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1.14.4.1.111 v3 Code System RoleCode

This code system (http://hl7.org/fhir/v3/RoleCode) is defined as part of HL7 v3.

Formal value Set definition (identifier http://hl7.org/fhir/v3/vs/RoleCode): XML or JSON

Release Date: 2014-08-07

1.14.4.1.111.1 Description

A set of codes further specifying the kind of Role; specific classification codes for further qualifying RoleClass codes.

LevelCodeDisplayDefinition
1(_AffiliationRoleType)  Concepts characterizing the type of association formed by player and scoper when there is a recognized Affiliate role by which the two parties are related.
Examples: Business Partner, Business Associate, Colleague
2  (_CoverageSponsorRoleType)  Description:Codes that indicate a specific type of sponsor. Used when the sponsor's role is only either as a fully insured sponsor or only as a self-insured sponsor. NOTE: Where a sponsor may be either, use the SponsorParticipationFunction.code (fully insured or self insured) to indicate the type of responsibility. (CO6-0057)
3    FULLINS Fully insured coverage sponsor Description:An employer or organization that contracts with an underwriter to assumes the financial risk and administrative responsibility for coverage of health services for covered parties.
3    SELFINS Self insured coverage sponsor Description:An employer or organization that assumes the financial risk and administrative responsibility for coverage of health services for covered parties.
2  (_PayorRoleType)  Description:PayorRoleType for a particular type of policy or program benefit package or plan where more detail about the coverage administration role of the Payor is required. The functions performed by a Payor qualified by a PayorRoleType may be specified by the PayorParticpationFunction value set.
Examples:A Payor that is a TPA may administer a managed care plan without underwriting the risk.
3    ENROLBKR Enrollment Broker Description:A payor that is responsible for functions related to the enrollment of covered parties.
3    TPA Third party administrator Description:Third party administrator (TPA) is a payor organization that processes health care claims without carrying insurance risk. Third party administrators are prominent players in the managed care industry and have the expertise and capability to administer all or a portion of the claims process. They are normally contracted by a health insurer or self-insuring companies to administer services, including claims administration, premium collection, enrollment and other administrative activities.
Self-insured employers often contract with third party administrator to handle their insurance functions. Insurance companies oftentimes outsource the claims, utilization review or membership functions to a TPA. Sometimes TPAs only manage provider networks, only claims or only utilization review.
While some third-party administrators may operate as units of insurance companies, they are often independent. However, hospitals or provider organizations desiring to set up their own health plans will often outsource certain responsibilities to TPAs. TPAs may perform one or several payor functions, specified by the PayorParticipationFunction value set, such as provider management, enrollment, utilization management, and fee for service claims adjudication management.
3    UMO Utilization management organization Description:A payor that is responsible for review and case management of health services covered under a policy or program.
2  RESPRSN responsible party The role played by a party who has legal responsibility for another party.
3    EXCEST executor of estate The role played by a person acting as the estate executor for a deceased subscriber or policyholder who was the responsible party
3    GUADLTM guardian ad lidem The role played by a person appointed by the court to look out for the best interests of a minor child during the course of legal proceedings.
3    GUARD guardian The role played by a person or institution legally empowered with responsibility for the care of a ward.
3    POWATT power of attorney A relationship between two people in which one person authorizes another to act for him in a manner which is a legally binding upon the person giving such authority as if he or she personally were to do the acts.
4      DPOWATT durable power of attorney A relationship between two people in which one person authorizes another, usually a family member or relative, to act for him or her in a manner which is a legally binding upon the person giving such authority as if he or she personally were to do the acts that is often limited in the kinds of powers that can be assigned. Unlike ordinary powers of attorney, durable powers can survive for long periods of time, and again, unlike standard powers of attorney, durable powers can continue after incompetency.
4      HPOWATT healthcare power of attorney A relationship between two people in which one person authorizes another to act for him or her in a manner which is a legally binding upon the person giving such authority as if he or she personally were to do the acts that continues (by its terms) to be effective even though the grantor has become mentally incompetent after signing the document.
4      SPOWATT special power of attorney A relationship between two people in which one person authorizes another to act for him or her in a manner which is a legally binding upon the person giving such authority as if he or she personally were to do the acts that is often limited in the kinds of powers that can be assigned.
1(_AssignedRoleType) 
2  (_AssignedNonPersonLivingSubjectRoleType)  Description:A role type that is used to further qualify a non-person subject playing a role where the role class attribute is set to RoleClass AssignedEntity
3    ASSIST Assistive non-person living subject Description:Dogs trained to assist the ill or physically challenged.
3    BIOTH Biotherapeutic non-person living subject Description:Animals, including fish and insects, and microorganisms which may participate as assigned entities in biotherapies.
4      ANTIBIOT Antibiotic Description:Non-person living subject used as antibiotic.
Examples:Bacteriophage, is a virus that infects bacteria.
4      DEBR Debridement Description:Maggots raised for biodebridement.
Discussion: Maggot Debridement Therapy is the medical use of live maggots for cleaning non-healing wounds.
Examples:Removal of burnt skin.
3    CCO Clinical Companion Description:Companion animals, such as dogs, cats, and rabbits, which may be provided to patients to improve general mood, decrease depression and loneliness, and distract from stress-inducing concerns to improve quality of life.
3    SEE Seeing Description:Dogs trained to assist persons who are seeing impaired or blind.
3    SNIFF Sniffing Description:Dogs trained or having the ability to detect imminent seizures or cancers in humans, probably as a result of volatile chemical (odors) given off by the malignancy of the host.
1_CitizenRoleType CitizenRoleType A role type used to qualify a person's legal status within a country or nation.
2  CAS asylum seeker A person who has fled his or her home country to find a safe place elsewhere.
3    CASM single minor asylum seeker A person who is someone of below legal age who has fled his or her home country, without his or her parents, to find a safe place elsewhere at time of categorization.
2  CN national A person who is legally recognized as a member of a nation or country, with associated rights and obligations.
2  CNRP non-country member without residence permit A foreigner who is present in a country (which is foreign to him/her) unlawfully or without the country's authorization (may be called an illegal alien).
3    CNRPM non-country member minor without residence permit A person who is below legal age present in a country, without his or her parents, (which is foreign to him/her) unlawfully or without the country's authorization.
2  CPCA permit card applicant A non-country member admitted to the territory of a nation or country as a non-resident for an explicit purpose.
2  CRP non-country member with residence permit A foreigner who is a resident of the country but does not have citizenship.
3    CRPM non-country member minor with residence permit A person who is a resident below legal age of the country without his or her parents and does not have citizenship.
1(_ContactRoleType)  Types of contact for Role code "CON"
2  (_AdministrativeContactRoleType)  A contact role used for business and/or administrative purposes.
3    BILL Billing Contact A contact role used to identify a person within a Provider organization that can be contacted for billing purposes (e.g. about the content of the Invoice).
3    ORG organizational contact A contact for an organization for administrative purposes. Contact role specifies a person acting as a liason for the organization.
Example: HR Department representative.
3    PAYOR Payor Contact A contact role used to identify a person within a Payor organization to whom this communication is addressed.
2  ECON Deprecatedemergency contact A contact designated for contact in emergent situations.
2  NOK Deprecatednext of kin Played by an individual who is designated as the next of kin for another individual which scopes the role.
1(_IdentifiedEntityType)  Definition: A code representing the type of identifier that has been assigned to the identified entity (IDENT).
Examples: Example values include Social Insurance Number, Product Catalog ID, Product Model Number.
2  (_LocationIdentifiedEntityRoleCode)  Description:Describes types of identifiers other than the primary location registry identifier for a service delivery location. Identifiers may be assigned by a local service delivery organization, a formal body capable of accrediting the location for the capability to provide specific services or the identifier may be assigned at a jurisdictional level.
3    ACHFID accreditation location identifier Description:Identifier assigned to a location by the organization responsible for accrediting the location.
3    JURID jurisdiction location identifier Description:Identifier assigned to a location by a jurisdiction.
3    LOCHFID local location identifier Description:Identifier assigned to a location by a local party (which could be the facility itself or organization overseeing a group of facilities).
1(_LivingSubjectProductionClass)  Code indicating the primary use for which a living subject is bred or grown
2  BF Beef Cattle used for meat production
2  BL Broiler Chickens raised for meat
2  BR Breeder Breeding/genetic stock
2  CO Companion Companion animals
2  DA Dairy Milk production
2  DR Draft Draft animals
2  DU Dual Dual purpose. Defined purposes based on species and breed
2  FI Fiber Animals raised for their fur, hair or skins
2  LY Layer Chickens raised for egg production
2  MT Meat Animals raised for meat production
2  MU Multiplier Poultry flocks used for chick/poult production
2  PL Pleasure Animals rasied for recreation
2  RC Racing Animals raised for racing perfomance
2  SH Show Animals raised for shows
2  VL Veal Cattle raised for veal meat production. Implicit is the husbandry method.
2  WL Wool Sheep, goats and other mammals raised for their fiber
2  WO Working Animals used to perform work
1(_MedicationGeneralizationRoleType)  Identifies the specific hierarchical relationship between the playing and scoping medications.
Examples: Generic, Generic Formulation, Therapeutic Class, etc.
2  DC therapeutic class Description:A categorization of medicinal products by their therapeutic properties and/or main therapeutic use.
2  GD generic drug Relates a manufactured drug product to the non-proprietary (generic) representation of its ingredients independent of strength, and form.
The scoping entity identifies a unique combination of medicine ingredients; sometimes referred to as "ingredient set".
3    GDF generic drug form Relates a manufactured drug product to the non-proprietary (generic) representation of its ingredients and dose form, independent of strength of the ingredients. The scoping entity identifies a unique combination of medicine ingredients in a specific dose form.
3    GDS generic drug strength Relates a manufactured drug product to the non-proprietary (generic) representation of is ingredients with their strength. The scoping entity identifies a unique combination of medicine ingredients with their strength.
3    GDSF generic drug strength form Relates a manufactured drug product to the non-proprietary (generic) representation of its ingredients with their strength in a specific dose form. The scoping entity identifies a unique combination of medicine ingredients with their strength in a single dose form.
2  MGDSF manufactured drug strength form Relates a manufactured drug product to the non-proprietary (generic) representation of its ingredients with their strength in a specific dose form. The scoping entity identifies a unique combination of medicine ingredients with their strength in a single dose form.
1(_MemberRoleType)  Types of membership for Role code "MBR"
2  TRB Tribal Member A person who is a member of a tribe.
1(_PersonalRelationshipRoleType) 
2  FAMMEMB family member A relationship between two people characterizing their "familial" relationship
3    CHILD child The player of the role is a child of the scoping entity.
4      CHLDADOPT adopted child The player of the role is a child taken into a family through legal means and raised by the scoping person (parent) as his or her own child.
5        DAUADOPT adopted daughter The player of the role is a female child taken into a family through legal means and raised by the scoping person (parent) as his or her own child.
5        SONADOPT adopted son The player of the role is a male child taken into a family through legal means and raised by the scoping person (parent) as his or her own child.
4      CHLDFOST foster child The player of the role is a child receiving parental care and nurture from the scoping person (parent) but not related to him or her through legal or blood ties.
5        DAUFOST foster daughter The player of the role is a female child receiving parental care and nurture from the scoping person (parent) but not related to him or her through legal or blood ties.
5        SONFOST foster son The player of the role is a male child receiving parental care and nurture from the scoping person (parent) but not related to him or her through legal or blood ties.
4      DAUC daughter Description: The player of the role is a female child (of any type) of scoping entity (parent)
5        DAUADOPT
5        DAUFOST
5        DAU natural daughter The player of the role is a female offspring of the scoping entity (parent).
5        STPDAU stepdaughter The player of the role is a daughter of the scoping person's spouse by a previous union.
4      NCHILD natural child The player of the role is an offspring of the scoping entity as determined by birth.
5        DAU
5        SON natural son The player of the role is a male offspring of the scoping entity (parent).
4      SONC son Description: The player of the role is a male child (of any type) of scoping entity (parent)
5        SONADOPT
5        SONFOST
5        SON
5        STPSON stepson The player of the role is a son of the scoping person's spouse by a previous union.
4      STPCHLD step child The player of the role is a child of the scoping person's spouse by a previous union.
5        STPDAU
5        STPSON
3    EXT extended family member Description: A family member not having an immediate genetic or legal relationship e.g. Aunt, cousin, great grandparent, grandchild, grandparent, niece, nephew or uncle.
4      AUNT aunt The player of the role is a sister of the scoping person's mother or father.
5        MAUNT maternal aunt Description:The player of the role is a biological sister of the scoping person's biological mother.
5        PAUNT paternal aunt Description:The player of the role is a biological sister of the scoping person's biological father.
4      COUSN cousin The player of the role is a relative of the scoping person descended from a common ancestor, such as a grandparent, by two or more steps in a diverging line.
5        MCOUSN maternal cousin Description:The player of the role is a biological relative of the scoping person descended from a common ancestor on the player's mother's side, such as a grandparent, by two or more steps in a diverging line.
5        PCOUSN paternal cousin Description:The player of the role is a biological relative of the scoping person descended from a common ancestor on the player's father's side, such as a grandparent, by two or more steps in a diverging line.
4      GGRPRN great grandparent The player of the role is a parent of the scoping person's grandparent.
5        GGRFTH great grandfather The player of the role is the father of the scoping person's grandparent.
6          MGGRFTH maternal great-grandfather Description:The player of the role is the biological father of the scoping person's biological mother's parent.
6          PGGRFTH paternal great-grandfather Description:The player of the role is the biological father of the scoping person's biological father's parent.
5        GGRMTH great grandmother The player of the role is the mother of the scoping person's grandparent.
6          MGGRMTH maternal great-grandmother Description:The player of the role is the biological mother of the scoping person's biological mother's parent.
6          PGGRMTH paternal great-grandmother Description:The player of the role is the biological mother of the scoping person's biological father's parent.
5        MGGRPRN maternal great-grandparent Description:The player of the role is a biological parent of the scoping person's biological mother's parent.
6          MGGRFTH
6          MGGRMTH
5        PGGRPRN paternal great-grandparent Description:The player of the role is a biological parent of the scoping person's biological father's parent.
6          PGGRFTH
6          PGGRMTH
4      GRNDCHILD grandchild The player of the role is a child of the scoping person's son or daughter.
5        GRNDDAU granddaughter The player of the role is a daughter of the scoping person's son or daughter.
5        GRNDSON grandson The player of the role is a son of the scoping person's son or daughter.
4      GRPRN grandparent The player of the role is a parent of the scoping person's mother or father.
5        GRFTH grandfather The player of the role is the father of the scoping person's mother or father.
6          MGRFTH maternal grandfather Description:The player of the role is the biological father of the scoping person's biological mother.
6          PGRFTH paternal grandfather Description:The player of the role is the biological father of the scoping person's biological father.
5        GRMTH grandmother The player of the role is the mother of the scoping person's mother or father.
6          MGRMTH maternal grandmother Description:The player of the role is the biological mother of the scoping person's biological mother.
6          PGRMTH paternal grandmother Description:The player of the role is the biological mother of the scoping person's biological father.
5        MGRPRN maternal grandparent Description:The player of the role is the biological parent of the scoping person's biological mother.
6          MGRFTH
6          MGRMTH
5        PGRPRN paternal grandparent Description:The player of the role is the biological parent of the scoping person's biological father.
6          PGRFTH
6          PGRMTH
4      INLAW inlaw A relationship between an individual and a member of their spousal partner's immediate family.
5        CHLDINLAW child-in-law The player of the role is the spouse of scoping person's child.
6          DAUINLAW daughter in-law The player of the role is the wife of scoping person's son.
6          SONINLAW son in-law The player of the role is the husband of scoping person's daughter.
5        PRNINLAW parent in-law The player of the role is the parent of scoping person's husband or wife.
6          FTHINLAW father-in-law The player of the role is the father of the scoping person's husband or wife.
6          MTHINLAW mother-in-law The player of the role is the mother of the scoping person's husband or wife.
5        SIBINLAW sibling in-law The player of the role is: (1) a sibling of the scoping person's spouse, or (2) the spouse of the scoping person's sibling, or (3) the spouse of a sibling of the scoping person's spouse.
6          BROINLAW brother-in-law The player of the role is: (1) a brother of the scoping person's spouse, or (2) the husband of the scoping person's sister, or (3) the husband of a sister of the scoping person's spouse.
6          SISINLAW sister-in-law The player of the role is: (1) a sister of the scoping person's spouse, or (2) the wife of the scoping person's brother, or (3) the wife of a brother of the scoping person's spouse.
4      NIENEPH niece/nephew The player of the role is a child of scoping person's brother or sister or of the brother or sister of the scoping person's spouse.
5        NEPHEW nephew The player of the role is a son of the scoping person's brother or sister or of the brother or sister of the scoping person's spouse.
5        NIECE niece The player of the role is a daughter of the scoping person's brother or sister or of the brother or sister of the scoping person's spouse.
4      UNCLE uncle The player of the role is a brother of the scoping person's mother or father.
5        MUNCLE maternal uncle Description:The player of the role is a biological brother of the scoping person's biological mother.
5        PUNCLE paternal uncle Description:The player of the role is a biological brother of the scoping person's biological father.
3    PRN parent The player of the role is one who begets, gives birth to, or nurtures and raises the scoping entity (child).
4      ADOPTP adoptive parent The player of the role (parent) has taken the scoper (child) into their family through legal means and raises them as his or her own child.
5        ADOPTF adoptive father The player of the role (father) is a male who has taken the scoper (child) into their family through legal means and raises them as his own child.
5        ADOPTM adoptive mother The player of the role (father) is a female who has taken the scoper (child) into their family through legal means and raises them as her own child.
4      FTH father The player of the role is a male who begets or raises or nurtures the scoping entity (child).
5        ADOPTF
5        FTHFOST foster father The player of the role (parent) who is a male state-certified caregiver responsible for the scoper (child) who has been placed in the parent's care. The placement of the child is usually arranged through the government or a social-service agency, and temporary.
The state, via a jurisdiction recognized child protection agency, stands as in loco parentis to the child, making all legal decisions while the foster parent is responsible for the day-to-day care of the specified child.
5        NFTH natural father The player of the role is a male who begets the scoping entity (child).
6          NFTHF natural father of fetus Indicates the biologic male parent of a fetus.
5        STPFTH stepfather The player of the role is the husband of scoping person's mother and not the scoping person's natural father.
4      MTH mother The player of the role is a female who conceives, gives birth to, or raises and nurtures the scoping entity (child).
5        ADOPTM
5        GESTM gestational mother The player is a female whose womb carries the fetus of the scoper. Generally used when the gestational mother and natural mother are not the same.
5        MTHFOST foster mother The player of the role (parent) who is a female state-certified caregiver responsible for the scoper (child) who has been placed in the parent's care. The placement of the child is usually arranged through the government or a social-service agency, and temporary.
The state, via a jurisdiction recognized child protection agency, stands as in loco parentis to the child, making all legal decisions while the foster parent is responsible for the day-to-day care of the specified child.
5        NMTH natural mother The player of the role is a female who conceives or gives birth to the scoping entity (child).
6          NMTHF natural mother of fetus The player is the biologic female parent of the scoping fetus.
5        STPMTH stepmother The player of the role is the wife of scoping person's father and not the scoping person's natural mother.
4      NPRN natural parent
5        NFTH
5        NMTH
4      PRNFOST foster parent The player of the role (parent) who is a state-certified caregiver responsible for the scoper (child) who has been placed in the parent's care. The placement of the child is usually arranged through the government or a social-service agency, and temporary.
The state, via a jurisdiction recognized child protection agency, stands as in loco parentis to the child, making all legal decisions while the foster parent is responsible for the day-to-day care of the specified child.
5        FTHFOST
5        MTHFOST
4      STPPRN step parent The player of the role is the spouse of the scoping person's parent and not the scoping person's natural parent.
5        STPFTH
5        STPMTH
3    SIB sibling The player of the role shares one or both parents in common with the scoping entity.
4      BRO brother The player of the role is a male sharing one or both parents in common with the scoping entity.
5        HBRO half-brother The player of the role is a male related to the scoping entity by sharing only one biological parent.
5        NBRO natural brother The player of the role is a male having the same biological parents as the scoping entity.
6          TWINBRO twin brother The scoper was carried in the same womb as the male player and shares common biological parents.
7            FTWINBRO fraternal twin brother The scoper was carried in the same womb as the male player and shares common biological parents but is the product of a distinct egg/sperm pair.
7            ITWINBRO identical twin brother The male scoper is an offspring of the same egg-sperm pair as the male player.
5        STPBRO stepbrother The player of the role is a son of the scoping person's stepparent.
4      HSIB half-sibling The player of the role is related to the scoping entity by sharing only one biological parent.
5        HBRO
5        HSIS half-sister The player of the role is a female related to the scoping entity by sharing only one biological parent.
4      NSIB natural sibling The player of the role has both biological parents in common with the scoping entity.
5        NBRO
5        NSIS natural sister The player of the role is a female having the same biological parents as the scoping entity.
6          TWINSIS twin sister The scoper was carried in the same womb as the female player and shares common biological parents.
7            FTWINSIS fraternal twin sister The scoper was carried in the same womb as the female player and shares common biological parents but is the product of a distinct egg/sperm pair.
7            ITWINSIS identical twin sister The female scoper is an offspring of the same egg-sperm pair as the female player.
5        TWIN twin The scoper and player were carried in the same womb and shared common biological parents.
6          TWINBRO
6          TWINSIS
6          FTWIN fraternal twin The scoper and player were carried in the same womb and share common biological parents but are the product of distinct egg/sperm pairs.
7            FTWINBRO
7            FTWINSIS
6          ITWIN identical twin The scoper and player are offspring of the same egg-sperm pair.
7            ITWINBRO
7            ITWINSIS
4      SIS sister The player of the role is a female sharing one or both parents in common with the scoping entity.
5        HSIS
5        NSIS
5        STPSIS stepsister The player of the role is a daughter of the scoping person's stepparent.
4      STPSIB step sibling The player of the role is a child of the scoping person's stepparent.
5        STPBRO
5        STPSIS
3    SIGOTHR significant other A person who is important to one's well being; especially a spouse or one in a similar relationship. (The player is the one who is important)
4      DOMPART domestic partner The player of the role cohabits with the scoping person but is not the scoping person's spouse.
4      SPS spouse The player of the role is a marriage partner of the scoping person.
5        HUSB husband The player of the role is a man joined to a woman (scoping person) in marriage.
5        WIFE wife The player of the role is a woman joined to a man (scoping person) in marriage.
2  FRND unrelated friend The player of the role is a person who is known, liked, and trusted by the scoping person.
2  NBOR neighbor The player of the role lives near or next to the scoping person.
2  ONESELF self The relationship that a person has with his or her self.
2  ROOM Roommate One who shares living quarters with the subject.
1(_PolicyOrProgramCoverageRoleType)  Description: A role recognized through the eligibility of an identified party for benefits covered under an insurance policy or a program based on meeting eligibility criteria.
Eligibility as a covered party may be conditioned on the party meeting criteria to qualify for coverage under a policy or program, which may be mandated by law. These criteria may be:
The sole basis for coverage, e.g., being differently abled may qualify a person for disability coverage
May more fully qualify a covered party role e.g, being differently abled may qualify an adult child as a dependent
May impact the level of coverage for a covered party under a policy or program, e.g., being differently abled may qualify a program eligible for additional benefits.
Discussion: The Abstract Value Set "CoverageRoleType", which was developed for use in the Canadian realm "pre-coordinate" coverage roles with other roles that a covered party must play in order to be eligible for coverage, e.g., "handicapped dependent". These role.codes may only be used with COVPTY to avoid overlapping concepts that would result from using them to specify the specializations of COVPTY, e.g., the role.class DEPEN should not be used with the role.code family dependent because that relationship has overlapping concepts due to the role.code precoodination and is conveyed in FICO with the personal relationship role that has a PART role link to the covered party role. For the same reasons, the role.class DEPEN should not be used with the role.code HANDIC (handicapped dependent); the role.code DIFFABLE (differently abled) should be used instead.
In summary, the coded concepts in the Abstract Value Set "CoveredPartyRoleType" can be "post-coordinated" with the "RoleClassCoveredParty" Abstract Value Set. Decoupling these concepts is intended to support an expansive range of covered party concepts and their semantic comparability.
2  (_CoverageRoleType)  Role recognized through the issuance of insurance coverage to an identified covered party who has this relationship with the policy holder such as the policy holder themselves (self), spouse, child, etc
3    FAMDEP family dependent The player of the role is dependent of the scoping entity.
3    HANDIC handicapped dependent Covered party is a dependent of the policy holder with a physical or mental disability causing a disadvantage that makes independent achievement unusually difficult.
3    INJ injured plaintiff Covered party is an injured party with a legal claim for compensation against a policy holder under an insurance policy.
3    SELF self Covered party is the policy holder. Also known as the subscriber.
3    SPON sponsored dependent Covered party is an individual that the policy holder has assumed responsibility for, such as foster child or legal ward.
3    STUD student Covered party to an insurance policy has coverage through full-time or part-time attendance at a recognized educational institution as defined by a particular insurance policy.
4      FSTUD full-time student Covered party to an insurance policy has coverage through full-time attendance at a recognized educational institution as defined by a particular insurance policy.
4      PSTUD part-time student Covered party to an insurance policy has coverage through part-time attendance at a recognized educational institution as defined by a particular insurance policy.
2  (_CoveredPartyRoleType)  A role recognized through the eligibility of an identified living subject for benefits covered under an insurance policy or a program. Eligibility as a covered party may be conditioned on a relationship with (1) the policy holder such as the policy holder who is covered as an individual under a poliy or as a party sponsored for coverage by the policy holder.
Example:An employee as a subscriber; or (2) on being scoped another covered party such as the subscriber, as in the case of a dependent.
Discussion: The Abstract Value Set "CoverageRoleType", which was developed for use in the Canadian realm "pre-coordinate" coverage roles with other roles that a covered party must play in order to be eligible for coverage, e.g., "handicapped dependent". Other codes in the Abstract Value Set CoveredPartyRoleType domain can be "post-coordinated" with the EligiblePartyRoleType codes to denote comparable concepts. Decoupling the concepts is intended to support a wider range of concepts and semantic comparability of coded concepts.
3    (_ClaimantCoveredPartyRoleType)  DescriptionA role recognized through the eligibility of a party play a claimant for benefits covered or provided under an insurance policy.
4      CRIMEVIC crime victim Description: A person playing the role of program eligible under a program based on allegations of being the victim of a crime.
Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is "program eligible" and the person's status as a crime victim meets jurisdictional or program criteria.
4      INJWKR injured worker Description: A person playing the role of program eligible under a workers compensation program based on the filing of work-related injury claim.
Discussion: This CoveredPartyRoleType.code is used when the CoveredPartyRole class code is either "program eligible", a "named insured", and "individual insured", or "dependent", and the person's status as differently abled or "handicapped" meets jurisdictional, policy, or program criteria.
3    (_DependentCoveredPartyRoleType)  Description: A role recognized through the eligibility of a party to play a dependent for benefits covered or provided under a health insurance policy because of an association with the subscriber that is recognized by the policy underwriter.
4      COCBEN continuity of coverage beneficiary Description: A person playing the role of an individual insured with continuity of coverage under a policy which is being terminated based on loss of original status that was the basis for coverage. Criteria for qualifying for continuity of coverage may be set by law.
Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the person's status as a continuity of coverage beneficiary meets jurisdictional or policy criteria.
4      DIFFABL differently abled Description: A person playing the role of program eligible under a program based on meeting criteria for health or functional limitation set by law or by the program.
Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible", "named insured", "individual insured", or "dependent", and the person's status as differently abled meets jurisdictional, policy, or program criteria.
4      WARD ward Description: A person, who is a minor or is deemed incompetent, who plays the role of a program eligible where eligibility for coverage is based on meeting program eligibility criteria for status as a ward of a court or jurisdiction.
Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is a "claimant", "program eligible", a "named insured", an "individual Insured" or a "dependent", and the person's status as a ward meets program or policy criteria. In the case of a ward covered under a program providing financial or health benefits, a governmental agency may take temporary custody of a minor or incompetent for his/her protection and care, e.g., if the ward is suffering from neglect or abuse, or has been in trouble with the law.
3    (_IndividualInsuredPartyRoleType)  A role recognized through the eligibility of a party to play an individual insured for benefits covered or provided under an insurance policy where the party is also the policy holder.
4      COCBEN
4      RETIREE retiree Description: A person playing the role of an individual insured under a policy based on meeting criteria for the employment status of retired set by law or the policy.
Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the person's status as a retiree meets jurisdictional or policy criteria.
3    (_ProgramEligiblePartyRoleType)  Description:A role recognized through the eligibility of a party to play a program eligible for benefits covered or provided under a program.
4      CRIMEVIC
4      INJWKR
4      DIFFABL
4      WARD
4      INDIG member of an indigenous people Description: A person playing the role of program eligible under a program based on aboriginal ancestry or as a member of an aboriginal community.
Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is "program eligible" and the person's status as a member of an indigenous people meets jurisdictional or program criteria.
4      MIL military Definition: A person playing the role of program eligible under a program based on military status.
Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the person's status as a member of the military meets jurisdictional or program criteria
5        ACTMIL active duty military Description: A person playing the role of program eligible under a program based on active military status.
Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the persons status as active duty military meets jurisdictional or program criteria.
5        RETMIL retired military Description: A person playing the role of program eligible under a program based on retired military status.
Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the persons status as retired military meets jurisdictional or program criteria.
5        VET veteran Description: A person playing the role of program eligible under a program based on status as a military veteran.
Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the persons status as a veteran meets jurisdictional or program criteria.
3    (_SubscriberCoveredPartyRoleType)  Description: A role recognized through the eligibility of a party to play a subscriber for benefits covered or provided under a health insurance policy.
4      COCBEN
4      RETIREE
4      MIL
1(_ResearchSubjectRoleBasis)  Specifies the administrative functionality within a formal experimental design for which the ResearchSubject role was established. Examples: screening - role is used for pre-enrollment evaluation portion of the design; enrolled - role is used for subjects admitted to the active treatment portion of the design.
2  ERL enrollment Definition:The specific role being played by a research subject participating in the active treatment or primary data collection portion of a research study.
2  SCN screening Definition:The specific role being played by a research subject participating in the pre-enrollment evaluation portion of a research study.
1(_ServiceDeliveryLocationRoleType)  A role of a place that further classifies the setting (e.g., accident site, road side, work site, community location) in which services are delivered.
2  (_DedicatedServiceDeliveryLocationRoleType)  A role of a place that further classifies a setting that is intended to house the provision of services.
3    (_DedicatedClinicalLocationRoleType)  A role of a place that further classifies the clinical setting (e.g., cardiology clinic, primary care clinic, rehabilitation hospital, skilled nursing facility) in which care is delivered during an encounter.
4      DX Diagnostics or therapeutics unit A practice setting where diagnostic procedures or therapeutic interventions are performed
5        CVDX Cardiovascular diagnostics or therapeutics unit A practice setting where cardiovascular diagnostic procedures or therapeutic interventions are performed (e.g., cardiac catheterization lab, echocardiography suite)
6          CATH Cardiac catheterization lab
6          ECHO Echocardiography lab
5        GIDX Gastroenterology diagnostics or therapeutics lab A practice setting where GI procedures (such as endoscopies) are performed
6          ENDOS Endoscopy lab (X12N 261QD0000N)
5        RADDX Radiology diagnostics or therapeutics unit A practice setting where radiology services (diagnostic or therapeutic) are provided (X12N 261QR0200N)
6          RADO Radiation oncology unit (X12N 261QX0203N)
6          RNEU Neuroradiology unit
4      HOSP Hospital An acute care institution that provides medical, surgical, or psychiatric care and treatment for the sick or the injured.
5        CHR Chronic Care Facility (1) A hospital including a physical plant and personnel that provides multidisciplinary diagnosis and treatment for diseases that have one or more of the following characteristics: is permanent; leaves residual disability; is caused by nonreversible pathological alteration; requires special training of the patient for rehabilitation; and/or may be expected to require a long period of supervision or care. In addition, patients require the safety, security, and shelter of these specialized inpatient or partial hospitalization settings. (2) A hospital that provides medical and skilled nursing services to patients with long-term illnesses who are not in an acute phase but who require an intensity of services not available in nursing homes
5        GACH Hospitals; General Acute Care Hospital (X12N 282N00000N)
5        MHSP Military Hospital A health care facility operated by the Department of Defense or other military operation.
5        PSYCHF Psychatric Care Facility Healthcare facility that cares for patients with psychiatric illness(s).
5        RH Rehabilitation hospital (X12N 283X00000N)
6          RHAT addiction treatment center Description: A location that plays the role of delivering services which may include life training and/or social support to people with addictions.
6          RHII intellectual impairment center Description: A location that plays the role of delivering services which may include adaptation, rehabilitation and social integration services for people with intellectual and/or pervasive development disorders such as autism or severe behaviour disorder.
6          RHMAD parents with adjustment difficulties center Description: A location that plays the role of delivering services which may social support services for adolescents who are pregnant or have child and are experiencing adaptation issues/difficulties in their current or eventual parenting role.
6          RHPI physical impairment center Description: A location that plays the role of delivering services which may include adaptation, rehabilitation and social integration services for people with physical impairments.
7            RHPIH physical impairment - hearing center Description: A location that plays the role of delivering services for people with hearing impairments.
7            RHPIMS physical impairment - motor skills center Description: A location that plays the role of delivering services for people with motor skill impairments.
7            RHPIVS physical impairment - visual skills center Description: A location that plays the role of delivering services for people with visual skill impairments.
6          RHYAD youths with adjustment difficulties center Description: A location that plays the role of delivering services which may include life training and/or social support services for the adaption, rehabilitation and social integration of youths with adjustment difficulties.
4      HU Hospital unit
5        BMTU Bone marrow transplant unit
5        CCU Coronary care unit
5        CHEST Chest unit A specialty unit in hospital that focuses on chronic respirator patients and pulmonary failure
5        EPIL Epilepsy unit
5        ER Emergency room The section of a health care facility for providing rapid treatment to victims of sudden illness or trauma.
6          ETU Emergency trauma unit
5        HD Hemodialysis unit
5        HLAB hospital laboratory Description: A location that plays the role of delivering services which may include tests done based on clinical specimens to get health information about a patient as pertaining to the diagnosis, treatment and prevention of disease. Hospital laboratories may be further divided into specialized units such as Anatomic Pathology, Microbiology, and Biochemistry.
6          INLAB inpatient laboratory Description: A location that plays the role of delivering services which may include tests are done on clinical specimens to get health information about a patient pertaining to the diagnosis, treatment, and prevention of disease for a hospital visit longer than one day.
6          OUTLAB outpatient laboratory Description: A location that plays the role of delivering services which may include tests are done on clinical specimens to get health information about a patient pertaining to the diagnosis, treatment, and prevention of disease for same day visits.
5        HRAD radiology unit Description: A location that plays the role of delivering services which may include the branch of medicine that uses ionizing and non-ionizing radiation to diagnose and treat diseases. The radiology unit may be further divided into subspecialties such as Imaging, Cardiovascular, Thoracic, and Ultrasound.
5        HUSCS specimen collection site Description: A location that plays the role of delivering services which may include collecting specimens and/or samples from patients for laboratory testing purposes, but does not perform any tests or analysis functions.
5        ICU Intensive care unit
6          PEDICU Pediatric intensive care unit
7            PEDNICU Pediatric neonatal intensive care unit
5        INPHARM inpatient pharmacy Description: A location that plays the role of delivering services which may include providing judicious, safe, efficacious, appropriate and cost effective use of medicines for treatment of patients for visits longer than one day. The distinction between inpatient pharmacies and retail (or outpatient) pharmacies is that they are part of a patient's continuity of care while staying in the hospital.
5        MBL medical laboratory Description: A location that plays the role of delivering services which include biochemistry, hematology, microbiology, immunochemistry, and toxicology.
5        NCCS Neurology critical care and stroke unit
5        NS Neurosurgery unit
5        OUTPHARM outpatient pharmacy Description: A location that plays the role of delivering services which may include providing judicious, safe, efficacious, appropriate and cost effective use of medicines for treatment of patients for outpatient visits and may also be used for discharge prescriptions.
5        PEDU Pediatric unit
6          PEDICU
5        PHU Psychiatric hospital unit (X12N 273R00000N)
5        RHU Rehabilitation hospital unit
5        SLEEP Sleep disorders unit (X12N 261QA1200N)
4      NCCF Nursing or custodial care facility
5        SNF Skilled nursing facility (X12N 314000000N)
4      OF Outpatient facility
5        ALL Allergy clinic
5        AMPUT Amputee clinic
5        BMTC Bone marrow transplant clinic
5        BREAST Breast clinic
5        CANC Child and adolescent neurology clinic
5        CAPC Child and adolescent psychiatry clinic
5        CARD Ambulatory Health Care Facilities; Clinic/Center; Rehabilitation: Cardiac Facilities
6          PEDCARD Pediatric cardiology clinic
5        COAG Coagulation clinic
5        CRS Colon and rectal surgery clinic
5        DERM Dermatology clinic
5        ENDO Endocrinology clinic
6          PEDE Pediatric endocrinology clinic
5        ENT Otorhinolaryngology clinic
5        FMC Family medicine clinic
5        GI Gastroenterology clinic
6          PEDGI Pediatric gastroenterology clinic
5        GIM General internal medicine clinic
5        GYN Gynecology clinic
5        HEM Hematology clinic
6          PEDHEM Pediatric hematology clinic
5        HTN Hypertension clinic
5        IEC Impairment evaluation center Focuses on assessing disability
5        INFD Infectious disease clinic
6          PEDID Pediatric infectious disease clinic
5        INV Infertility clinic
5        LYMPH Lympedema clinic
5        MGEN Medical genetics clinic
5        NEPH Nephrology clinic
6          PEDNEPH Pediatric nephrology clinic
5        NEUR Neurology clinic
5        OB Obstetrics clinic
5        OMS Oral and maxillofacial surgery clinic
5        ONCL Medical oncology clinic
6          PEDHO Pediatric oncology clinic
5        OPH Opthalmology clinic
5        OPTC optometry clinic Description: A location that plays the role of delivering services which may include examination, diagnosis, treatment, management, and prevention of diseases and disorders of the eye as well as prescribing and fitting appropriate corrective lenses (glasses or contact lenses) as needed. Optometry clinics may also provide tests for visual field screening, measuring intra-ocular pressure and ophthalmoscopy, as and when required.
5        ORTHO Orthopedics clinic
6          HAND Hand clinic
5        PAINCL Pain clinic (X12N 261QP3300N)
5        PC Primary care clinic (X12N 261QP2300N)
5        PEDC Pediatrics clinic
6          PEDCARD
6          PEDE
6          PEDGI
6          PEDHEM
6          PEDID
6          PEDNEPH
6          PEDHO
6          PEDRHEUM Pediatric rheumatology clinic
5        POD Podiatry clinic (X12N 261QP1100N)
5        PREV Preventive medicine clinic
5        PROCTO Proctology clinic
5        PROFF Provider's Office Location where healthcare service was delivered, identified as the healthcare provider's practice office.
5        PROS Prosthodontics clinic
5        PSI Psychology clinic
5        PSY Psychiatry clinic
5        RHEUM Rheumatology clinic
6          PEDRHEUM
5        SPMED Sports medicine clinic
5        SU Surgery clinic
6          PLS Plastic surgery clinic
6          URO Urology clinic
5        TR Transplant clinic
5        TRAVEL Travel and geographic medicine clinic
5        WND Wound clinic
4      RTF Residential treatment facility
5        PRC Pain rehabilitation center
5        SURF Substance use rehabilitation facility (X12N 324500000N)
3    (_DedicatedNonClinicalLocationRoleType)  A role of a place that further classifies a setting that is intended to house the provision of non-clinical services.
4      DADDR Delivery Address Location address where medical supplies were transported to for use.
4      MOBL Mobile Unit Location (mobile) where healthcare service was delivered.
5        AMB Ambulance Location (mobile) where healthcare service was delivered, identified specifically as an ambulance.
4      PHARM Pharmacy Location where healthcare service was delivered, identified as a pharmacy.
5        INPHARM
5        OUTPHARM
2  (_IncidentalServiceDeliveryLocationRoleType) 
3    ACC accident site Location of an accident where healthcare service was delivered, such as a roadside.
3    COMM Community Location Community location where healthcare is delivered.
4      CSC community service center Description: A location that plays the role of delivering services which may include providing front-line services to the population of a defined geographic area such as: healthcare services and social services, preventive or curative, rehabilitation or reintegration.
3    PTRES Patient's Residence location where healthcare was delivered which is the residence of the Patient.
3    SCHOOL school Location where healthcare service was delivered, identified as a school or educational facility.
3    UPC underage protection center Description: A location that plays the role of delivering services which may include: social emergency services required for a young person as required under any jurisdictional youth laws, child placement, and family mediation in the defined geographical area the SDL is responsible for. It may provide expertise in a judiciary setting on child custody, adoption and biological history research.
3    WORK work site Location where healthcare service was delivered, identified as a work place.
1(_SpecimenRoleType) 
2  C Calibrator A specimen used for initial calibration settings of an instrument
2  G Group A set of patient samples in which the individuals of the group may or may not be identified.
2  L Pool Aliquots of individual specimens combined to form a single specimen representing all of the included individuals.
2  P Patient A specimen that has been collected from a patient.
2  Q Quality Control A specimen specifically used to verify the sensitivity, specificity, accuracy or other perfomance parameter of a diagnostic test.
3    B Blind Quality Control specimen submitted to the lab whose identity and composition is not known to the lab.
3    E Electronic QC An electronically simulated QC specimen
3    F Filler Proficiency Specimen used for testing proficiency of an organization performing testing (how does this differ from O?)
3    O Operator Proficiency A specimen used for evaluation of operator proficiency (operator in what context?)
3    V Verifying A specimen used for periodic calibration checks of instruments
2  R Replicate A portion of an original patent sample that is tested at the same time as the original sample
1CLAIM claimant A party that makes a claim for coverage under a policy.
1communityLaboratory Community Laboratory
1GT Guarantor An individual or organization that makes or gives a promise, assurance, pledge to pay or has paid the healthcare service provider.
1homeHealth Home Health
1laboratory Laboratory
1pathologist Pathologist
1PH Policy Holder Policy holder for the insurance policy.
1phlebotomist Phlebotomist
1PROG program eligible A party that meets the eligibility criteria for coverage under a program.
1PT Patient The recipient for the service(s) and/or product(s) when they are not the covered party.
1subject Self
1thirdParty Third Party