R4 Draft for Comment

This page is part of the FHIR Specification (v3.2.0: R4 Ballot 1). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions . Page versions: R4 R3

4.3.2.88 HL7 v3 Value Set ParticipationFunction

Vocabulary

Work Group

Maturity Level: N/A

External

Use Context: Any

This value set (http://hl7.org/fhir/ValueSet/v3-ParticipationFunction) is defined as part of HL7 v3.

Summary

Defining URL:

http://hl7.org/fhir/ValueSet/v3-ParticipationFunction

Name:

v3 Code System ParticipationFunction

Definition:

This code is used to specify the exact function an actor had in a service in all necessary detail. This domain may include local extensions (CWE).

OID:

2.16.840.1.113883.1.11.10267 (for OID based terminology systems)

Source Resource

XML / JSON

This value set is used in the following places:

This value set is the designated 'entire code system' value set for v3 Code System ParticipationFunction

4.3.2.88.1 Content Logical Definition

This value set includes codes from the following code systems:

Include all codes defined in http://hl7.org/fhir/v3/ParticipationFunction

4.3.2.88.2 Expansion

This expansion generated 20 Dec 2017

This value set contains 41 concepts

Expansion based on http://hl7.org/fhir/v3/ParticipationFunction version 2017-07-31

All codes from system http://hl7.org/fhir/v3/ParticipationFunction

Lvl	Code	Display	Definition
0	_AuthorizedParticipationFunction	AuthorizedParticipationFunction	This code is used to specify the exact function an actor is authorized to have in a service in all necessary detail.
1	_AuthorizedReceiverParticipationFunction	AuthorizedReceiverParticipationFunction	This code is used to specify the exact function an actor is authorized to have as a receiver of information that is the subject of a consent directive or consent override.
2	AUCG	caregiver information receiver	Description:Caregiver authorized to receive patient health information.
2	AULR	legitimate relationship information receiver	Description:Provider with legitimate relationship authorized to receive patient health information.
2	AUTM	care team information receiver	Description:Member of care team authorized to receive patient health information.
2	AUWA	work area information receiver	Description:Entities within specified work area authorized to receive patient health information.
1	_ConsenterParticipationFunction	ConsenterParticipationFunction	This code is used to specify the exact function an actor is authorized to have in authoring a consent directive.
2	GRDCON	legal guardian consent author	Description:Legal guardian of the subject of consent authorized to author a consent directive for the subject of consent.
2	POACON	healthcare power of attorney consent author	Description:Person authorized with healthcare power of attorney to author a consent directive for the subject of consent.
2	PRCON	personal representative consent author	Description:Personal representative of the subject of consent authorized to author a consent directive for the subject of consent.
2	PROMSK	authorized provider masking author	Definition:Provider authorized to mask information to protect the patient, a third party, or to ensure that the provider has consulted with the patient prior to release of this information.
2	SUBCON	subject of consent author	Description:Subject of consent authorized to author a consent directive.
1	_OverriderParticipationFunction	OverriderParticipationFunction	This code is used to specify the exact function an actor is authorized to have in authoring a consent override.
2	AUCOV	consent overrider	Description:Entity authorized to override a consent directive.
2	AUEMROV	emergency overrider	Description:Entity authorized to override a consent directive or privacy policy in an emergency.
0	_CoverageParticipationFunction	CoverageParticipationFunction	Definition: Set of codes indicating the manner in which sponsors, underwriters, and payers participate in a policy or program.
1	_PayorParticipationFunction	PayorParticipationFunction	Definition: Set of codes indicating the manner in which payors participate in a policy or program.</
2	CLMADJ	claims adjudication	Definition: Manages all operations required to adjudicate fee for service claims or managed care encounter reports.
2	ENROLL	enrollment broker	Definition: Managing the enrollment of covered parties.
2	FFSMGT	ffs management	Definition: Managing all operations required to administer a fee for service or indemnity health plan including enrolling covered parties and providing customer service, provider contracting, claims payment, care management and utilization review.
2	MCMGT	managed care management	Definition: Managing all operations required to administer a managed care plan including enrolling covered parties and providing customer service,, provider contracting, claims payment, care management and utilization review.
2	PROVMGT	provider management	Definition: Managing provider contracting, provider services, credentialing, profiling, performance measures, and ensuring network adequacy.
2	UMGT	utilization management	Definition: Managing utilization of services by ensuring that providers adhere to, e.g., payeraTMs clinical protocols for medical appropriateness and standards of medical necessity. May include management of authorizations for services and referrals.
1	_SponsorParticipationFunction	SponsorParticipationFunction	Definition: Set of codes indicating the manner in which sponsors participate in a policy or program. NOTE: use only when the Sponsor is not further specified with a SponsorRoleType as being either a fully insured sponsor or a self insured sponsor.
2	FULINRD	fully insured	Definition: Responsibility taken by a sponsor to contract with one or more underwriters for the assumption of full responsibility for the risk and administration of a policy or program.
2	SELFINRD	self insured	Definition: Responsibility taken by a sponsor to organize the underwriting of risk and administration of a policy or program.
1	_UnderwriterParticipationFunction	UnderwriterParticipationFunction	Definition: Set of codes indicating the manner in which underwriters participate in a policy or program.
2	PAYORCNTR	payor contracting	Definition: Contracting for the provision and administration of health services to payors while retaining the risk for coverage. Contracting may be for all provision and administration; or for provision of certain types of services; for provision of services by region; and by types of administration, e.g., claims adjudication, enrollment, provider management, and utilization management. Typically done by underwriters for sponsors who need coverage provided to covered parties in multiple regions. The underwriter may act as the payor in some, but not all of the regions in which coverage is provided.
2	REINS	reinsures	Definition: Underwriting reinsurance for another underwriter for the policy or program.
2	RETROCES	retrocessionaires	Definition: Underwriting reinsurance for another reinsurer.
2	SUBCTRT	subcontracting risk	Definition: Delegating risk for a policy or program to one or more subcontracting underwriters, e.g., a major health insurer may delegate risk for provision of coverage under a national health plan to other underwriters by region .
2	UNDERWRTNG	underwriting	Definition: Provision of underwriting analysis for another underwriter without assumption of risk.
0	ADMPHYS	admitting physician	A physician who admitted a patient to a hospital or other care unit that is the context of this service.
0	ANEST	anesthesist	In a typical anesthesia setting an anesthesiologist or anesthesia resident in charge of the anesthesia and life support, but only a witness to the surgical procedure itself. To clarify responsibilities anesthesia should always be represented as a separate service related to the surgery.
0	ANRS	anesthesia nurse	In a typical anesthesia setting the nurse principally assisting the anesthesiologist during the critical periods.
0	ASSEMBLER	assembly software	A device that operates independently of an author on custodian's algorithms for data extraction of existing information for purpose of generating a new artifact. UsageConstraint: ASSEMBLER ParticipationFunction should be used with DEV (device) ParticipationType.
0	ATTPHYS	attending physician	A physician who is primarily responsible for a patient during the hospitalization, which is the context of the service.
0	COMPOSER	composer software	A device used by an author to record new information, which may also be used by the author to select existing information for aggregation with newly recorded information for the purpose of generating a new artifact. UsageConstraint: COMPOSER ParticipationFunction should be used with DEV (device) ParticipationType. Usage Note: This code will enable implementers to more specifically represent the manner in which a Device participated in and facilitated the generation of a CDA Clinical Document or a CDA Entry by the responsible Author, which is comprised of the Author's newly entered content, and may include the pre-existing content selected by the Author, for the purpose of establishing the provenance and accountability for these acts.
0	DISPHYS	discharging physician	A physician who discharged a patient from a hospital or other care unit that is the context of this service.
0	FASST	first assistant surgeon	In a typical surgery setting the assistant facing the primary surgeon. The first assistant performs parts of the operation and assists in others (e.g., incision, approach, electrocoutering, ligatures, sutures).
0	MDWF	midwife	A person (usually female) helping a woman deliver a baby. Responsibilities vary locally, ranging from a mere optional assistant to a full required participant, responsible for (normal) births and pre- and post-natal care for both mother and baby.
0	NASST	nurse assistant	In a typical surgery setting the non-sterile nurse handles material supply from the stock, forwards specimen to pathology, and helps with other non-sterile tasks (e.g., phone calls, etc.).
0	PCP	primary care physician	The healthcare provider that holds primary responsibility for the overall care of a patient.
0	PRISURG	primary surgeon	In a typical surgery setting the primary performing surgeon.
0	REVIEWER	reviewer	A verifier who is accountable for reviewing and asserting that the verification of an Act complies with jurisdictional or organizational policy. UsageConstraint: UsageConstraint: Specifies the exact function that an actor is authorized to have as a verifier of an Act. Connotes that a specialized verifier asserts compliance for veracity of the review per jurisdictional or organizational policy. E.g., The Provider who takes responsibility for authenticity of a record submitted to a payer. REVIEW ParticipationFunction should be used with VFR (verifier)
0	RNDPHYS	rounding physician	A physician who made rounds on a patient in a hospital or other care center.
0	SASST	second assistant surgeon	In a typical surgery setting the assistant who primarily holds the hooks.
0	SNRS	scrub nurse	In a typical surgery setting the nurse in charge of the instrumentation.
0	TASST	third assistant	In a typical surgery setting there is rarely a third assistant (e.g., in some Hip operations the third assistant postures the affected leg).