Release 4B

This page is part of the FHIR Specification (v4.3.0: R4B - STU). 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: R5 R4B R4

4.4.1.405 Value Set http://hl7.org/fhir/ValueSet/eligibilityrequest-purpose

Financial Management

Work Group

Maturity Level: 2

Trial Use

Use Context: Any

This is a value set defined by the FHIR project.

Summary

Defining URL:

http://hl7.org/fhir/ValueSet/eligibilityrequest-purpose

Version:

4.3.0

Name:

EligibilityRequestPurpose

Title:

EligibilityRequestPurpose

Definition:

A code specifying the types of information being requested.

Committee:

Financial Management

Work Group

OID:

2.16.840.1.113883.4.642.3.1182 (for OID based terminology systems)

Source Resource

XML / JSON

This value set is used in the following places:

CodeSystem: This value set is the designated 'entire code system' value set for EligibilityRequestPurpose
Resource: CoverageEligibilityRequest.purpose (code / Required)

4.4.1.405.1 Content Logical Definition

Include all codes defined in http://hl7.org/fhir/eligibilityrequest-purpose

4.4.1.405.2 Expansion

This expansion generated 28 May 2022

This value set contains 4 concepts

Expansion based on EligibilityRequestPurpose v4.3.0 (CodeSystem)

All codes in this table are from the system http://hl7.org/fhir/eligibilityrequest-purpose

Code	Display	Definition
auth-requirements	Coverage auth-requirements	The prior authorization requirements for the listed, or discovered if specified, converages for the categories of service and/or specifed biling codes are requested.
benefits	Coverage benefits	The plan benefits and optionally benefits consumed for the listed, or discovered if specified, converages are requested.
discovery	Coverage Discovery	The insurer is requested to report on any coverages which they are aware of in addition to any specifed.
validation	Coverage Validation	A check that the specified coverages are in-force is requested.

See the full registry of value sets defined as part of FHIR.

Explanation of the columns that may appear on this page:

Lvl

A few code lists that FHIR defines are hierarchical - each code is assigned a level. For value sets, levels are mostly used to organize codes for user convenience, but may follow code system hierarchy - see Code System for further information

Source

The source of the definition of the code (when the value set draws in codes defined elsewhere)

Code

The code (used as the code in the resource instance). If the code is in italics, this indicates that the code is not selectable ('Abstract')

Display

The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application

Definition

An explanation of the meaning of the concept

Comments

Additional notes about how to use the code