefitBalance.category (CodeableConcept / Example)
• Resource: Coverage.costToBeneficiary.category (CodeableConcept / Example)
• Resource: CoverageEligibilityRequest.item.category (CodeableConcept / Example)
• Resource: Claim.item.category (CodeableConcept / Example)
• Resource: Claim.item.detail.category (CodeableConcept / Example)
• Resource: Claim.item.detail.subDetail.category (CodeableConcept / Example)

4.4.1.201.1 Definition

This value set includes examples of Benefit Category codes.

4.4.1.201.2 Content Logical Definition

4.4.1.201.3 Expansion

This expansion generated 26 Mar 2023

This value set contains 28 concepts

Expansion based on Benefit Category Codes v0.1.0 (CodeSystem)

Code	System	Display	Definition
1	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Medical Care	Medical Care.
2	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Surgical	Surgical.
3	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Consultation	Consultation.
4	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Diagnostic XRay	Diagnostic XRay.
5	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Diagnostic Lab	Diagnostic Lab.
14	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Renal Supplies	Renal Supplies excluding Dialysis.
23	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Diagnostic Dental	Diagnostic Dental.
24	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Periodontics	Periodontics.
25	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Restorative	Restorative.
26	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Endodontics	Endodontics.
27	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Maxillofacial Prosthetics	Maxillofacial Prosthetics.
28	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Adjunctive Dental Services	Adjunctive Dental Services.
30	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Health Benefit Plan Coverage	Health Benefit Plan Coverage.
35	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Dental Care	Dental Care.
36	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Dental Crowns	Dental Crowns.
37	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Dental Accident	Dental Accident.
49	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Hospital Room and Board	Hospital Room and Board.
55	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Major Medical	Major Medical.
56	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Medically Related Transportation	Medically Related Transportation.
61	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	In-vitro Fertilization	In-vitro Fertilization.
62	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	MRI Scan	MRI Scan.
63	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Donor Procedures	Donor Procedures such as organ harvest.
69	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Maternity	Maternity.
76	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Renal Dialysis	Renal dialysis.
F1	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Medical Coverage	Medical Coverage.
F3	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Dental Coverage	Dental Coverage.
F4	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Hearing Coverage	Hearing Coverage.
F6	http://terminology.hl7.org/CodeSystem/ex-benefitcategory	Vision Coverage	Vision Coverage.

See the full registry of value sets defined as part of FHIR.

Explanation of the columns that may appear on this page: