This value set includes codes based on the following rules:

• Include these codes as defined in http://terminology.hl7.org/CodeSystem/v3-ActReason version 2.1.0

  Code	Display	Definition
  DISCONT	product discontinued	**Description:**The medication is no longer being manufactured or is otherwise no longer available.
  INEFFECT	ineffective	**Description:**The therapy has been found to not have the desired therapeutic benefit on the patient.
  MONIT	response to monitoring	**Description:**Monitoring the patient while taking the medication, the decision has been made that the therapy is no longer appropriate.
  NOREQ	no longer required for treatment	**Description:**The underlying condition has been resolved or has evolved such that a different treatment is no longer needed.
  NOTCOVER	not covered	**Description:**The product does not have (or no longer has) coverage under the patientaTMs insurance policy.
  PREFUS	patient refuse	**Description:**The patient refused to take the product.
  RECALL	product recalled	**Description:**The manufacturer or other agency has requested that stocks of a medication be removed from circulation.
  REPLACE	change in order	**Description:**Item in current order is no longer in use as requested and a new one has/will be created to replace it.
  DOSECHG	change in medication/dose	**Description:**The medication is being re-prescribed at a different dosage.
  REPLACEFIX	error in order	**Description:**Current order was issued with incorrect data and a new order has/will be created to replace it.
  UNABLE	unable to use	**Description:**<The patient is not (or is no longer) able to use the medication in a manner prescribed. **Example:**CanaTMt swallow.

• Include these codes as defined in http://terminology.hl7.org/CodeSystem/v3-ActCode version 8.0.0

  Code	Display	Definition
  ISSUE	detected issue	There is a clinical issue for the therapy that makes continuation of the therapy inappropriate. *Open Issue:* The definition of this code does not correctly represent the concept space of its specializations (children)
  NAT	Insufficient authorization	The requesting party has insufficient authorization to invoke the interaction.
  SUPPRESSED	record suppressed	**Description:** One or more records in the query response have been suppressed due to consent or privacy restrictions.
  VALIDAT	validation issue	**Description:**The specified element did not pass business-rule validation.
  KEY204	Unknown key identifier	The ID of the patient, order, etc., was not found. Used for transactions other than additions, e.g. transfer of a non-existent patient.
  KEY205	Duplicate key identifier	The ID of the patient, order, etc., already exists. Used in response to addition transactions (Admit, New Order, etc.).
  COMPLY	Compliance Alert	There may be an issue with the patient complying with the intentions of the proposed therapy
  DUPTHPY	Duplicate Therapy Alert	The proposed therapy appears to duplicate an existing therapy
  DUPTHPCLS	duplicate therapeutic alass alert	**Description:**The proposed therapy appears to have the same intended therapeutic benefit as an existing therapy, though the specific mechanisms of action vary.
  DUPTHPGEN	duplicate generic alert	**Description:**The proposed therapy appears to have the same intended therapeutic benefit as an existing therapy and uses the same mechanisms of action as the existing therapy.
  ABUSE	commonly abused/misused alert	**Description:**The proposed therapy is frequently misused or abused and therefore should be used with caution and/or monitoring.
  FRAUD	potential fraud	**Description:**The request is suspected to have a fraudulent basis.
  PLYDOC	Poly-orderer Alert	A similar or identical therapy was recently ordered by a different practitioner.
  PLYPHRM	Poly-supplier Alert	This patient was recently supplied a similar or identical therapy from a different pharmacy or supplier.
  DOSE	Dosage problem	Proposed dosage instructions for therapy differ from standard practice.
  DOSECOND	dosage-condition alert	**Description:**Proposed dosage is inappropriate due to patient's medical condition.
  DOSEDUR	Dose-Duration Alert	Proposed length of therapy differs from standard practice.
  DOSEDURH	Dose-Duration High Alert	Proposed length of therapy is longer than standard practice
  DOSEDURHIND	Dose-Duration High for Indication Alert	Proposed length of therapy is longer than standard practice for the identified indication or diagnosis
  DOSEDURL	Dose-Duration Low Alert	Proposed length of therapy is shorter than that necessary for therapeutic effect
  DOSEDURLIND	Dose-Duration Low for Indication Alert	Proposed length of therapy is shorter than standard practice for the identified indication or diagnosis
  DOSEH	High Dose Alert	Proposed dosage exceeds standard practice
  DOSEHINDA	High Dose for Age Alert	Proposed dosage exceeds standard practice for the patient's age
  DOSEHIND	High Dose for Indication Alert
  DOSEHINDSA	High Dose for Height/Surface Area Alert	Proposed dosage exceeds standard practice for the patient's height or body surface area
  DOSEHINDW	High Dose for Weight Alert	Proposed dosage exceeds standard practice for the patient's weight
  DOSEIVL	Dose-Interval Alert	Proposed dosage interval/timing differs from standard practice
  DOSEIVLIND	Dose-Interval for Indication Alert	Proposed dosage interval/timing differs from standard practice for the identified indication or diagnosis
  DOSEL	Low Dose Alert	Proposed dosage is below suggested therapeutic levels
  DOSELINDA	Low Dose for Age Alert	Proposed dosage is below suggested therapeutic levels for the patient's age
  DOSELIND	Low Dose for Indication Alert
  DOSELINDSA	Low Dose for Height/Surface Area Alert	Proposed dosage is below suggested therapeutic levels for the patient's height or body surface area
  DOSELINDW	Low Dose for Weight Alert	Proposed dosage is below suggested therapeutic levels for the patient's weight
  MDOSE	maximum dosage reached	**Description:**The maximum quantity of this drug allowed to be administered within a particular time-range (month, year, lifetime) has been reached or exceeded.
  OBSA	Observation Alert	Proposed therapy may be inappropriate or contraindicated due to conditions or characteristics of the patient
  AGE	Age Alert	Proposed therapy may be inappropriate or contraindicated due to patient age
  ADALRT	adult alert	Proposed therapy is outside of the standard practice for an adult patient.
  GEALRT	geriatric alert	Proposed therapy is outside of standard practice for a geriatric patient.
  PEALRT	pediatric alert	Proposed therapy is outside of the standard practice for a pediatric patient.
  COND	Condition Alert	Proposed therapy may be inappropriate or contraindicated due to an existing/recent patient condition or diagnosis
  HGHT
  LACT	Lactation Alert	Proposed therapy may be inappropriate or contraindicated when breast-feeding
  PREG	Pregnancy Alert	Proposed therapy may be inappropriate or contraindicated during pregnancy
  WGHT
  CREACT	common reaction alert	**Description:**Proposed therapy may be inappropriate or contraindicated because of a common but non-patient specific reaction to the product. **Example:**There is no record of a specific sensitivity for the patient, but the presence of the sensitivity is common and therefore caution is warranted.
  GEN	Genetic Alert	Proposed therapy may be inappropriate or contraindicated due to patient genetic indicators.
  GEND	Gender Alert	Proposed therapy may be inappropriate or contraindicated due to patient gender.
  LAB	Lab Alert	Proposed therapy may be inappropriate or contraindicated due to recent lab test results
  REACT	Reaction Alert	Proposed therapy may be inappropriate or contraindicated based on the potential for a patient reaction to the proposed product
  ALGY	Allergy Alert	Proposed therapy may be inappropriate or contraindicated because of a recorded patient allergy to the proposed product. (Allergies are immune based reactions.)
  INT	Intolerance Alert	Proposed therapy may be inappropriate or contraindicated because of a recorded patient intolerance to the proposed product. (Intolerances are non-immune based sensitivities.)
  RREACT	Related Reaction Alert	Proposed therapy may be inappropriate or contraindicated because of a potential patient reaction to a cross-sensitivity related product.
  RALG	Related Allergy Alert	Proposed therapy may be inappropriate or contraindicated because of a recorded patient allergy to a cross-sensitivity related product. (Allergies are immune based reactions.)
  RAR	Related Prior Reaction Alert	Proposed therapy may be inappropriate or contraindicated because of a recorded prior adverse reaction to a cross-sensitivity related product.
  RINT	Related Intolerance Alert	Proposed therapy may be inappropriate or contraindicated because of a recorded patient intolerance to a cross-sensitivity related product. (Intolerances are non-immune based sensitivities.)
  BUS	business constraint violation	**Description:**A local business rule relating multiple elements has been violated.
  CODE_INVAL	code is not valid	**Description:**The specified code is not valid against the list of codes allowed for the element.
  CODE_DEPREC	code has been deprecated	**Description:**The specified code has been deprecated and should no longer be used. Select another code from the code system.
  FORMAT	invalid format	**Description:**The element does not follow the formatting or type rules defined for the field.
  ILLEGAL	illegal	**Description:**The request is missing elements or contains elements which cause it to not meet the legal standards for actioning.
  LEN_RANGE	length out of range	**Description:**The length of the data specified falls out of the range defined for the element.
  LEN_LONG	length is too long	**Description:**The length of the data specified is greater than the maximum length defined for the element.
  LEN_SHORT	length is too short	**Description:**The length of the data specified is less than the minimum length defined for the element.
  MISSCOND	conditional element missing	**Description:**The specified element must be specified with a non-null value under certain conditions. In this case, the conditions are true but the element is still missing or null.
  MISSMAND	mandatory element missing	**Description:**The specified element is mandatory and was not included in the instance.
  NODUPS	duplicate values are not permitted	**Description:**More than one element with the same value exists in the set. Duplicates not permission in this set in a set.
  NOPERSIST	element will not be persisted	**Description:** Element in submitted message will not persist in data storage based on detected issue.
  REP_RANGE	repetitions out of range	**Description:**The number of repeating elements falls outside the range of the allowed number of repetitions.
  MAXOCCURS	repetitions above maximum	**Description:**The number of repeating elements is above the maximum number of repetitions allowed.
  MINOCCURS	repetitions below minimum	**Description:**The number of repeating elements is below the minimum number of repetitions allowed.
  KEY206	non-matching identification	**Description:** Metadata associated with the identification (e.g. name or gender) does not match the identification being verified.
  OBSOLETE	obsolete record returned	**Description:** One or more records in the query response have a status of 'obsolete'.
  FOOD	Food Interaction Alert	Proposed therapy may interact with certain foods
  TPROD	Therapeutic Product Alert	Proposed therapy may interact with an existing or recent therapeutic product
  DRG	Drug Interaction Alert	Proposed therapy may interact with an existing or recent drug therapy
  NHP	Natural Health Product Alert	Proposed therapy may interact with existing or recent natural health product therapy
  NONRX	Non-Prescription Interaction Alert	Proposed therapy may interact with a non-prescription drug (e.g. alcohol, tobacco, Aspirin)
  PREVINEF	previously ineffective	**Definition:**The same or similar treatment has previously been attempted with the patient without achieving a positive effect.
  DACT	drug action detected issue	**Description:**Proposed therapy may be contraindicated or ineffective based on an existing or recent drug therapy.
  TIME	timing detected issue	**Description:**Proposed therapy may be inappropriate or ineffective based on the proposed start or end time.
  ALRTENDLATE	end too late alert	**Definition:**Proposed therapy may be inappropriate or ineffective because the end of administration is too close to another planned therapy.
  ALRTSTRTLATE	start too late alert	**Definition:**Proposed therapy may be inappropriate or ineffective because the start of administration is too late after the onset of the condition.
  ENDLATE	End Too Late Alert	Proposed therapy may be inappropriate or ineffective because the end of administration is too close to another planned therapy
  STRTLATE	Start Too Late Alert	Proposed therapy may be inappropriate or ineffective because the start of administration is too late after the onset of the condition
  ALLDONE	already performed	**Definition:**The requested action has already been performed and so this request has no effect
  FULFIL	fulfillment alert	**Definition:**The therapy being performed is in some way out of alignment with the requested therapy.
  NOTACTN	no longer actionable	**Definition:**The status of the request being fulfilled has changed such that it is no longer actionable. This may be because the request has expired, has already been completely fulfilled or has been otherwise stopped or disabled. (Not used for 'suspended' orders.)
  NOTEQUIV	not equivalent alert	**Definition:**The therapy being performed is not sufficiently equivalent to the therapy which was requested.
  NOTEQUIVGEN	not generically equivalent alert	**Definition:**The therapy being performed is not generically equivalent (having the identical biological action) to the therapy which was requested.
  NOTEQUIVTHER	not therapeutically equivalent alert	**Definition:**The therapy being performed is not therapeutically equivalent (having the same overall patient effect) to the therapy which was requested.
  TIMING	event timing incorrect alert	**Definition:**The therapy is being performed at a time which diverges from the time the therapy was requested
  INTERVAL	outside requested time	**Definition:**The therapy action is being performed outside the bounds of the time period requested
  MINFREQ	too soon within frequency based on the usage	**Definition:**The therapy action is being performed too soon after the previous occurrence based on the requested frequency
  HELD	held/suspended alert	**Definition:**There should be no actions taken in fulfillment of a request that has been held or suspended.
  TOOLATE	Refill Too Late Alert	The patient is receiving a subsequent fill significantly later than would be expected based on the amount previously supplied and the therapy dosage instructions
  TOOSOON	Refill Too Soon Alert	The patient is receiving a subsequent fill significantly earlier than would be expected based on the amount previously supplied and the therapy dosage instructions
  HISTORIC	record recorded as historical	**Description:** While the record was accepted in the repository, there is a more recent version of a record of this type.
  PATPREF	violates stated preferences	**Definition:**The proposed therapy goes against preferences or consent constraints recorded in the patient's record.
  PATPREFALT	violates stated preferences, alternate available	**Definition:**The proposed therapy goes against preferences or consent constraints recorded in the patient's record. An alternate therapy meeting those constraints is available.
  CAREGAP	Caregap	Identifies the type of detected issue is a care gap
  CODINGGAP	Codinggap	Identifies the type of detected issue is a risk adjustment coding gap

This value set expansion contains 112 concepts.