ActReason
A set of codes specifying the motivation, cause, or rationale of an Act, when such rationale is not reasonably represented
as an ActRelationship of type "has reason" linking to another Act.
Examples: Example reasons that might qualify for being coded in this field might be: "routine requirement", "infectious disease reporting
requirement", "on patient request", "required by law".
|
| Lvl |
Type, Domain name and/or Mnemonic code |
Concept ID |
Mnemonic |
Print Name |
Definition/Description |
| 1
|
A: ActAccommodationReason |
V17425 |
|
|
Identifies the reason the patient is assigned to this accommodation type
|
| 2
|
L: (ACCREQNA)
|
17429 |
ACCREQNA |
Accommodation Requested Not Available |
Accommodation requested is not available.
|
| 2
|
L: (FLRCNV)
|
17430 |
FLRCNV |
Floor Convenience |
Accommodation is assigned for floor convenience.
|
| 2
|
L: (MEDNEC)
|
17428 |
MEDNEC |
Medical Necessity |
Required for medical reasons(s).
|
| 2
|
L: (PAT)
|
14880 |
PAT |
Patient request |
The Patient requested the action
|
| 1
|
A: ActAdjudicationReason |
V19385 |
|
|
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.
|
| 1
|
A: ActBillableClinicalServiceReason |
V19388 |
|
|
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.
|
| 1
|
A: ActIneligibilityReason |
V19355 |
|
|
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.
|
| 2
|
L: (COVSUS)
|
19731 |
COVSUS |
coverage suspended |
When a client has no contact with the health system for an extended period, coverage is suspended. Client will be reinstated
to original start date upon proof of identification, residency etc.
Example: Coverage may be suspended during a strike situation, when employer benefits for employees are not covered (i.e. not
in effect).
|
| 2
|
L: (DECSD)
|
19729 |
DECSD |
deceased |
Client deceased.
|
| 2
|
L: (REGERR)
|
19730 |
REGERR |
registered in error |
Client was registered in error.
|
| 1
|
A: ReasonForNotEvaluatingDevice |
V19644 |
|
|
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.
|
| 1
|
A: SchedulingActReason |
V14879 |
|
|
Reasons for cancelling or rescheduling an Appointment
|
| 2
|
L: (BLK)
|
14885 |
BLK |
Unexpected Block (of Schedule) |
The time slots previously allocated are now blocked and no longer available for booking Appointments
|
| 2
|
L: (DEC)
|
14884 |
DEC |
Patient Deceased |
The Patient is deceased
|
| 2
|
L: (FIN)
|
14882 |
FIN |
No Financial Backing |
Patient unable to pay and not covered by insurance
|
| 2
|
L: (MED)
|
14883 |
MED |
Medical Status Altered |
The medical condition of the Patient has changed
|
| 2
|
L: (MTG)
|
14886 |
MTG |
In an outside meeting |
The Physician is in a meeting. For example, he/she may request administrative time to talk to family after appointment
|
| 2
|
L: (PAT)
|
14880 |
PAT |
Patient request |
The Patient requested the action
|
| 2
|
L: (PHY)
|
14881 |
PHY |
Physician request |
The Physician requested the action
|
| 1
|
A: SubstanceAdminSubstitutionReason |
V19377 |
|
|
|
| 2
|
L: (CT)
|
19989 |
CT |
continuing therapy |
Indicates that the decision to substitute or to not substitute was driven by a desire to maintain consistency with a pre-existing
therapy. I.e. The performer provided the same item/service as had been previously provided rather than providing exactly
what was ordered, or rather than substituting with a lower-cost equivalent.
|
| 2
|
L: (FP)
|
19990 |
FP |
formulary policy |
Indicates that the decision to substitute or to not substitute was driven by a policy expressed within the formulary.
|
| 2
|
L: (OS)
|
19987 |
OS |
out of stock |
In the case of 'substitution', indicates that the substitution occurred because the ordered item was not in stock. In the
case of 'no substitution', indicates that a cheaper equivalent was not substituted because it was not in stock.
|
| 2
|
L: (RR)
|
19988 |
RR |
regulatory requirement |
Indicates that the decision to substitute or to not substitute was driven by a jurisdictional regulatory requirement mandating
or prohibiting substitution.
|
| 1
|
A: TransferActReason |
V15983 |
|
|
The explanation for why a patient is moved from one location to another within the organization
|
| 2
|
L: (ER)
|
15984 |
ER |
Error |
Moved to an error in placing the patient in the original location.
|
| 2
|
L: (RQ)
|
15985 |
RQ |
Request |
Moved at the request of the patient.
|
| 1
|
A: x_ActEncounterReason |
V19456 |
|
|
|
| 2
|
L: (MEDNEC)
|
17428 |
MEDNEC |
Medical Necessity |
Required for medical reasons(s).
|
| 2
|
L: (PAT)
|
14880 |
PAT |
Patient request |
The Patient requested the action
|
| 1
|
L: (MEDNEC)
|
17428 |
MEDNEC |
Medical Necessity |
Required for medical reasons(s).
|
| 1
|
L: (PAT)
|
14880 |
PAT |
Patient request |
The Patient requested the action
|