This page is part of the FHIR Specification (v4.2.0: R5 Preview #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: R4B R4 R3
Financial Management Work Group | Maturity Level: N/A | Standards Status: Informative |
Raw XML (canonical form + also see XML Format Specification)
Definition for Code System BenefitTypeCodes
<?xml version="1.0" encoding="UTF-8"?> <CodeSystem xmlns="http://hl7.org/fhir"> <id value="benefit-type"/> <meta> <lastUpdated value="2019-12-31T21:03:40.621+11:00"/> <profile value="http://hl7.org/fhir/StructureDefinition/shareablecodesystem"/> </meta> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"> <h2> Benefit Type Codes</h2> <div> <p> This value set includes a smattering of Benefit type codes.</p> </div> <p> <b> Copyright Statement:</b> This is an example set. </p> <p> This code system http://terminology.hl7.org/CodeSystem/benefit-type defines the following codes:</p> <table class="codes"> <tr> <td style="white-space:nowrap"> <b> Code</b> </td> <td> <b> Display</b> </td> <td> <b> Definition</b> </td> </tr> <tr> <td style="white-space:nowrap">benefit <a name="benefit-type-benefit"> </a> </td> <td> Benefit</td> <td> Maximum benefit allowable.</td> </tr> <tr> <td style="white-space:nowrap">deductible <a name="benefit-type-deductible"> </a> </td> <td> Deductible</td> <td> Cost to be incurred before benefits are applied</td> </tr> <tr> <td style="white-space:nowrap">visit <a name="benefit-type-visit"> </a> </td> <td> Visit</td> <td> Service visit</td> </tr> <tr> <td style="white-space:nowrap">room <a name="benefit-type-room"> </a> </td> <td> Room</td> <td> Type of room</td> </tr> <tr> <td style="white-space:nowrap">copay <a name="benefit-type-copay"> </a> </td> <td> Copayment per service</td> <td> Copayment per service</td> </tr> <tr> <td style="white-space:nowrap">copay-percent <a name="benefit-type-copay-percent"> </a> </td> <td> Copayment Percent per service</td> <td> Copayment percentage per service</td> </tr> <tr> <td style="white-space:nowrap">copay-maximum <a name="benefit-type-copay-maximum"> </a> </td> <td> Copayment maximum per service</td> <td> Copayment maximum per service</td> </tr> <tr> <td style="white-space:nowrap">vision-exam <a name="benefit-type-vision-exam"> </a> </td> <td> Vision Exam</td> <td> Vision Exam</td> </tr> <tr> <td style="white-space:nowrap">vision-glasses <a name="benefit-type-vision-glasses"> </a> </td> <td> Vision Glasses</td> <td> Frames and lenses</td> </tr> <tr> <td style="white-space:nowrap">vision-contacts <a name="benefit-type-vision-contacts"> </a> </td> <td> Vision Contacts Coverage</td> <td> Contact Lenses</td> </tr> <tr> <td style="white-space:nowrap">medical-primarycare <a name="benefit-type-medical-primarycare"> </a> </td> <td> Medical Primary Health Coverage</td> <td> Medical Primary Health Coverage</td> </tr> <tr> <td style="white-space:nowrap">pharmacy-dispense <a name="benefit-type-pharmacy-dispense"> </a> </td> <td> Pharmacy Dispense Coverage</td> <td> Pharmacy Dispense Coverage</td> </tr> </table> </div> </text> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg"> <valueCode value="fm"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status"> <valueCode value="draft"/> </extension> <extension url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm"> <valueInteger value="1"/> </extension> <url value="http://terminology.hl7.org/CodeSystem/benefit-type"/> <identifier> <system value="urn:ietf:rfc:3986"/> <value value="urn:oid:2.16.840.1.113883.4.642.1.1176"/> </identifier> <version value="4.2.0"/> <name value="BenefitTypeCodes"/> <title value="Benefit Type Codes"/> <status value="draft"/> <experimental value="false"/> <publisher value="Financial Management"/> <contact> <telecom> <system value="url"/> <value value="http://hl7.org/fhir"/> </telecom> </contact> <description value="This value set includes a smattering of Benefit type codes."/> <copyright value="This is an example set."/> <caseSensitive value="true"/> <valueSet value="http://hl7.org/fhir/ValueSet/benefit-type"/> <content value="complete"/> <concept> <code value="benefit"/> <display value="Benefit"/> <definition value="Maximum benefit allowable."/> </concept> <concept> <code value="deductible"/> <display value="Deductible"/> <definition value="Cost to be incurred before benefits are applied"/> </concept> <concept> <code value="visit"/> <display value="Visit"/> <definition value="Service visit"/> </concept> <concept> <code value="room"/> <display value="Room"/> <definition value="Type of room"/> </concept> <concept> <code value="copay"/> <display value="Copayment per service"/> <definition value="Copayment per service"/> </concept> <concept> <code value="copay-percent"/> <display value="Copayment Percent per service"/> <definition value="Copayment percentage per service"/> </concept> <concept> <code value="copay-maximum"/> <display value="Copayment maximum per service"/> <definition value="Copayment maximum per service"/> </concept> <concept> <code value="vision-exam"/> <display value="Vision Exam"/> <definition value="Vision Exam"/> </concept> <concept> <code value="vision-glasses"/> <display value="Vision Glasses"/> <definition value="Frames and lenses"/> </concept> <concept> <code value="vision-contacts"/> <display value="Vision Contacts Coverage"/> <definition value="Contact Lenses"/> </concept> <concept> <code value="medical-primarycare"/> <display value="Medical Primary Health Coverage"/> <definition value="Medical Primary Health Coverage"/> </concept> <concept> <code value="pharmacy-dispense"/> <display value="Pharmacy Dispense Coverage"/> <definition value="Pharmacy Dispense Coverage"/> </concept> </CodeSystem>
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.