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-copay-type.xml

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

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

Definition for Code System CoverageCoPayTypeCodes

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

<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="coverage-copay-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/coverage-copay-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">gpvisit
            <a name="coverage-copay-type-gpvisit"> </a> 
          </td> 
          <td> GP Office Visit</td> 
          <td> An office visit for a general practitioner of a discipline.</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">spvisit
            <a name="coverage-copay-type-spvisit"> </a> 
          </td> 
          <td> Specialist Office Visit</td> 
          <td> An office visit for a specialist practitioner of a discipline</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">emergency
            <a name="coverage-copay-type-emergency"> </a> 
          </td> 
          <td> Emergency</td> 
          <td> An episode in an emergency department.</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">inpthosp
            <a name="coverage-copay-type-inpthosp"> </a> 
          </td> 
          <td> Inpatient Hospital</td> 
          <td> An episode of an Inpatient hospital stay.</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">televisit
            <a name="coverage-copay-type-televisit"> </a> 
          </td> 
          <td> Tele-visit</td> 
          <td> A visit held where the patient is remote relative to the practitioner, e.g. by phone,
             computer or video conference.</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">urgentcare
            <a name="coverage-copay-type-urgentcare"> </a> 
          </td> 
          <td> Urgent Care</td> 
          <td> A visit to an urgent care facility - typically a community care clinic.</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">copaypct
            <a name="coverage-copay-type-copaypct"> </a> 
          </td> 
          <td> Copay Percentage</td> 
          <td> A standard percentage applied to all classes or service or product not otherwise specified.</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">copay
            <a name="coverage-copay-type-copay"> </a> 
          </td> 
          <td> Copay Amount</td> 
          <td> A standard fixed currency amount applied to all classes or service or product not otherwise
             specified.</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">deductible
            <a name="coverage-copay-type-deductible"> </a> 
          </td> 
          <td> Deductible</td> 
          <td> The accumulated amount of patient payment before the coverage begins to pay for services.</td> 
        </tr> 
        <tr> 
          <td style="white-space:nowrap">maxoutofpocket
            <a name="coverage-copay-type-maxoutofpocket"> </a> 
          </td> 
          <td> Maximum out of pocket</td> 
          <td> The maximum amout of payment for services which a patient, or family, is expected to incur
             - typically annually.</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-copay-type"/> 
  <identifier> 
    <system value="urn:ietf:rfc:3986"/> 
    <value value="urn:oid:2.16.840.1.113883.4.642.1.1149"/> 
  </identifier> 
  <version value="4.1.0"/> 
  <name value="CoverageCoPayTypeCodes"/> 
  <title value="Coverage CoPay Type Codes"/> 
  <status value="draft"/> 
  <publisher value="Financial Management"/> 
  <contact> 
    <telecom> 
      <system value="url"/> 
      <value value="http://hl7.org/fhir"/> 
    </telecom> 
  </contact> 
  <description value="This codeset includes Coverage Copayment Type codes."/> 
  <copyright value="HL7 Inc."/> 
  <caseSensitive value="true"/> 
  <content value="complete"/> 
  <concept> 
    <code value="gpvisit"/> 
    <display value="GP Office Visit"/> 
    <definition value="An office visit for a general practitioner of a discipline."/> 
  </concept> 
  <concept> 
    <code value="spvisit"/> 
    <display value="Specialist Office Visit"/> 
    <definition value="An office visit for a specialist practitioner of a discipline"/> 
  </concept> 
  <concept> 
    <code value="emergency"/> 
    <display value="Emergency"/> 
    <definition value="An episode in an emergency department."/> 
  </concept> 
  <concept> 
    <code value="inpthosp"/> 
    <display value="Inpatient Hospital"/> 
    <definition value="An episode of an Inpatient hospital stay."/> 
  </concept> 
  <concept> 
    <code value="televisit"/> 
    <display value="Tele-visit"/> 
    <definition value="A visit held where the patient is remote relative to the practitioner, e.g. by phone,
     computer or video conference."/> 
  </concept> 
  <concept> 
    <code value="urgentcare"/> 
    <display value="Urgent Care"/> 
    <definition value="A visit to an urgent care facility - typically a community care clinic."/> 
  </concept> 
  <concept> 
    <code value="copaypct"/> 
    <display value="Copay Percentage"/> 
    <definition value="A standard percentage applied to all classes or service or product not otherwise specified."/> 
  </concept> 
  <concept> 
    <code value="copay"/> 
    <display value="Copay Amount"/> 
    <definition value="A standard fixed currency amount applied to all classes or service or product not otherwise
     specified."/> 
  </concept> 
  <concept> 
    <code value="deductible"/> 
    <display value="Deductible"/> 
    <definition value="The accumulated amount of patient payment before the coverage begins to pay for services."/> 
  </concept> 
  <concept> 
    <code value="maxoutofpocket"/> 
    <display value="Maximum out of pocket"/> 
    <definition value="The maximum amout of payment for services which a patient, or family, is expected to incur
     - typically annually."/> 
  </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.