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

Codesystem-coverage-class.xml

Financial Management Work GroupMaturity Level: N/AStandards Status: Informative

Raw XML (canonical form + also see XML Format Specification)

Definition for Code System CoverageClassCodes

<?xml version="1.0" encoding="UTF-8"?>

<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="coverage-class"/> 
  <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/coverage-class 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">group
            <a name="coverage-class-group"> </a> 
          </td> 
          <td> Group</td> 
          <td> An employee group</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">subgroup
            <a name="coverage-class-subgroup"> </a> 
          </td> 
          <td> SubGroup</td> 
          <td> A sub-group of an employee group</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">plan
            <a name="coverage-class-plan"> </a> 
          </td> 
          <td> Plan</td> 
          <td> A specific suite of benefits.</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">subplan
            <a name="coverage-class-subplan"> </a> 
          </td> 
          <td> SubPlan</td> 
          <td> A subset of a specific suite of benefits.</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">class
            <a name="coverage-class-class"> </a> 
          </td> 
          <td> Class</td> 
          <td> A class of benefits.</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">subclass
            <a name="coverage-class-subclass"> </a> 
          </td> 
          <td> SubClass</td> 
          <td> A subset of a class of benefits.</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">sequence
            <a name="coverage-class-sequence"> </a> 
          </td> 
          <td> Sequence</td> 
          <td> A sequence number associated with a short-term continuance of the coverage.</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">rxbin
            <a name="coverage-class-rxbin"> </a> 
          </td> 
          <td> RX BIN</td> 
          <td> Pharmacy benefit manager's Business Identification Number.</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">rxpcn
            <a name="coverage-class-rxpcn"> </a> 
          </td> 
          <td> RX PCN</td> 
          <td> A Pharmacy Benefit Manager specified Processor Control Number.</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">rxid
            <a name="coverage-class-rxid"> </a> 
          </td> 
          <td> RX Id</td> 
          <td> A Pharmacy Benefit Manager specified Member ID.</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">rxgroup
            <a name="coverage-class-rxgroup"> </a> 
          </td> 
          <td> RX Group</td> 
          <td> A Pharmacy Benefit Manager specified Group number.</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/coverage-class"/> 
  <identifier> 
    <system value="urn:ietf:rfc:3986"/> 
    <value value="urn:oid:2.16.840.1.113883.4.642.1.1147"/> 
  </identifier> 
  <version value="4.1.0"/> 
  <name value="CoverageClassCodes"/> 
  <title value="Coverage Class Codes"/> 
  <status value="draft"/> 
  <publisher value="Financial Management"/> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://hl7.org/fhir"/> 
    </telecom> 
  </contact> 
  <description value="This value set includes Coverage Class codes."/> 
  <copyright value="HL7 Inc."/> 
  <caseSensitive value="true"/> 
  <content value="complete"/> 
  <concept> 
    <code value="group"/> 
    <display value="Group"/> 
    <definition value="An employee group"/> 
  </concept> 
  <concept> 
    <code value="subgroup"/> 
    <display value="SubGroup"/> 
    <definition value="A sub-group of an employee group"/> 
  </concept> 
  <concept> 
    <code value="plan"/> 
    <display value="Plan"/> 
    <definition value="A specific suite of benefits."/> 
  </concept> 
  <concept> 
    <code value="subplan"/> 
    <display value="SubPlan"/> 
    <definition value="A subset of a specific suite of benefits."/> 
  </concept> 
  <concept> 
    <code value="class"/> 
    <display value="Class"/> 
    <definition value="A class of benefits."/> 
  </concept> 
  <concept> 
    <code value="subclass"/> 
    <display value="SubClass"/> 
    <definition value="A subset of a class of benefits."/> 
  </concept> 
  <concept> 
    <code value="sequence"/> 
    <display value="Sequence"/> 
    <definition value="A sequence number associated with a short-term continuance of the coverage."/> 
  </concept> 
  <concept> 
    <code value="rxbin"/> 
    <display value="RX BIN"/> 
    <definition value="Pharmacy benefit manager's Business Identification Number."/> 
  </concept> 
  <concept> 
    <code value="rxpcn"/> 
    <display value="RX PCN"/> 
    <definition value="A Pharmacy Benefit Manager specified Processor Control Number."/> 
  </concept> 
  <concept> 
    <code value="rxid"/> 
    <display value="RX Id"/> 
    <definition value="A Pharmacy Benefit Manager specified Member ID."/> 
  </concept> 
  <concept> 
    <code value="rxgroup"/> 
    <display value="RX Group"/> 
    <definition value="A Pharmacy Benefit Manager specified Group number."/> 
  </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.