FHIR Cross-Version Extensions package for FHIR R4 from FHIR R5
0.0.1-snapshot-2 - informative
FHIR Cross-Version Extensions package for FHIR R4 from FHIR R5
0.0.1-snapshot-2 - informative
FHIR Cross-Version Extensions package for FHIR R4 from FHIR R5 - Version 0.0.1-snapshot-2. See the Directory of published versions
| Page standards status: Informative | Maturity Level: 0 |
{
"resourceType" : "ValueSet",
"id" : "R5-v3-ActInvoiceOverrideCode-for-R4",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p class=\"res-header-id\"><b>Generated Narrative: ValueSet R5-v3-ActInvoiceOverrideCode-for-R4</b></p><a name=\"R5-v3-ActInvoiceOverrideCode-for-R4\"> </a><a name=\"hcR5-v3-ActInvoiceOverrideCode-for-R4\"> </a><p>This value set expansion contains 15 concepts.</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>System</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActInvoiceOverrideCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-COVGE\"> </a>\u00a0\u00a0<a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-COVGE\">COVGE</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>coverage problem</td><td><div><p>Insurance coverage problems have been encountered. Additional explanation information to be supplied.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActInvoiceOverrideCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-EFORM\"> </a>\u00a0\u00a0<a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-EFORM\">EFORM</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>electronic form to follow</td><td><div><p>Electronic form with supporting or additional information to follow.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActInvoiceOverrideCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-FAX\"> </a>\u00a0\u00a0<a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-FAX\">FAX</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>fax to follow</td><td><div><p>Fax with supporting or additional information to follow.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActInvoiceOverrideCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-GFTH\"> </a>\u00a0\u00a0<a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-GFTH\">GFTH</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>good faith indicator</td><td><div><p>The medical service was provided to a patient in good faith that they had medical coverage, although no evidence of coverage was available before service was rendered.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActInvoiceOverrideCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-LATE\"> </a>\u00a0\u00a0<a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-LATE\">LATE</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>late invoice</td><td><div><p>Knowingly over the payor's published time limit for this invoice possibly due to a previous payor's delays in processing. Additional reason information will be supplied.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActInvoiceOverrideCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-MANUAL\"> </a>\u00a0\u00a0<a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-MANUAL\">MANUAL</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>manual review</td><td><div><p>Manual review of the invoice is requested. Additional information to be supplied. This may be used in the case of an appeal.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActInvoiceOverrideCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-OOJ\"> </a>\u00a0\u00a0<a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-OOJ\">OOJ</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>out of jurisdiction</td><td><div><p>The medical service and/or product was provided to a patient that has coverage in another jurisdiction.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActInvoiceOverrideCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-ORTHO\"> </a>\u00a0\u00a0<a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-ORTHO\">ORTHO</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>orthodontic service</td><td><div><p>The service provided is required for orthodontic purposes. If the covered party has orthodontic coverage, then the service may be paid.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActInvoiceOverrideCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-PAPER\"> </a>\u00a0\u00a0<a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-PAPER\">PAPER</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>paper documentation to follow</td><td><div><p>Paper documentation (or other physical format) with supporting or additional information to follow.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActInvoiceOverrideCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-PIE\"> </a>\u00a0\u00a0<a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-PIE\">PIE</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>public insurance exhausted</td><td><div><p>Public Insurance has been exhausted. Invoice has not been sent to Public Insuror and therefore no Explanation Of Benefits (EOB) is provided with this Invoice submission.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActInvoiceOverrideCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-PYRDELAY\"> </a>\u00a0\u00a0<a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-PYRDELAY\">PYRDELAY</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>delayed by a previous payor</td><td><div><p>Allows provider to explain lateness of invoice to a subsequent payor.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActInvoiceOverrideCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-REFNR\"> </a>\u00a0\u00a0<a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-REFNR\">REFNR</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>referral not required</td><td><div><p>Rules of practice do not require a physician's referral for the provider to perform a billable service.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActInvoiceOverrideCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-REPSERV\"> </a>\u00a0\u00a0<a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-REPSERV\">REPSERV</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>repeated service</td><td><div><p>The same service was delivered within a time period that would usually indicate a duplicate billing. However, the repeated service is a medical necessity and therefore not a duplicate.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActInvoiceOverrideCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-UNRELAT\"> </a>\u00a0\u00a0<a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-UNRELAT\">UNRELAT</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>unrelated service</td><td><div><p>The service provided is not related to another billed service. For example, 2 unrelated services provided on the same day to the same patient which may normally result in a refused payment for one of the items.</p>\n</div></td></tr><tr><td style=\"white-space:nowrap\"><a name=\"R5-v3-ActInvoiceOverrideCode-for-R4-http://terminology.hl7.org/CodeSystem/v3-ActCode-VERBAUTH\"> </a>\u00a0\u00a0<a href=\"http://terminology.hl7.org/6.5.0/CodeSystem-v3-ActCode.html#v3-ActCode-VERBAUTH\">VERBAUTH</a></td><td>http://terminology.hl7.org/CodeSystem/v3-ActCode</td><td>verbal authorization</td><td><div><p>The provider has received a verbal permission from an authoritative source to perform the service or supply the item being invoiced.</p>\n</div></td></tr></table></div>"
},
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode" : "fhir"
},
{
"extension" : [
{
"url" : "packageId",
"valueId" : "hl7.fhir.uv.xver-r5.r4"
},
{
"url" : "version",
"valueString" : "0.0.1-snapshot-2"
}
],
"url" : "http://hl7.org/fhir/StructureDefinition/package-source"
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger" : 0,
"_valueInteger" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
"valueCanonical" : "http://hl7.org/fhir/5.0/ImplementationGuide/hl7.fhir.uv.xver-r5.r4"
}
]
}
},
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode" : "informative",
"_valueCode" : {
"extension" : [
{
"url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
"valueCanonical" : "http://hl7.org/fhir/5.0/ImplementationGuide/hl7.fhir.uv.xver-r5.r4"
}
]
}
}
],
"url" : "http://hl7.org/fhir/5.0/ValueSet/R5-v3-ActInvoiceOverrideCode-for-R4",
"version" : "0.0.1-snapshot-2",
"name" : "R5_v3_ActInvoiceOverrideCode_for_R4",
"title" : "Cross-version VS for R5.ActInvoiceOverrideCode for use in FHIR R4",
"status" : "active",
"experimental" : false,
"date" : "2025-09-01T22:37:04.907511+10:00",
"publisher" : "FHIR Infrastructure",
"contact" : [
{
"name" : "FHIR Infrastructure",
"telecom" : [
{
"system" : "url",
"value" : "http://www.hl7.org/Special/committees/fiwg"
}
]
}
],
"description" : "This cross-version ValueSet represents concepts from http://terminology.hl7.org/ValueSet/v3-ActInvoiceOverrideCode|2.0.0 for use in FHIR R4. Concepts not present here have direct `equivalent` mappings crossing all versions from R5 to R4.",
"jurisdiction" : [
{
"coding" : [
{
"system" : "http://unstats.un.org/unsd/methods/m49/m49.htm",
"code" : "001",
"display" : "World"
}
]
}
],
"compose" : {
"include" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version" : "8.0.0",
"concept" : [
{
"code" : "COVGE",
"display" : "coverage problem"
},
{
"code" : "EFORM",
"display" : "electronic form to follow"
},
{
"code" : "FAX",
"display" : "fax to follow"
},
{
"code" : "GFTH",
"display" : "good faith indicator"
},
{
"code" : "LATE",
"display" : "late invoice"
},
{
"code" : "MANUAL",
"display" : "manual review"
},
{
"code" : "OOJ",
"display" : "out of jurisdiction"
},
{
"code" : "ORTHO",
"display" : "orthodontic service"
},
{
"code" : "PAPER",
"display" : "paper documentation to follow"
},
{
"code" : "PIE",
"display" : "public insurance exhausted"
},
{
"code" : "PYRDELAY",
"display" : "delayed by a previous payor"
},
{
"code" : "REFNR",
"display" : "referral not required"
},
{
"code" : "REPSERV",
"display" : "repeated service"
},
{
"code" : "UNRELAT",
"display" : "unrelated service"
},
{
"code" : "VERBAUTH",
"display" : "verbal authorization"
}
]
}
]
},
"expansion" : {
"timestamp" : "2025-09-01T22:37:04.907507+10:00",
"contains" : [
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version" : "8.0.0",
"code" : "COVGE",
"display" : "coverage problem"
},
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version" : "8.0.0",
"code" : "EFORM",
"display" : "electronic form to follow"
},
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version" : "8.0.0",
"code" : "FAX",
"display" : "fax to follow"
},
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version" : "8.0.0",
"code" : "GFTH",
"display" : "good faith indicator"
},
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version" : "8.0.0",
"code" : "LATE",
"display" : "late invoice"
},
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version" : "8.0.0",
"code" : "MANUAL",
"display" : "manual review"
},
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version" : "8.0.0",
"code" : "OOJ",
"display" : "out of jurisdiction"
},
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version" : "8.0.0",
"code" : "ORTHO",
"display" : "orthodontic service"
},
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version" : "8.0.0",
"code" : "PAPER",
"display" : "paper documentation to follow"
},
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version" : "8.0.0",
"code" : "PIE",
"display" : "public insurance exhausted"
},
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version" : "8.0.0",
"code" : "PYRDELAY",
"display" : "delayed by a previous payor"
},
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version" : "8.0.0",
"code" : "REFNR",
"display" : "referral not required"
},
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version" : "8.0.0",
"code" : "REPSERV",
"display" : "repeated service"
},
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version" : "8.0.0",
"code" : "UNRELAT",
"display" : "unrelated service"
},
{
"system" : "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version" : "8.0.0",
"code" : "VERBAUTH",
"display" : "verbal authorization"
}
]
}
}
IG © 2025+ FHIR Infrastructure. Package hl7.fhir.uv.xver-r5.r4#0.0.1-snapshot-2 based on FHIR 4.0.1. Generated 2025-09-13
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