Release 4B Ballot #1

This page is part of the FHIR Specification (v4.1.0: Release 4B 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: R4B R4 R3

Codesystem-benefit-type.xml

Financial Management Work GroupMaturity Level: N/AStandards 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="2021-03-11T17:06:20.662+11:00"/> 
    <profile value="http://hl7.org/fhir/StructureDefinition/shareablecodesystem"/> 
  </meta> 
  <text> 
    <status value="generated"/> 
    <div xmlns="http://www.w3.org/1999/xhtml">
      <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> 
  <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="4.1.0"/> 
  <name value="BenefitTypeCodes"/> 
  <title value="Benefit Type Codes"/> 
  <status value="draft"/> 
  <experimental value="false"/> 
  <description value="This value set includes a smattering of Benefit type codes."/> 
  <copyright value="This is an example set."/> 
  <caseSensitive value="true"/> 
  <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.