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ActCode     

A code specifying the particular kind of Act that the Act-instance represents within its class.

Constraints: The kind of Act (e.g. physical examination, serum potassium, inpatient encounter, charge financial transaction, etc.) is specified with a code from one of several, typically external, coding systems. The coding system will depend on the class of Act, such as LOINC for observations, etc.

Conceptually, the Act.code must be a specialization of the Act.classCode. This is why the structure of ActClass domain should be reflected in the superstructure of the ActCode domain and then individual codes or externally referenced vocabularies subordinated under these domains that reflect the ActClass structure.

Act.classCode and Act.code are not modifiers of each other but the Act.code concept should really imply the Act.classCode concept. For a negative example, it is not appropriate to use an Act.code "potassium" together with and Act.classCode for "laboratory observation" to somehow mean "potassium laboratory observation" and then use the same Act.code for "potassium" together with Act.classCode for "medication" to mean "substitution of potassium". This mutually modifying use of Act.code and Act.classCode is not permitted.

Lvl Type, Domain name and/or Mnemonic code Concept ID Mnemonic Print Name Definition/Description
1 A: ActClaimAttachmentCode A19672
1 A: ActCognitiveProfessionalServiceCode A19706

Denotes the specific service that has been performed. This is obtained from the professional service catalog pertaining to the discipline of the health service provider. Professional services are generally cognitive in nature and exclude surgical procedures. E.g. Provided training, Provided drug therapy review, Gave smoking-cessation counseling, etc.

1 A: ActInformationCategoryCode A19752

Definition:Indicates the set of information types which may be manipulated or referenced, such as for recommending access restrictions.

2   L:  (ALLGCAT) C21614 ALLGCAT allergy category

Definition:All information pertaining to a patient's allergy and intolerance records.

2   L:  (COBSCAT) C21617 COBSCAT common observation category

Definition:All information pertaining to a patient's common observation records (height, weight, blood pressure, temperature, etc.).

2   L:  (DEMOCAT) C21618 DEMOCAT demographics category

Definition:All information pertaining to a patient's demographics (such as name, date of birth, gender, address, etc).

2   L:  (DICAT) C21613 DICAT diagnostic image category

Definition:All information pertaining to a patient's diagnostic image records (orders & results).

2   L:  (IMMUCAT) C21619 IMMUCAT immunization category

Definition:All information pertaining to a patient's vaccination records.

2   L:  (LABCAT) C21611 LABCAT lab test category

Definition:

2   L:  (MEDCCAT) C21616 MEDCCAT medical condition category

Definition:All information pertaining to a patient's medical condition records.

2   L:  (RXCAT) C21612 RXCAT medication category

Definition:All information pertaining to a patient's medication records (orders, dispenses and other active medications).

2   L:  (PSVCCAT) C21615 PSVCCAT professional service category

Definition:All information pertaining to a patient's professional service records (such as smoking cessation, counseling, medication review, mental health).

1 A: ActInjuryCode A19669
1 A: ActInvoicePaymentCode A19673
2   L:  (BONUS) C20058 BONUS bonus

Bonus payments based on performance, volume, etc. as agreed to by the payor.

2   L:  (CFWD) C20068 CFWD carry forward adjusment

An amount still owing to the payor but the payment is 0$ and this cannot be settled until a future payment is made.

2   L:  (EPYMT) C20065 EPYMT early payment fee

Fees deducted on behalf of a payee for charges based on a shorter payment frequency (i.e. next day versus biweekly payments.

2   L:  (EDU) C20059 EDU education fees

Fees deducted on behalf of a payee for tuition and continuing education.

2   L:  (GARN) C20066 GARN garnishee

Fees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee.

2   L:  (PINV) C20067 PINV paper invoice

Payment initiated by the payor as the result of adjudicating a paper (original, may have been faxed) invoice.

2   L:  (PPRD) C20069 PPRD prior period adjustment

An amount that was owed to the payor as indicated, by a carry forward adjusment, in a previous payment advice

2   L:  (PROA) C20060 PROA professional association deduction

Professional association fee that is collected by the payor from the practitioner/provider on behalf of the association

2   L:  (RECOV) C20061 RECOV recovery

Retroactive adjustment such as fee rate adjustment due to contract negotiations.

2   L:  (RETRO) C20062 RETRO retro adjustment

Bonus payments based on performance, volume, etc. as agreed to by the payor.

2   L:  (INVOICE) C20063 INVOICE submitted invoice

Payment is based on a payment intent for a previously submitted Invoice, based on formal adjudication results..

2   L:  (TRAN) C20064 TRAN transaction fee

Fees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee.

1 A: ActTransportationModeCode A19732

Characterizes how a transportation act was or will be carried out.

Examples: Via private transport, via public transit, via courier.

2   A: ActPatientTransportationModeCode A19733

Definition: Characterizes how a patient was or will be transported to the site of a patient encounter.

Examples: Via ambulance, via public transit, on foot.

3     S: Ambulance (AMBT) S21547 AMBT ambulance transport
4       L:  (AMBAIR) C21554 AMBAIR fixed-wing ambulance transport
4       L:  (AMBGRND) C21552 AMBGRND ground ambulance transport
4       L:  (AMBHELO) C21553 AMBHELO helicopter ambulance transport
3     L:  (LAWENF) C21548 LAWENF law enforcement transport
3     L:  (AFOOT) C21551 AFOOT pedestrian transport
3     L:  (PRVTRN) C21550 PRVTRN private transport
3     L:  (PUBTRN) C21549 PUBTRN public transport
1 A: ExternallyDefinedActCodes A16493
2   A: DocumentSectionType A10871

The type of document section. Possible values: review of systems, medical history, family history, microscopic findings, etc.

2   A: DocumentType A10870

The kind of document. Possible values: discharge summary, progress note, Oncology note, etc.

3     A: ActMedicationDocumentCode A19723

Indicates the types of documents that can be associated with a medication or group of medications.

Examples include: Patient monographs, Provider monographs, Drug protocols, etc.

1 A: HL7DefinedActCodes A13954

Domain provides the root for HL7-defined detailed or rich codes for the Act classes.

2   A: ActAccountCode A14809

An account represents a grouping of financial transactions that are tracked and reported together with a single balance. Examples of account codes (types) are Patient billing accounts (collection of charges), Cost centers; Cash.

3     L:  (CASH) C14810 CASH Cash
3     A: CreditCard A14811
4       L:  (AE) C14814 AE American Express
4       L:  (DN) C14815 DN Diner's Club
4       L:  (DV) C14816 DV Discover Card
4       L:  (MC) C14813 MC Master Card
4       L:  (V) C14812 V Visa
3     L:  (ACCTRECEIVABLE) C21361 ACCTRECEIVABLE account receivable

An account for collecting charges, reversals, adjustments and payments, including deductibles, copayments, coinsurance (financial transactions) credited or debited to the account receivable account for a patient's encounter.

3     L:  (PBILLACCT) C21301 PBILLACCT patient billing account

An account representing charges and credits (financial transactions) for a patient's encounter.

2   A: ActAdjudicationCode A17616

Includes coded responses that will occur as a result of the adjudication of an electronic invoice at a summary level and provides guidance on interpretation of the referenced adjudication results.

3     S: AdjudicatedWithAdjustments (AA) S19347 AA adjudicated with adjustments

The invoice element has been accepted for payment but one or more adjustment(s) have been made to one or more invoice element line items (component charges).

Also includes the concept 'Adjudicate as zero' and items not covered under a particular Policy.

Invoice element can be reversed (nullified).

Recommend that the invoice element is saved for DUR (Drug Utilization Reporting).

4       L:  (ANF) C19708 ANF adjudicated with adjustments and no financial impact

The invoice element has been accepted for payment but one or more adjustment(s) have been made to one or more invoice element line items (component charges) without changing the amount.

Invoice element can be reversed (nullified).

Recommend that the invoice element is saved for DUR (Drug Utilization Reporting).

3     L:  (AR) C17619 AR adjudicated as refused

The invoice element has passed through the adjudication process but payment is refused due to one or more reasons.

Includes items such as patient not covered, or invoice element is not constructed according to payer rules (e.g. 'invoice submitted too late').

If one invoice element line item in the invoice element structure is rejected, the remaining line items may not be adjudicated and the complete group is treated as rejected.

A refused invoice element can be forwarded to the next payer (for Coordination of Benefits) or modified and resubmitted to refusing payer.

Invoice element cannot be reversed (nullified) as there is nothing to reverse.

Recommend that the invoice element is not saved for DUR (Drug Utilization Reporting).

3     L:  (AS) C17617 AS adjudicated as submitted

The invoice element was/will be paid exactly as submitted, without financial adjustment(s).

If the dollar amount stays the same, but the billing codes have been amended or financial adjustments have been applied through the adjudication process, the invoice element is treated as "Adjudicated with Adjustment".

If information items are included in the adjudication results that do not affect the monetary amounts paid, then this is still Adjudicated as Submitted (e.g. 'reached Plan Maximum on this Claim').

Invoice element can be reversed (nullified).

Recommend that the invoice element is saved for DUR (Drug Utilization Reporting).

2   A: ActAdjudicationGroupCode A17968

Catagorization of grouping criteria for the associated transactions and/or summary (totals, subtotals).

3     L:  (CONT) C17974 CONT contract

Transaction counts and value totals by Contract Identifier.

3     L:  (DAY) C17969 DAY day

Transaction counts and value totals for each calendar day within the date range specified.

3     L:  (LOC) C17976 LOC location

Transaction counts and value totals by service location (e.g clinic).

3     L:  (MONTH) C17970 MONTH month

Transaction counts and value totals for each calendar month within the date range specified.

3     L:  (PERIOD) C17971 PERIOD period

Transaction counts and value totals for the date range specified.

3     L:  (PROV) C17975 PROV provider

Transaction counts and value totals by Provider Identifier.

3     L:  (WEEK) C17972 WEEK week

Transaction counts and value totals for each calendar week within the date range specified.

3     L:  (YEAR) C17973 YEAR year

Transaction counts and value totals for each calendar year within the date range specified.

2   A: ActAdjudicationInformationCode A19383

Explanatory codes that provide information derived by an Adjudicator during the course of adjudicating an invoice.

Codes from this domain are purely informational and do not materially affect the adjudicated invoice. That is, these codes do not impact or explain financial adjustments to an invoice. A companion domain (ActAdjudicationReasonCode) includes reasons which have a financial impact on an Invoice (claim).

Example adjudication information code is 54540 - Patient has reached Plan Maximum for current year.

2   A: ActAdjudicationResultActionCode A17472

Actions to be carried out by the recipient of the Adjudication Result information.

3     L:  (DISPLAY) C17475 DISPLAY Display

The adjudication result associated is to be displayed to the receiver of the adjudication result.

3     L:  (FORM) C17473 FORM Print on Form

The adjudication result associated is to be printed on the specified form, which is then provided to the covered party.

2   A: ActBillableTreatmentPlanCode A19440
2   A: ActBillingArrangementCode A17478

The type of provision(s) made for reimbursing for the deliver of healthcare services and/or goods provided by a Provider, over a specified period.

3     L:  (BLK) C17480 BLK block funding

A billing arrangement where a Provider charges a lump sum to provide a prescribed group (volume) of services to a single patient which occur over a period of time. Services included in the block may vary.

This billing arrangement is also known as Program of Care for some specific Payors and Program Fees for other Payors.

3     L:  (CAP) C17484 CAP capitation funding

A billing arrangement where the payment made to a Provider is determined by analyzing one or more demographic attributes about the persons/patients who are enrolled with the Provider (in their practice).

3     L:  (CONTF) C17481 CONTF contract funding

A billing arrangement where a Provider charges a lump sum to provide a particular volume of one or more interventions/procedures or groups of interventions/procedures.

3     L:  (FFS) C17479 FFS fee for service

A billing arrangement where a Provider charges a separate fee for each intervention/procedure/event or product.

Fee for Service is used when an individual intervention/procedure/event is used for billing purposes. In other words, fees are associated with the intervention/procedure/event. For example, a specific CCI (Canadian Classification of Interventions) code has an associated fee and is used for billing purposes.

3     L:  (FINBILL) C19723 FINBILL financial

A billing arrangement where a Provider charges for non-clinical items. This includes interest in arrears, mileage, etc. Clinical content is not included in Invoices submitted with this type of billing arrangement.

3     L:  (ROST) C17482 ROST roster funding

A billing arrangement where funding is based on a list of individuals registered as patients of the Provider.

3     L:  (SESS) C17483 SESS sessional funding

A billing arrangement where a Provider charges a sum to provide a group (volume) of interventions/procedures to one or more patients within a defined period of time, typically on the same date. Interventions/procedures included in the session may vary.

2   A: ActBoundedROICode A17896

Type of bounded ROI.

3     L:  (ROIFS) C17897 ROIFS fully specified ROI

A fully specified bounded Region of Interest (ROI) delineates a ROI in which only those dimensions participate that are specified by boundary criteria, whereas all other dimensions are excluded. For example a ROI to mark an episode of "ST elevation" in a subset of the EKG leads V2, V3, and V4 would include 4 boundaries, one each for time, V2, V3, and V4.

3     L:  (ROIPS) C17898 ROIPS partially specified ROI

A partially specified bounded Region of Interest (ROI) specifies a ROI in which at least all values in the dimensions specified by the boundary criteria participate. For example, if an episode of ventricular fibrillations (VFib) is observed, it usually doesn't make sense to exclude any EKG leads from the observation and the partially specified ROI would contain only one boundary for time indicating the time interval where VFib was observed.

2   L:  (_ActClaimAttachmentCode) C20859 _ActClaimAttachmentCode ActClaimAttachmentCode

Identifies the type of attachment (document, XRAY, bit map image, etc.) included to support a healthcare claim. It will be a specification for the type of document (i.e. WCB First Report of Acccident - Form 8).

2   A: ActContainerRegistrationCode A14058

Constrains the ActCode to the domain of Container Registration

3     L:  (X) C14065 X Container Unavailable

Used by one system to inform another that the container is no longer available within the scope of the system (e.g., tube broken or discarded).

3     L:  (ID) C14059 ID Identified

Used by one system to inform another that it has received a container.

3     L:  (IP) C14060 IP In Position

Used by one system to inform another that the container is in position for specimen transfer (e.g., container removal from track, pipetting, etc.).

3     L:  (O) C14061 O In Process

Used by one system to inform another that the specific container is being processed by the equipment. It is useful as a response to a query about Container Status, when the specific step of the process is not relevant.

3     L:  (L) C14063 L Left Equipment

Used by one system to inform another that the container has been released from that system.

3     L:  (M) C14064 M Missing

Used by one system to inform another that the container did not arrive at its next expected location.

3     L:  (R) C14062 R Process Completed

Status is used by one system to inform another that the processing has been completed, but the container has not been released from that system.

2   A: ActControlVariable A16857

An observation form that determines parameters or attributes of an Act. Examples are the settings of a ventilator machine as parameters of a ventilator treatment act; the controls on dillution factors of a chemical analyzer as a parameter of a laboratory observation act; the settings of a physiologic measurement assembly (e.g., time skew) or the position of the body while measuring blood pressure.

Control variables are forms of observations because just as with clinical observations, the Observation.code determines the parameter and the Observation.value assigns the value. While control variables sometimes can be observed (by noting the control settings or an actually measured feedback loop) they are not primary observations, in the sense that a control variable without a primary act is of no use (e.g., it makes no sense to record a blood pressure position without recording a blood pressure, whereas it does make sense to record a systolic blood pressure without a diastolic blood pressure).

3     A: ECGControlVariable A19331
4       A: ECGControlVariableMDC A19336

ISO 11073-10101 Health informatics - Point-of-care device codes, restricted to ECG Control Variables

3     L:  (AUTO) C16860 AUTO auto-repeat permission

Specifies whether or not automatic repeat testing is to be initiated on specimens.

3     L:  (ENDC) C16858 ENDC endogenous content

A baseline value for the measured test that is inherently contained in the diluent. In the calculation of the actual result for the measured test, this baseline value is normally considered.

3     L:  (REFLEX) C16859 REFLEX reflex permission

Specifies whether or not further testing may be automatically or manually initiated on specimens.

2   A: ActCoverageConfirmationCode A17487

Response to an insurance coverage eligibility query or authorization request.

3     A: ActCoverageAuthorizationConfirmationCode A17491

Indication of authorization for healthcare service(s) and/or product(s). If authorization is approved, funds are set aside.

4       L:  (AUTH) C17492 AUTH Authorized

Authorization approved and funds have been set aside to pay for specified healthcare service(s) and/or product(s) within defined criteria for the authorization.

4       L:  (NAUTH) C17493 NAUTH Not Authorized

Authorization for specified healthcare service(s) and/or product(s) denied.

3     A: ActCoverageEligibilityConfirmationCode A17488

Indication of eligibility coverage for healthcare service(s) and/or product(s).

4       L:  (ELG) C17489 ELG Eligible

Insurance coverage is in effect for healthcare service(s) and/or product(s).

4       L:  (NELG) C17490 NELG Not Eligible

Insurance coverage is not in effect for healthcare service(s) and/or product(s). May optionally include reasons for the ineligibility.

2   A: ActCoverageLimitCode A17496

Criteria that are applicable to the authorized coverage.

3     L:  (NETAMT) C17497 NETAMT Net Amount

Maximum net amount that will be covered for the product or service specified.

3     L:  (UNITPRICE) C17499 UNITPRICE Unit Price

Maximum unit price that will be covered for the authorized product or service.

3     L:  (UNITQTY) C17498 UNITQTY Unit Quantity

Maximum number of items that will be covered of the product or service specified.

2   A: ActDetectedIssueCode A16124

Identifies types of detected issues for Act class "ALRT"

3     A: ActAdministrativeDetectedIssueCode A19429

Identifies types of detectyed issues for Act class "ALRT" for the administrative and patient administrative acts domains.

4       A: ActAdministrativeAuthorizationDetectedIssueCode A19620
5         L:  (NAT) C21390 NAT Insufficient authorization

The requesting party has insufficient authorization to invoke the interaction.

4       A: ActAdministrativeRuleDetectedIssueCode A19621
5         L:  (KEY205) C21393 KEY205 Duplicate key identifier

The ID of the patient, order, etc., already exists. Used in response to addition transactions (Admit, New Order, etc.).

5         L:  (KEY204) C21392 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.

3     A: ActFinancialDetectedIssueCode A19428

Identifies types of detected issues for Act class "ALRT" for the financial acts domain.

3     A: ActSuppliedItemDetectedIssueCode A16656

Identifies types of detected issues regarding the administration or supply of an item to a patient.

4       A: AdministrationDetectedIssueCode A16657

Administration of the proposed therapy may be inappropriate or contraindicated as proposed

5         A: AppropriatenessDetectedIssueCode A16658
6           A: InteractionDetectedIssueCode A16659
7             L:  (FOOD) C16662 FOOD Food Interaction Alert

Proposed therapy may interact with certain foods

7             S: TherapeuticProductDetectedIssueCode (TPROD) S17807 TPROD Therapeutic Product Alert

Proposed therapy may interact with an existing or recent therapeutic product

8               L:  (DRG) C16660 DRG Drug Interaction Alert

Proposed therapy may interact with an existing or recent drug therapy

8               L:  (NHP) C16661 NHP Natural Health Product Alert

Proposed therapy may interact with existing or recent natural health product therapy

8               L:  (NONRX) C16663 NONRX Non-Prescription Interaction Alert

Proposed therapy may interact with a non-prescription drug (e.g. alcohol, tobacco, Aspirin)

6           S: ObservationDetectedIssueCode (OBSA) S16664 OBSA Observation Alert

Proposed therapy may be inappropriate or contraindicated due to conditions or characteristics of the patient

7             S: AgeDetectedIssueCode (AGE) S16669 AGE Age Alert

Proposed therapy may be inappropriate or contraindicated due to patient age

8               L:  (DOSEHINDA) C17788 DOSEHINDA High Dose for Age Alert

Proposed dosage exceeds standard practice for the patient's age

8               L:  (DOSELINDA) C17792 DOSELINDA Low Dose for Age Alert

Proposed dosage is below suggested therapeutic levels for the patient's age

7             S: ConditionDetectedIssueCode (COND) S16665 COND Condition Alert

Proposed therapy may be inappropriate or contraindicated due to an existing/recent patient condition or diagnosis

8               A: HeightSurfaceAreaAlert A17795

Proposed therapy may be inappropriate based on the patient's height or body surface area

9                 L:  (DOSEHINDSA) C17787 DOSEHINDSA High Dose for Height/Surface Area Alert

Proposed dosage exceeds standard practice for the patient's height or body surface area

9                 L:  (DOSELINDSA) C17791 DOSELINDSA Low Dose for Height/Surface Area Alert

Proposed dosage is below suggested therapeutic levels for the patient's height or body surface area

8               L:  (LACT) C16667 LACT Lactation Alert

Proposed therapy may be inappropriate or contraindicated when breast-feeding

8               L:  (PREG) C16666 PREG Pregnancy Alert

Proposed therapy may be inappropriate or contraindicated during pregnancy

8               A: WeightAlert A17794

Proposed therapy may be inappropriate based on the patient's weight

9                 L:  (DOSEHINDW) C17786 DOSEHINDW High Dose for Weight Alert

Proposed dosage exceeds standard practice for the patient's weight

9                 L:  (DOSELINDW) C17790 DOSELINDW Low Dose for Weight Alert

Proposed dosage is below suggested therapeutic levels for the patient's weight

7             L:  (GEND) C16670 GEND Gender Alert

Proposed therapy may be inappropriate or contraindicated due to patient gender.

7             L:  (GEN) C16671 GEN Genetic Alert

Proposed therapy may be inappropriate or contraindicated due to patient genetic indicators.

7             L:  (LAB) C16668 LAB Lab Alert

Proposed therapy may be inappropriate or contraindicated due to recent lab test results

7             S: ReactionDetectedIssueCode (REACT) S16672 REACT Reaction Alert

Proposed therapy may be inappropriate or contraindicated based on the potential for a patient reaction to the proposed product

8               L:  (ALGY) C16674 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.)

8               L:  (INT) C16673 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.)

7             S: RelatedReactionDetectedIssueCode (RREACT) S16676 RREACT Related Reaction Alert

Proposed therapy may be inappropriate or contraindicated because of a potential patient reaction to a cross-sensitivity related product.

8               L:  (RALG) C16678 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.)

8               L:  (RINT) C16677 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.)

8               L:  (RAR) C16679 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.

5         S: ComplianceDetectedIssueCode (COMPLY) S16687 COMPLY Compliance Alert

There may be an issue with the patient complying with the intentions of the proposed therapy

6           L:  (DUPTHPY) C16688 DUPTHPY Duplicate Therapy Alert

The proposed therapy appears to duplicate an existing therapy

6           L:  (PLYDOC) C16689 PLYDOC Poly-orderer Alert

A similar or identical therapy was recently ordered by a different practitioner.

6           L:  (PLYPHRM) C16690 PLYPHRM Poly-supplier Alert

This patient was recently supplied a similar or identical therapy from a different pharmacy or supplier.

5         S: DosageProblemDetectedIssueCode (DOSE) S16680 DOSE Dosage problem

Proposed dosage instructions for therapy differ from standard practice.

6           S: DoseDurationDetectedIssueCode (DOSEDUR) S16684 DOSEDUR Dose-Duration Alert

Proposed length of therpay differs from standard practice

7             S: DoseDurationHighDetectedIssueCode (DOSEDURH) S16686 DOSEDURH Dose-Duration High Alert

Proposed length of therapy is longer than standard practice

8               L:  (DOSEDURHIND) C17782 DOSEDURHIND Dose-Duration High for Indication Alert

Proposed length of therapy is longer than standard practice for the identified indication or diagnosis

7             S: DoseDurationLowDetectedIssueCode (DOSEDURL) S16685 DOSEDURL Dose-Duration Low Alert

Proposed length of therapy is shorter than that necessary for therapeutic effect

8               L:  (DOSEDURLIND) C17783 DOSEDURLIND Dose-Duration Low for Indication Alert

Proposed length of therapy is shorter than standard practice for the identified indication or diagnosis

6           S: DoseHighDetectedIssueCode (DOSEH) S16681 DOSEH High Dose Alert

Proposed dosage exceeds standard practice

7             L:  (DOSEHINDA) C17788 DOSEHINDA High Dose for Age Alert

Proposed dosage exceeds standard practice for the patient's age

7             L:  (DOSEHINDSA) C17787 DOSEHINDSA High Dose for Height/Surface Area Alert

Proposed dosage exceeds standard practice for the patient's height or body surface area

7             L:  (DOSEHIND) C17785 DOSEHIND High Dose for Indication Alert
7             L:  (DOSEHINDW) C17786 DOSEHINDW High Dose for Weight Alert

Proposed dosage exceeds standard practice for the patient's weight

6           S: DoseIntervalDetectedIssueCode (DOSEIVL) S16683 DOSEIVL Dose-Interval Alert

Proposed dosage interval/timing differs from standard practice

7             L:  (DOSEIVLIND) C17784 DOSEIVLIND Dose-Interval for Indication Alert

Proposed dosage interval/timing differs from standard practice for the identified indication or diagnosis

6           S: DoseLowDetectedIssueCode (DOSEL) S16682 DOSEL Low Dose Alert

Proposed dosage is below suggested therapeutic levels

7             L:  (DOSELINDA) C17792 DOSELINDA Low Dose for Age Alert

Proposed dosage is below suggested therapeutic levels for the patient's age

7             L:  (DOSELINDSA) C17791 DOSELINDSA Low Dose for Height/Surface Area Alert

Proposed dosage is below suggested therapeutic levels for the patient's height or body surface area

7             L:  (DOSELIND) C17789 DOSELIND Low Dose for Indication Alert
7             L:  (DOSELINDW) C17790 DOSELINDW Low Dose for Weight Alert

Proposed dosage is below suggested therapeutic levels for the patient's weight

5         A: DrugActionDetectedIssueCode A17815

Proposed therapy may be contraindicated or ineffective based on an existing or recent drug therapy

5         A: TimingDetectedIssueCode A17816

Proposed therapy may be inappropriate or ineffective based on the proposed start or end time.

6           L:  (ENDLATE) C17818 ENDLATE End Too Late Alert

Proposed therapy may be inappropriate or ineffective because the end of administration is too close to another planned therapy

6           L:  (STRTLATE) C17817 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

4       A: SupplyDetectedIssueCode A16691

Supplying the product at this time may be inappropriate or indicate compliance issues with the associated therapy

5         L:  (TOOLATE) C16693 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

5         L:  (TOOSOON) C16692 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

3     A: ClinicalActionDetectedIssueCode A17814

Identifies types of issues detected regarding the performance of a clinical action on a patient.

2   A: ActDetectedIssueManagementCode A16695

Codes dealing with the management of Detected Issue observations

3     A: ActAdministrativeDetectedIssueManagementCode A19431

Codes dealing with the management of Detected Issue observations for the administrative and patient administrative acts domains.

4       A: AuthorizationIssueManagementCode A19619
5         L:  (EMAUTH) C21388 EMAUTH emergency authorization override

Used to temporarily override normal authorization rules to gain access to data in a case of emergency. Use of this override code will typically be monitored, and a procedure to verify its proper use may be triggered when used.

3     A: ActFinancialDetectedIssueManagementCode A19430

Codes dealing with the management of Detected Issue observations for the financial acts domain.

3     S: OtherActionTakenManagementCode (8) S16703 8 Other Action Taken

Order is performed as issued, but other action taken to mitigate potential adverse effects

4       L:  (11) C16706 11 Added Concurrent Therapy

Instituted an additional therapy to mitigate potential negative effects

4       L:  (9) C16704 9 Instituted Ongoing Monitoring Program

Arranged to monitor patient for adverse effects

4       L:  (10) C16705 10 Provided Patient Education

Provided education or training to the patient on appropriate therapy use

4       L:  (13) C16708 13 Stopped Concurrent Therapy

Aborted existing therapy that triggered interaction.

4       L:  (12) C16707 12 Temporarily Suspended Concurrent Therapy

Suspended existing therapy that triggered interaction for the duration of this therapy

3     S: SupplyAppropriateManagementCode (14) S16709 14 Supply Appropriate

Confirmed supply action appropriate

4       L:  (18) C17835 18 Leave of Absence

Supply is intended for use during a leave of absence from an institution.

4       L:  (15) C16710 15 Replacement

Patient's existing supply was lost/wasted

4       L:  (16) C16711 16 Vacation Supply

Supply date is due to patient vacation

4       L:  (17) C16712 17 Weekend Supply

Supply date is intended to carry patient over weekend

3     S: TherapyAppropriateManagementCode (1) S16696 1 Therapy Appropriate

Confirmed drug therapy appropriate

4       L:  (2) C16697 2 Assessed Patient

Assessed patient, therapy is appropriate

4       L:  (4) C16699 4 Consulted Other Source

Consulted other supply source, therapy still appropriate

4       L:  (19) C17836 19 Consulted Supplier

Consulted other supplier/pharmacy, therapy confirmed

4       S: ConsultedPrescriberManagementCode (5) S16700 5 Consulted Prescriber

Consulted prescriber, therapy confirmed

5         L:  (6) C16701 6 Prescriber Declined Change

Consulted prescriber and recommended change, prescriber declined

4       L:  (7) C16702 7 Interacting Therapy No Longer Active/Planned

Concurrent therapy triggering alert is no longer on-going or planned

4       L:  (3) C16698 3 Patient Explanation

Patient gave adequate explanation

2   A: ActDietCode A10376

Code set to define specialized/allowed diets

3     L:  (BR) C10379 BR breikost (GE)

A diet exclusively composed of oatmeal, semolina, or rice, to be extremely easy to eat and digest.

3     L:  (DM) C10383 DM diabetes mellitus diet

A diet that uses carbohydrates sparingly. Typically with a restriction in daily energy content (e.g. 1600-2000 kcal).

3     L:  (FAST) C10382 FAST fasting

No enteral intake of foot or liquids whatsoever, no smoking. Typically 6 to 8 hours before anesthesia.

3     L:  (GF) C10390 GF gluten free

Gluten free diet for celiac disease.

3     L:  (LQ) C10380 LQ liquid

A strictly liquid diet, that can be fully absorbed in the intestine, and therefore may not contain fiber. Used before enteral surgeries.

3     L:  (LF) C10386 LF low fat

A diet low in fat, particularly to patients with hepatic diseases.

3     L:  (LP) C10389 LP low protein

A low protein diet for patients with renal failure.

3     L:  (LS) C10388 LS low sodium

A diet low in sodium for patients with congestive heart failure and/or renal failure.

3     L:  (VLI) C10392 VLI low valin, leucin, isoleucin

Diet with low content of the amino-acids valin, leucin, and isoleucin, for "maple syrup disease."

3     L:  (NF) C10387 NF no fat

A no fat diet for acute hepatic diseases.

3     L:  (N) C10377 N normal diet

A normal diet, i.e. no special preparations or restrictions for medical reasons. This is notwithstanding any preferences the patient might have regarding special foods, such as vegetarian, kosher, etc.

3     L:  (PAR) C10385 PAR parenteral

Patient is supplied with parenteral nutrition, typically described in terms of i.v. medications.

3     L:  (PAF) C10391 PAF phenylalanine free

Phenylketonuria diet.

3     L:  (RD) C10384 RD reduction diet

A diet that seeks to reduce body fat, typically low energy content (800-1600 kcal).

3     L:  (SCH) C10378 SCH schonkost (GE)

A diet that avoids ingredients that might cause digestion problems, e.g., avoid excessive fat, avoid too much fiber (cabbage, peas, beans).

3     L:  (T) C10381 T tea only

This is not really a diet, since it contains little nutritional value, but is essentially just water. Used before coloscopy examinations.

2   A: ActDisciplinaryActionCode A19642

An action taken with respect to a subject Entity by a regulatory or authoritative body with supervisory capacity over that entity. The action is taken in response to behavior by the subject Entity that body finds to be undesirable.

Suspension, license restrictions, monetary fine, letter of reprimand, mandated training, mandated supervision, etc.Examples:

2   A: ActEncounterAccommodationCode A16130

Accommodation type. In Intent mood, represents the accommodation type requested. In Event mood, represents accommodation assigned/used. In Definition mood, represents the available accommodation type.

3     L:  (I) C16134 I Isolation

Accommodations used in the care of diseases that are transmitted through casual contact or respiratory transmission.

3     L:  (P) C16131 P Private

Accommodations in which there is only 1 bed.

3     L:  (SP) C16132 SP Semi-private

Accommodations in which there are 2 beds.

3     L:  (S) C16133 S Suite

Uniquely designed and elegantly decorated accommodations with many amenities available for an additional charge.

3     L:  (W) C16135 W Ward

Accommodations in which there are 3 or more beds.

2   A: ActEncounterCode A13955

Domain provides codes that qualify the ActEncounterClass (ENC)

3     S: ActInpatientEncounterCode (IMP) S16847 IMP inpatient encounter

An inpatient encounter is an encounter in which the patient is admitted to a hospital or equivalent facility.

4       L:  (ACUTE) C13956 ACUTE inpatient acute

An acute inpatient encounter.

4       L:  (NONAC) C16238 NONAC inpatient non-acute

Any category of inpatient encounter except 'acute'

3     A: ActMedicalServiceCode A17449

General category of medical service provided to the patient during their encounter.

4       L:  (ALC) C17459 ALC Alternative Level of Care

Provision of Alternate Level of Care to a patient in an acute bed. Patient is waiting for placement in a long-term care facility and is unable to return home.

4       L:  (CARD) C20092 CARD Cardiology

Provision of diagnosis and treatment of diseases and disorders affecting the heart

4       L:  (CHR) C17453 CHR Chronic

Provision of recurring care for chronic illness.

4       L:  (DNTL) C17456 DNTL Dental

Provision of treatment for oral health and/or dental surgery.

4       L:  (DRGRHB) C17454 DRGRHB Drug Rehab

Provision of treatment for drug abuse.

4       L:  (GENRL) C19974 GENRL General

General care performed by a general practitioner or family doctor as a responsible provider for a patient.

4       L:  (MED) C17450 MED Medical

Provision of diagnostic and/or therapeutic treatment.

4       L:  (OBS) C17460 OBS Obstetrics

Provision of care of women during pregnancy, childbirth and immediate postpartum period. Also known as Maternity.

4       L:  (ONC) C17457 ONC Oncology

Provision of treatment and/or diagnosis related to tumors and/or cancer.

4       L:  (PALL) C17452 PALL Palliative

Provision of care for patients who are living or dying from an advanced illness.

4       L:  (PED) C17461 PED Pediatrics

Provision of diagnosis and treatment of diseases and disorders affecting children.

4       L:  (PHAR) C19975 PHAR Pharmaceutical

Pharmaceutical care performed by a pharmacist.

4       L:  (PHYRHB) C17455 PHYRHB Physical Rehab

Provision of treatment for physical injury.

4       L:  (PSYCH) C17458 PSYCH Psychiatric

Provision of treatment of psychiatric disorder relating to mental illness.

4       L:  (SURG) C17451 SURG Surgical

Provision of surgical treatment.

3     L:  (AMB) C16239 AMB ambulatory

A comprehensive term for health care provided in a healthcare facility (e.g. a practitioneraTMs office, clinic setting, or hospital) on a nonresident basis. The term ambulatory usually implies that the patient has come to the location and is not assigned to a bed. Sometimes referred to as an outpatient encounter.

3     L:  (EMER) C16240 EMER emergency

A patient encounter that takes place at a dedicated healthcare service delivery location where the patient receives immediate evaluation and treatment, provided until the patient can be discharged or responsibility for the patient's care is transferred elsewhere (for example, the patient could be admitted as an inpatient or transferred to another facility.)

3     L:  (FLD) C16235 FLD field

A patient encounter that takes place both outside a dedicated service delivery location and outside a patient's residence. Example locations might include an accident site and at a supermarket.

3     L:  (HH) C16237 HH home health

Healthcare encounter that takes place in the residence of the patient or a designee

3     L:  (SS) C21444 SS short stay

An encounter where the patient is admitted to a health care facility for a predetermined length of time, usually less than 24 hours.

3     L:  (VR) C16236 VR virtual

A patient encounter where the patient and the practitioner(s) are not in the same physical location. Examples include telephone conference, email exchange, robotic surgery, and televideo conference.

2   A: ActFinancialTransactionCode A14804
3     L:  (CHRG) C14805 CHRG Standard Charge

A type of transaction that represents a charge for a service or product. Expressed in monetary terms.

3     L:  (REV) C14806 REV Standard Charge Reversal

A type of transaction that represents a reversal of a previous charge for a service or product. Expressed in monetary terms. It has the opposite effect of a standard charge.

2   A: ActIncidentCode A16508

Set of codes indicating the type of incident or accident.

3     L:  (MVA) C16509 MVA Motor vehicle accident

Incident or accident as the result of a motor vehicle accident

3     L:  (SCHOOL) C17468 SCHOOL School Accident

Incident or accident is the result of a school place accident.

3     L:  (SPT) C17469 SPT Sporting Accident

Incident or accident is the result of a sporting accident.

3     L:  (WPA) C16510 WPA Workplace accident

Incident or accident is the result of a work place accident

2   A: ActInsurancePolicyCode A19350

Set of codes indicating the type of insurance policy or other source of funds to cover healthcare costs.

3     L:  (AUTOPOL) C19721 AUTOPOL automobile

Insurance policy for injuries sustained in an automobile accident. Will also typically covered non-named parties to the policy, such as pedestrians and passengers.

3     L:  (EHCPOL) C19722 EHCPOL extended healthcare

Private insurance policy that provides coverage in addition to other policies (e.g. in addition to a Public Healthcare insurance policy).

3     L:  (HSAPOL) C19720 HSAPOL health spending account

Insurance policy that provides for an allotment of funds replenished on a periodic (e.g. annual) basis. The use of the funds under this policy is at the discretion of the covered party.

3     L:  (PUBLICPOL) C19718 PUBLICPOL public healthcare

Insurance policy funded by a public health system such as a provincial or national health plan. Examples include BC MSP (British Columbia Medical Services Plan) OHIP (Ontario Health Insurance Plan), NHS (National Health Service).

3     L:  (WCBPOL) C19719 WCBPOL worker's compensation

Insurance policy for injuries sustained in the work place or in the course of employment.

2   A: ActInvoiceElementCode A19397

Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results.

3     A: ActInvoiceAdjudicationPaymentCode A19412

Codes representing a grouping of invoice elements (totals, sub-totals), reported through a Payment Advice or a Statement of Financial Activity (SOFA). The code can represent summaries by day, location, payee and other cost elements such as bonus, retroactive adjustment and transaction fees.

4       A: ActInvoiceAdjudicationPaymentGroupCode A19414

Codes representing adjustments to a Payment Advice such as retroactive, clawback, garnishee, etc.

4       A: ActInvoiceAdjudicationPaymentSummaryCode A19413

Codes representing a grouping of invoice elements (totals, sub-totals), reported through a Payment Advice or a Statement of Financial Activity (SOFA). The code can represent summaries by day, location, payee, etc.

5         L:  (CONT) C17974 CONT contract

Transaction counts and value totals by Contract Identifier.

5         L:  (DAY) C17969 DAY day

Transaction counts and value totals for each calendar day within the date range specified.

5         L:  (INVTYPE) C20055 INVTYPE invoice type

Transaction counts and value totals by invoice type (e.g. RXDINV - Pharmacy Dispense)

5         L:  (LOC) C17976 LOC location

Transaction counts and value totals by service location (e.g clinic).

5         L:  (MONTH) C17970 MONTH month

Transaction counts and value totals for each calendar month within the date range specified.

5         L:  (PAYEE) C20057 PAYEE payee

Transaction counts and value totals by each instance of an invoice payee.

5         L:  (PAYOR) C20056 PAYOR payor

Transaction counts and value totals by each instance of an invoice payor.

5         L:  (PERIOD) C17971 PERIOD period

Transaction counts and value totals for the date range specified.

5         L:  (PROV) C17975 PROV provider

Transaction counts and value totals by Provider Identifier.

5         L:  (SENDAPP) C20054 SENDAPP sending application

Transaction counts and value totals by each instance of a messaging application on a single processor. It is a registered identifier known to the receivers.

5         L:  (WEEK) C17972 WEEK week

Transaction counts and value totals for each calendar week within the date range specified.

5         L:  (YEAR) C17973 YEAR year

Transaction counts and value totals for each calendar year within the date range specified.

3     A: ActInvoiceDetailCode A19401

Codes representing a service or product that is being invoiced (billed). The code can represent such concepts as "office visit", "drug X", "wheelchair" and other billable items such as taxes, service charges and discounts.

4       A: ActInvoiceDetailClinicalProductCode A19404

An identifying data string for healthcare products.

4       A: ActInvoiceDetailClinicalServiceCode A19405

An identifying data string for healthcare procedures.

4       A: ActInvoiceDetailDrugProductCode A19402

An identifying data string for A substance used as a medication or in the preparation of medication.

4       A: ActInvoiceDetailGenericCode A19407

The detail item codes to identify charges or changes to the total billing of a claim due to insurance rules and payments.

5         A: ActInvoiceDetailGenericAdjudicatorCode A19411

The billable item codes to identify adjudicator specified components to the total billing of a claim.

6           L:  (DEDUCTIBLE) C20051 DEDUCTIBLE deductible

That portion of the eligible charges which a covered party must pay in a particular period (e.g. annual) before the benefits are payable by the adjudicator. This amount represents the covered party's deductible that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results.

6           L:  (COPAYMENT) C20052 COPAYMENT patient co-pay

That portion of the eligible charges which a covered party must pay for each service and/or product. It is either a defined amount per service/product or percentage of the eligibile amount for the service/product. This amount represents the covered party's copayment that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results.

6           L:  (PAY) C21362 PAY payment

The guarantor, who may be the patient, pays the entire charge for a service. Reasons for such action may include: there is no insurance coverage for the service (e.g. cosmetic surgery); the patient wishes to self-pay for the service; or the insurer denies payment for the service due to contractual provisions such as the need for prior authorization.

5         A: ActInvoiceDetailGenericModifierCode A19410

The billable item codes to identify modifications to a billable item charge. As for example after hours increase in the office visit fee.

6           L:  (ISOL) C20048 ISOL isolation allowance

Premium paid on service fees in compensation for practicing in a remote location.

6           L:  (AFTHRS) C20049 AFTHRS non-normal hours

Premium paid on service fees in compensation for practicing outside of normal working hours.

6           L:  (OOO) C20050 OOO out of office

Premium paid on service fees in compensation for practicing at a location other than normal working location.

5         A: ActInvoiceDetailGenericProviderCode A19408

The billable item codes to identify provider supplied charges or changes to the total billing of a claim.

6           L:  (CANCAPT) C20040 CANCAPT cancelled appointment

A charge to compensate the provider when a patient cancels an appointment with insufficient time for the provider to make another appointment with another patient.

6           L:  (DSC) C20042 DSC discount

A reduction in the amount charged as a percentage of the amount. For example a 5% discount for volume purchase.

6           L:  (ESA) C20043 ESA extraordinary service assessment

A premium on a service fee is requested because, due to extenuating circumstances, the service took an extraordinary amount of time or supplies.

6           L:  (FFSTOP) C21311 FFSTOP fee for service top off

Under agreement between the parties (payor and provider), a guaranteed level of income is established for the provider over a specific, pre-determined period of time. The normal course of business for the provider is submission of fee-for-service claims. Should the fee-for-service income during the specified period of time be less than the agreed to amount, a top-up amount is paid to the provider equal to the difference between the fee-for-service total and the guaranteed income amount for that period of time. The details of the agreement may specify (or not) a requirement for repayment to the payor in the event that the fee-for-service income exceeds the guaranteed amount.

6           L:  (FNLFEE) C21314 FNLFEE final fee

Anticipated or actual final fee associated with treating a patient.

6           L:  (FRSTFEE) C21313 FRSTFEE first fee

Anticipated or actual initial fee associated with treating a patient.

6           L:  (MARKUP) C20038 MARKUP markup or up-charge

An increase in the amount charged as a percentage of the amount. For example, 12% markup on product cost.

6           L:  (MISSAPT) C20039 MISSAPT missed appointment

A charge to compensate the provider when a patient does not show for an appointment.

6           L:  (PERMBNS) C21310 PERMBNS performance bonus

The amount for a performance bonus that is being requested from a payor for the performance of certain services (childhood immunizations, influenza immunizations, mammograms, pap smears) on a sliding scale. That is, for 90% of childhood immunizations to a maximum of $2200/yr. An invoice is created at the end of the service period (one year) and a code is submitted indicating the percentage achieved and the dollar amount claimed.

6           L:  (PERFEE) C21312 PERFEE periodic fee

Anticipated or actual periodic fee associated with treating a patient. For example, expected billing cycle such as monthly, quarterly. The actual period (e.g. monthly, quarterly) is specified in the unit quantity of the Invoice Element.

6           L:  (RESTOCK) C20044 RESTOCK restocking fee

A charge is requested because the patient failed to pick up the item and it took an amount of time to return it to stock for future use.

6           L:  (TRAVEL) C20041 TRAVEL travel

A charge to cover the cost of travel time and/or cost in conjuction with providing a service or product. It may be charged per kilometer or per hour based on the effective agreement.

6           L:  (URGENT) C21315 URGENT urgent

Premium paid on service fees in compensation for providing an expedited response to an urgent situation.

5         A: ActInvoiceDetailTaxCode A19409

The billable item codes to identify modifications to a billable item charge by a tax factor applied to the amount. As for example 7% provincial sales tax.

6           L:  (FST) C20045 FST federal sales tax

Federal tax on transactions such as the Goods and Services Tax (GST)

6           L:  (HST) C20047 HST harmonized sales Tax

Joint Federal/Provincial Sales Tax

6           L:  (PST) C20046 PST provincial/state sales tax

Tax levied by the provincial or state jurisdiction such as Provincial Sales Tax

4       A: ActInvoiceDetailPreferredAccommodationCode A19406

An identifying data string for medical facility accommodations.

5         A: ActEncounterAccommodationCode A16130

Accommodation type. In Intent mood, represents the accommodation type requested. In Event mood, represents accommodation assigned/used. In Definition mood, represents the available accommodation type.

6           L:  (I) C16134 I Isolation

Accommodations used in the care of diseases that are transmitted through casual contact or respiratory transmission.

6           L:  (P) C16131 P Private

Accommodations in which there is only 1 bed.

6           L:  (SP) C16132 SP Semi-private

Accommodations in which there are 2 beds.

6           L:  (S) C16133 S Suite

Uniquely designed and elegantly decorated accommodations with many amenities available for an additional charge.

6           L:  (W) C16135 W Ward

Accommodations in which there are 3 or more beds.

4       A: CanadianActInvoiceDetailClinicalProductCode A19432

An identifying data string for healthcare products, for use in Canada.

4       A: CanadianActInvoiceDetailClinicalServiceCode A19434

An identifying data string for healthcare products., for use in Canada.

4       A: x_ActInvoiceDetailPharmacyCode A19415

The billable codes selected for use for Pharmacy Invoices. Steward is Financial Management.

5         A: ActInvoiceDetailClinicalProductCode A19404

An identifying data string for healthcare products.

5         A: ActInvoiceDetailClinicalServiceCode A19405

An identifying data string for healthcare procedures.

5         A: ActInvoiceDetailDrugProductCode A19402

An identifying data string for A substance used as a medication or in the preparation of medication.

5         A: ActInvoiceDetailGenericCode A19407

The detail item codes to identify charges or changes to the total billing of a claim due to insurance rules and payments.

6           A: ActInvoiceDetailGenericAdjudicatorCode A19411

The billable item codes to identify adjudicator specified components to the total billing of a claim.

7             L:  (DEDUCTIBLE) C20051 DEDUCTIBLE deductible

That portion of the eligible charges which a covered party must pay in a particular period (e.g. annual) before the benefits are payable by the adjudicator. This amount represents the covered party's deductible that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results.

7             L:  (COPAYMENT) C20052 COPAYMENT patient co-pay

That portion of the eligible charges which a covered party must pay for each service and/or product. It is either a defined amount per service/product or percentage of the eligibile amount for the service/product. This amount represents the covered party's copayment that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results.

7             L:  (PAY) C21362 PAY payment

The guarantor, who may be the patient, pays the entire charge for a service. Reasons for such action may include: there is no insurance coverage for the service (e.g. cosmetic surgery); the patient wishes to self-pay for the service; or the insurer denies payment for the service due to contractual provisions such as the need for prior authorization.

6           A: ActInvoiceDetailGenericModifierCode A19410

The billable item codes to identify modifications to a billable item charge. As for example after hours increase in the office visit fee.

7             L:  (ISOL) C20048 ISOL isolation allowance

Premium paid on service fees in compensation for practicing in a remote location.

7             L:  (AFTHRS) C20049 AFTHRS non-normal hours

Premium paid on service fees in compensation for practicing outside of normal working hours.

7             L:  (OOO) C20050 OOO out of office

Premium paid on service fees in compensation for practicing at a location other than normal working location.

6           A: ActInvoiceDetailGenericProviderCode A19408

The billable item codes to identify provider supplied charges or changes to the total billing of a claim.

7             L:  (CANCAPT) C20040 CANCAPT cancelled appointment

A charge to compensate the provider when a patient cancels an appointment with insufficient time for the provider to make another appointment with another patient.

7             L:  (DSC) C20042 DSC discount

A reduction in the amount charged as a percentage of the amount. For example a 5% discount for volume purchase.

7             L:  (ESA) C20043 ESA extraordinary service assessment

A premium on a service fee is requested because, due to extenuating circumstances, the service took an extraordinary amount of time or supplies.

7             L:  (FFSTOP) C21311 FFSTOP fee for service top off

Under agreement between the parties (payor and provider), a guaranteed level of income is established for the provider over a specific, pre-determined period of time. The normal course of business for the provider is submission of fee-for-service claims. Should the fee-for-service income during the specified period of time be less than the agreed to amount, a top-up amount is paid to the provider equal to the difference between the fee-for-service total and the guaranteed income amount for that period of time. The details of the agreement may specify (or not) a requirement for repayment to the payor in the event that the fee-for-service income exceeds the guaranteed amount.

7             L:  (FNLFEE) C21314 FNLFEE final fee

Anticipated or actual final fee associated with treating a patient.

7             L:  (FRSTFEE) C21313 FRSTFEE first fee

Anticipated or actual initial fee associated with treating a patient.

7             L:  (MARKUP) C20038 MARKUP markup or up-charge

An increase in the amount charged as a percentage of the amount. For example, 12% markup on product cost.

7             L:  (MISSAPT) C20039 MISSAPT missed appointment

A charge to compensate the provider when a patient does not show for an appointment.

7             L:  (PERMBNS) C21310 PERMBNS performance bonus

The amount for a performance bonus that is being requested from a payor for the performance of certain services (childhood immunizations, influenza immunizations, mammograms, pap smears) on a sliding scale. That is, for 90% of childhood immunizations to a maximum of $2200/yr. An invoice is created at the end of the service period (one year) and a code is submitted indicating the percentage achieved and the dollar amount claimed.

7             L:  (PERFEE) C21312 PERFEE periodic fee

Anticipated or actual periodic fee associated with treating a patient. For example, expected billing cycle such as monthly, quarterly. The actual period (e.g. monthly, quarterly) is specified in the unit quantity of the Invoice Element.

7             L:  (RESTOCK) C20044 RESTOCK restocking fee

A charge is requested because the patient failed to pick up the item and it took an amount of time to return it to stock for future use.

7             L:  (TRAVEL) C20041 TRAVEL travel

A charge to cover the cost of travel time and/or cost in conjuction with providing a service or product. It may be charged per kilometer or per hour based on the effective agreement.

7             L:  (URGENT) C21315 URGENT urgent

Premium paid on service fees in compensation for providing an expedited response to an urgent situation.

6           A: ActInvoiceDetailTaxCode A19409

The billable item codes to identify modifications to a billable item charge by a tax factor applied to the amount. As for example 7% provincial sales tax.

7             L:  (FST) C20045 FST federal sales tax

Federal tax on transactions such as the Goods and Services Tax (GST)

7             L:  (HST) C20047 HST harmonized sales Tax

Joint Federal/Provincial Sales Tax

7             L:  (PST) C20046 PST provincial/state sales tax

Tax levied by the provincial or state jurisdiction such as Provincial Sales Tax

4       A: x_ActInvoiceDetailPreferredAccommodationCode A19416

The billable codes selected for use for Preferred Accommodation Invoices. Steward is Financial Management.

5         A: ActInvoiceDetailPreferredAccommodationCode A19406

An identifying data string for medical facility accommodations.

6           A: ActEncounterAccommodationCode A16130

Accommodation type. In Intent mood, represents the accommodation type requested. In Event mood, represents accommodation assigned/used. In Definition mood, represents the available accommodation type.

7             L:  (I) C16134 I Isolation

Accommodations used in the care of diseases that are transmitted through casual contact or respiratory transmission.

7             L:  (P) C16131 P Private

Accommodations in which there is only 1 bed.

7             L:  (SP) C16132 SP Semi-private

Accommodations in which there are 2 beds.

7             L:  (S) C16133 S Suite

Uniquely designed and elegantly decorated accommodations with many amenities available for an additional charge.

7             L:  (W) C16135 W Ward

Accommodations in which there are 3 or more beds.

3     A: ActInvoiceGroupCode A19398

Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results.

Invoice elements of this type signify a grouping of one or more children (detail) invoice elements. They do not have intrinsic costing associated with them, but merely reflect the sum of all costing for it's immediate children invoice elements.

4       A: ActInvoiceInterGroupCode A19400

Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results.

Invoice elements of this type signify a grouping of one or more children (detail) invoice elements. They do not have intrinsic costing associated with them, but merely reflect the sum of all costing for it's immediate children invoice elements.

The domain is only specified for an intermediate invoice element group (non-root or non-top level) for an Invoice.

5         L:  (CPNDDRGING) C20033 CPNDDRGING compound drug invoice group

A grouping of invoice element groups and details including the ones specifying the compound ingredients being invoiced. It may also contain generic detail items such as markup.

5         L:  (CPNDINDING) C20034 CPNDINDING compound ingredient invoice group

A grouping of invoice element details including the one specifying an ingredient drug being invoiced. It may also contain generic detail items such as tax or markup.

5         L:  (CPNDSUPING) C20035 CPNDSUPING compound supply invoice group

A grouping of invoice element groups and details including the ones specifying the compound supplies being invoiced. It may also contain generic detail items such as markup.

5         L:  (DRUGING) C20032 DRUGING drug invoice group

A grouping of invoice element details including the one specifying the drug being invoiced. It may also contain generic detail items such as markup.

5         L:  (FRAMEING) C20037 FRAMEING frame invoice group

A grouping of invoice element details including the ones specifying the frame fee and the frame dispensing cost that are being invoiced.

5         L:  (LENSING) C20036 LENSING lens invoice group

A grouping of invoice element details including the ones specifying the lens fee and the lens dispensing cost that are being invoiced.

5         L:  (PRDING) C20031 PRDING product invoice group

A grouping of invoice element details including the one specifying the product (good or supply) being invoiced. It may also contain generic detail items such as tax or discount.

4       A: ActInvoiceRootGroupCode A19399

Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results.

Invoice elements of this type signify a grouping of one or more children (detail) invoice elements. They do not have intrinsic costing associated with them, but merely reflect the sum of all costing for it's immediate children invoice elements.

Codes from this domain reflect the type of Invoice such as Pharmacy Dispense, Clinical Service and Clinical Product. The domain is only specified for the root (top level) invoice element group for an Invoice.

5         L:  (RXCINV) C20027 RXCINV Rx compound invoice

Pharmacy dispense invoice for a compound.

5         L:  (RXDINV) C20028 RXDINV Rx dispense invoice

Pharmacy dispense invoice not involving a compound

5         L:  (CPINV) C19715 CPINV clinical product invoice

Clinical product invoice where the Invoice Grouping contains one or more billable item and is supported by clinical product(s).

For example, a crutch or a wheelchair.

5         L:  (CSPINV) C20076 CSPINV clinical service and product

A clinical Invoice Grouping consisting of one or more services and one or more product. Billing for these service(s) and product(s) are supported by multiple clinical billable events (acts).

All items in the Invoice Grouping must be adjudicated together to be acceptable to the Adjudicator.

For example , a brace (product) invoiced together with the fitting (service).

5         L:  (CSINV) C19714 CSINV clinical service invoice

Clinical Services Invoice which can be used to describe a single service, multiple services or repeated services.

[1] Single Clinical services invoice where the Invoice Grouping contains one billable item and is supported by one clinical service.

For example, a single service for an office visit or simple clinical procedure (e.g. knee mobilization).

[2] Multiple Clinical services invoice where the Invoice Grouping contains more than one billable item, supported by one or more clinical services. The services can be distinct and over multiple dates, but for the same patient. This type of invoice includes a series of treatments which must be adjudicated together.

For example, an adjustment and ultrasound for a chiropractic session where fees are associated for each of the services and adjudicated (invoiced) together.

[3] Repeated Clinical services invoice where the Invoice Grouping contains one or more billable item, supported by the same clinical service repeated over a period of time.

For example, the same Chiropractic adjustment (service or treatment) delivered on 3 separate occasions over a period of time at the discretion of the provider (e.g. month).

5         L:  (FININV) C19716 FININV financial invoice

Invoice Grouping without clinical justification. These will not require identification of participants and associations from a clinical context such as patient and provider.

Examples are interest charges and mileage.

5         L:  (OHSINV) C21309 OHSINV oral health service

A clinical Invoice Grouping consisting of one or more oral health services. Billing for these service(s) are supported by multiple clinical billable events (acts).

All items in the Invoice Grouping must be adjudicated together to be acceptable to the Adjudicator.

5         L:  (PAINV) C20029 PAINV preferred accommodation invoice

HealthCare facility preferred accommodation invoice.

5         L:  (SBFINV) C19717 SBFINV sessional or block fee invoice

Clinical services invoice where the Invoice Group contains one billable item for multiple clinical services in one or more sessions.

5         L:  (VRXINV) C20030 VRXINV vision dispense invoice

Vision dispense invoice for up to 2 lens (left and right), frame and optional discount. Eye exams are invoiced as a clinical service invoice.

2   A: ActInvoiceElementSummaryCode A17522

Identifies the different types of summary information that can be reported by queries dealing with Statement of Financial Activity (SOFA). The summary information is generally used to help resolve balance discrepancies between providers and payors.

3     A: InvoiceElementAdjudicated A17530

Total counts and total net amounts adjudicated for all Invoice Groupings that were adjudicated within a time period based on the adjudication date of the Invoice Grouping.

4       L:  (ADNPPPELAT) C17544 ADNPPPELAT adjud. non-payee payable prior-period electronic amount

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

4       L:  (ADNPPPELCT) C17543 ADNPPPELCT adjud. non-payee payable prior-period electronic count

Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

4       L:  (ADNPPPMNAT) C17546 ADNPPPMNAT adjud. non-payee payable prior-period manual amount

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.

4       L:  (ADNPPPMNCT) C17545 ADNPPPMNCT adjud. non-payee payable prior-period manual count

Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.

4       L:  (ADNPSPELAT) C17540 ADNPSPELAT adjud. non-payee payable same-period electronic amount

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

4       L:  (ADNPSPELCT) C17539 ADNPSPELCT adjud. non-payee payable same-period electronic count

Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

4       L:  (ADNPSPMNAT) C17542 ADNPSPMNAT adjud. non-payee payable same-period manual amount

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.

4       L:  (ADNPSPMNCT) C17541 ADNPSPMNCT adjud. non-payee payable same-period manual count

Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.

4       L:  (ADNFPPELAT) C20007 ADNFPPELAT adjud. nullified prior-period electronic amount

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically.

4       L:  (ADNFPPELCT) C20006 ADNFPPELCT adjud. nullified prior-period electronic count

Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically.

4       L:  (ADNFPPMNAT) C20009 ADNFPPMNAT adjud. nullified prior-period manual amount

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.

4       L:  (ADNFPPMNCT) C20008 ADNFPPMNCT adjud. nullified prior-period manual count

Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.

4       L:  (ADNFSPELAT) C20005 ADNFSPELAT adjud. nullified same-period electronic amount

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently nullified in the specified period and submitted electronically.

4       L:  (ADNFSPELCT) C20004 ADNFSPELCT adjud. nullified same-period electronic count

Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently nullified in the specified period and submitted electronically.

4       L:  (ADNFSPMNAT) C20011 ADNFSPMNAT adjud. nullified same-period manual amount

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.

4       L:  (ADNFSPMNCT) C20010 ADNFSPMNCT adjud. nullified same-period manual count

Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.

4       L:  (ADPPPPELAT) C17536 ADPPPPELAT adjud. payee payable prior-period electronic amount

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.

4       L:  (ADPPPPELCT) C17535 ADPPPPELCT adjud. payee payable prior-period electronic count

Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.

4       L:  (ADPPPPMNAT) C17538 ADPPPPMNAT adjud. payee payable prior-period manual amout

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.

4       L:  (ADPPPPMNCT) C17537 ADPPPPMNCT adjud. payee payable prior-period manual count

Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.

4       L:  (ADPPSPELAT) C17532 ADPPSPELAT adjud. payee payable same-period electronic amount

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.

4       L:  (ADPPSPELCT) C17531 ADPPSPELCT adjud. payee payable same-period electronic count

Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.

4       L:  (ADPPSPMNAT) C17534 ADPPSPMNAT adjud. payee payable same-period manual amount

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.

4       L:  (ADPPSPMNCT) C17533 ADPPSPMNCT adjud. payee payable same-period manual count

Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.

4       L:  (ADRFPPELAT) C17560 ADRFPPELAT adjud. refused prior-period electronic amount

Identifies the total net amount of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted electronically.

4       L:  (ADRFPPELCT) C17559 ADRFPPELCT adjud. refused prior-period electronic count

Identifies the total number of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted electronically.

4       L:  (ADRFPPMNAT) C17562 ADRFPPMNAT adjud. refused prior-period manual amount

Identifies the total net amount of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted manually.

4       L:  (ADRFPPMNCT) C17561 ADRFPPMNCT adjud. refused prior-period manual count

Identifies the total number of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted manually.

4       L:  (ADRFSPELAT) C17556 ADRFSPELAT adjud. refused same-period electronic amount

Identifies the total net amount of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted electronically.

4       L:  (ADRFSPELCT) C17555 ADRFSPELCT adjud. refused same-period electronic count

Identifies the total number of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted electronically.

4       L:  (ADRFSPMNAT) C17558 ADRFSPMNAT adjud. refused same-period manual amount

Identifies the total net amount of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted manually.

4       L:  (ADRFSPMNCT) C17557 ADRFSPMNCT adjud. refused same-period manual count

Identifies the total number of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted manually.

3     A: InvoiceElementPaid A17563

Total counts and total net amounts paid for all Invoice Groupings that were paid within a time period based on the payment date.

4       L:  (PDNPPPELAT) C17577 PDNPPPELAT paid non-payee payable prior-period electronic amount

Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

4       L:  (PDNPPPELCT) C17576 PDNPPPELCT paid non-payee payable prior-period electronic count

Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

4       L:  (PDNPPPMNAT) C17579 PDNPPPMNAT paid non-payee payable prior-period manual amount

Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually.

4       L:  (PDNPPPMNCT) C17578 PDNPPPMNCT paid non-payee payable prior-period manual count

Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually.

4       L:  (PDNPSPELAT) C17573 PDNPSPELAT paid non-payee payable same-period electronic amount

Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

4       L:  (PDNPSPELCT) C17572 PDNPSPELCT paid non-payee payable same-period electronic count

Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

4       L:  (PDNPSPMNAT) C17575 PDNPSPMNAT paid non-payee payable same-period manual amount

Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually.

4       L:  (PDNPSPMNCT) C17574 PDNPSPMNCT paid non-payee payable same-period manual count

Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually.

4       L:  (PDNFPPELAT) C20017 PDNFPPELAT paid nullified prior-period electronic amount

Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently nullified in the specified period and submitted electronically.

4       L:  (PDNFPPELCT) C20016 PDNFPPELCT paid nullified prior-period electronic count

Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently nullified in the specified period and submitted electronically.

4       L:  (PDNFPPMNAT) C20019 PDNFPPMNAT paid nullified prior-period manual amount

Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently nullified in the specified period and submitted manually.

4       L:  (PDNFPPMNCT) C20018 PDNFPPMNCT paid nullified prior-period manual count

Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently nullified in the specified period and submitted manually.

4       L:  (PDNFSPELAT) C20013 PDNFSPELAT paid nullified same-period electronic amount

Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently nullified in the specified period and submitted electronically.

4       L:  (PDNFSPELCT) C20012 PDNFSPELCT paid nullified same-period electronic count

Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently cancelled in the specified period and submitted electronically.

4       L:  (PDNFSPMNAT) C20015 PDNFSPMNAT paid nullified same-period manual amount

Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently nullified in the specified period and submitted manually.

4       L:  (PDNFSPMNCT) C20014 PDNFSPMNCT paid nullified same-period manual count

Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently nullified in the specified period and submitted manually.

4       L:  (PDPPPPELAT) C17569 PDPPPPELAT paid payee payable prior-period electronic amount

Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically.

4       L:  (PDPPPPELCT) C17568 PDPPPPELCT paid payee payable prior-period electronic count

Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically.

4       L:  (PDPPPPMNAT) C17571 PDPPPPMNAT paid payee payable prior-period manual amount

Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually.

4       L:  (PDPPPPMNCT) C17570 PDPPPPMNCT paid payee payable prior-period manual count

Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually.

4       L:  (PDPPSPELAT) C17565 PDPPSPELAT paid payee payable same-period electronic amount

Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically.

4       L:  (PDPPSPELCT) C17564 PDPPSPELCT paid payee payable same-period electronic count

Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically.

4       L:  (PDPPSPMNAT) C17567 PDPPSPMNAT paid payee payable same-period manual amount

Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually.

4       L:  (PDPPSPMNCT) C17566 PDPPSPMNCT paid payee payable same-period manual count

Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually.

3     A: InvoiceElementSubmitted A17523

Total counts and total net amounts billed for all Invoice Groupings that were submitted within a time period. Adjudicated invoice elements are included.

4       L:  (SBBLELAT) C19999 SBBLELAT submitted billed electronic amount

Identifies the total net amount billed for all submitted Invoice Groupings within a time period and submitted electronically. Adjudicated invoice elements are included.

4       L:  (SBBLELCT) C19998 SBBLELCT submitted billed electronic count

Identifies the total number of submitted Invoice Groupings within a time period and submitted electronically. Adjudicated invoice elements are included.

4       L:  (SBNFELCT) C20000 SBNFELCT submitted cancelled electronic count

Identifies the total number of submitted Invoice Groupings that were nullified within a time period and submitted electronically. Adjudicated invoice elements are included.

4       L:  (SBNFELAT) C20001 SBNFELAT submitted nullified electronic amount

Identifies the total net amount billed for all submitted Invoice Groupings that were nullified within a time period and submitted electronically. Adjudicated invoice elements are included.

4       L:  (SBPDELAT) C20003 SBPDELAT submitted pending electronic amount

Identifies the total net amount billed for all submitted Invoice Groupings that are pended or held by the payor, within a time period and submitted electronically. Adjudicated invoice elements are not included.

4       L:  (SBPDELCT) C20002 SBPDELCT submitted pending electronic count

Identifies the total number of submitted Invoice Groupings that are pended or held by the payor, within a time period and submitted electronically. Adjudicated invoice elements are not included.

2   A: ActInvoiceOverrideCode A17590

Includes coded responses that will occur as a result of the adjudication of an electronic invoice at a summary level and provides guidance on interpretation of the referenced adjudication results.

3     L:  (COVGE) C17594 COVGE coverage problem

Insurance coverage problems have been encountered. Additional explanation information to be supplied.

3     L:  (PYRDELAY) C17591 PYRDELAY delayed by a previous payor

Allows provider to explain lateness of invoice to a subsequent payor.

3     L:  (EFORM) C20021 EFORM electronic form to follow

Electronic form with supporting or additional information to follow.

3     L:  (FAX) C20022 FAX fax to follow

Fax with supporting or additional information to follow.

3     L:  (GFTH) C17592 GFTH good faith indicator

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.

3     L:  (LATE) C17593 LATE late invoice

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.

3     L:  (MANUAL) C19713 MANUAL manual review

Manual review of the invoice is requested. Additional information to be supplied. This may be used in the case of an appeal.

3     L:  (ORTHO) C21317 ORTHO orthodontic service

The service provided is required for orthodontic purposes. If the covered party has orthodontic coverage, then the service may be paid.

3     L:  (OOJ) C18036 OOJ out of jurisdiction

The medical service and/or product was provided to a patient that has coverage in another jurisdiction.

3     L:  (PAPER) C20020 PAPER paper documentation to follow

Paper documentation (or other physical format) with supporting or additional information to follow.

3     L:  (PIE) C20023 PIE public insurance exhausted

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.

3     L:  (REFNR) C18037 REFNR referral not required

Rules of practice do not require a physician's referral for the provider to perform a billable service.

3     L:  (REPSERV) C19711 REPSERV repeated service

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.

3     L:  (UNRELAT) C21316 UNRELAT unrelated service

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.

3     L:  (VERBAUTH) C19712 VERBAUTH verbal authorization

The provider has received a verbal permission from an authoritative source to perform the service or supply the item being invoiced.

2   A: ActListCode A19364

Provides codes associated with ActClass value of LIST (working list)

3     S: ActMedicationList (MEDLIST) S19976 MEDLIST medication list

List of medications.

4       L:  (CURMEDLIST) C19977 CURMEDLIST current medication list

List of current medications.

4       L:  (DISCMEDLIST) C19979 DISCMEDLIST discharge medication list

List of discharge medications.

4       L:  (HISTMEDLIST) C19978 HISTMEDLIST medication history

Historical list of medications.

3     A: ActObservationList A19370
4       S: ActConditionList (CONDLIST) S21322 CONDLIST condition list

List of condition observations.

5         L:  (INTOLIST) C19982 INTOLIST intolerance list

List of intolerance observations.

5         L:  (PROBLIST) C19980 PROBLIST problem list

List of problem observations.

5         L:  (RISKLIST) C19983 RISKLIST risk factors

List of risk factor observations.

4       L:  (CARELIST) C19984 CARELIST care plan

List of acts representing a care plan. The acts can be in a varierty of moods including event (EVN) to record acts that have been carried out as part of the care plan.

4       L:  (GOALLIST) C19981 GOALLIST goal list

List of observations in goal mood.

3     A: ActTherapyDurationWorkingListCode A19710

Codes used to identify different types of 'duration-based' working lists. Examples include "Continuous/Chronic", "Short-Term" and "As-Needed".

2   A: ActMonitoringProtocolCode A16231

Identifies types of monitoring programs

3     S: ControlledSubstanceMonitoringProtocol (CTLSUB) S16232 CTLSUB Controlled Substance

A monitoring program that focuses on narcotics and/or commonly abused substances that are subject to legal restriction.

4       A: DEADrugSchedule A19254

DEA schedule for a drug.

2   A: ActOrderCode A19586

The type of order that was fulfilled by the clinical service

2   A: ActPaymentCode A17610

Code identifying the method or the movement of payment instructions.

Codes are drawn from X12 data element 591 (PaymentMethodCode)

3     L:  (ACH) C17611 ACH Automated Clearing House

Automated Clearing House (ACH).

3     L:  (CHK) C17612 CHK Cheque

A written order to a bank to pay the amount specified from funds on deposit.

3     L:  (DDP) C17613 DDP Direct Deposit

Electronic Funds Transfer (EFT) deposit into the payee's bank account

3     L:  (NON) C17614 NON Non-Payment Data

Non-Payment Data.

2   A: ActPharmacySupplyType A16208

Identifies types of dispensing events

3     S: EmergencyPharmacySupplyType (EM) S16220 EM Emergency Supply

A supply action where there is no 'valid' order for the supplied medication. E.g. Emergency vacation supply, weekend supply (when prescriber is unavailable to provide a renewal prescription)

4       L:  (SO) C16221 SO Script Owing

An emergency supply where the expectation is that a formal order authorizing the supply will be provided at a later date.

3     S: FirstFillPharmacySupplyType (FF) S16209 FF First Fill

The initial fill against an order. (This includes initial fills against refill orders.)

4       L:  (DF) C16214 DF Daily Fill

A fill providing sufficient supply for one day

4       L:  (FFC) C16210 FFC First Fill - Complete

A first fill where the quantity supplied is equal to one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets).

4       L:  (FFP) C16211 FFP First Fill - Part Fill

A first fill where the quantity supplied is less than one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.)

4       L:  (TF) C16212 TF Trial Fill

A fill where a small portion is provided to allow for determination of the therapy effectiveness and patient tolerance.

4       L:  (UD) C16223 UD Unit Dose

A supply action that provides sufficient material for a single dose.

3     L:  (FS) C16222 FS Floor stock

A supply action to restock a smaller more local dispensary.

3     L:  (MS) C16219 MS Manufacturer Sample

A supply of a manufacturer sample

3     S: RefillPharmacySupplyType (RF) S16215 RF Refill

A fill against an order that has already been filled (or partially filled) at least once.

4       L:  (DF) C16214 DF Daily Fill

A fill providing sufficient supply for one day

4       L:  (RFF) C16218 RFF Refill (First fill this facility)

The first fill against an order that has already been filled at least once at another facility.

4       L:  (RFC) C16216 RFC Refill - Complete

A refill where the quantity supplied is equal to one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets.)

4       L:  (RFP) C16217 RFP Refill - Part Fill

A refill where the quantity supplied is less than one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.)

4       L:  (TB) C16213 TB Trial Balance

A fill where the remainder of a 'complete' fill is provided after a trial fill has been provided.

4       L:  (UD) C16223 UD Unit Dose

A supply action that provides sufficient material for a single dose.

2   A: ActPrivilegeCategorization A19725

An Act which characterizes a Privilege can have additional observations to provide a finer definition of the requested or conferred privilege. This domain describes the categories under which this additional information is classified.

2   A: ActProcedureCode A16535

An identifying code for healthcare interventions/procedures.

2   A: ActProductAcquisitionCode A17958

The method that a product is obtained for use by the subject of the supply act (e.g. patient). Product examples are consumable or durable goods.

3     S: Loan (LOAN) S17961 LOAN Loan

Temporary supply of a product without transfer of ownership for the product.

4       L:  (RENT) C17962 RENT Rent

Temporary supply of a product with financial compensation, without transfer of ownership for the product.

3     S: Transfer (TRANSFER) S17959 TRANSFER Transfer

Transfer of ownership for a product.

4       L:  (SALE) C17960 SALE Sale

Transfer of ownership for a product for financial compensation.

2   L:  (_ActRegistryCode) C20904 _ActRegistryCode ActRegistryCode

This is the domain of registry types. Examples include Master Patient Registry, Staff Registry, Employee Registry, Tumor Registry.

2   A: ActSpecObsCode A13957

Identifies the type of observation that is made about a specimen that may affect its processing, analysis or further result interpretation

3     L:  (ARTBLD) C14387 ARTBLD ActSpecObsArtBldCode

Describes the artificial blood identifier that is associated with the specimen.

3     S: ActSpecObsDilutionCode (DILUTION) S14352 DILUTION ActSpecObsDilutionCode

An observation that reports the dilution of a sample.

4       L:  (AUTO-HIGH) C13958 AUTO-HIGH Auto-High Dilution

The dilution of a sample performed by automated equipment. The value is specified by the equipment

4       L:  (AUTO-LOW) C13959 AUTO-LOW Auto-Low Dilution

The dilution of a sample performed by automated equipment. The value is specified by the equipment

4       L:  (PRE) C13961 PRE Pre-Dilution

The dilution of the specimen made prior to being loaded onto analytical equipment

4       L:  (RERUN) C13960 RERUN Rerun Dilution

The value of the dilution of a sample after it had been analyzed at a prior dilution value

3     L:  (EVNFCTS) C14390 EVNFCTS ActSpecObsEvntfctsCode

Domain provides codes that qualify the ActLabObsEnvfctsCode domain. (Environmental Factors)

3     S: ActSpecObsInterferenceCode (INTFR) S14382 INTFR ActSpecObsInterferenceCode

An observation that relates to factors that may potentially cause interference with the observation

4       L:  (FIBRIN) C14386 FIBRIN Fibrin

The Fibrin Index of the specimen. In the case of only differentiating between Absent and Present, recommend using 0 and 1

4       L:  (HEMOLYSIS) C14383 HEMOLYSIS Hemolysis

An observation of the hemolysis index of the specimen in g/L

4       L:  (ICTERUS) C14385 ICTERUS Icterus

An observation that describes the icterus index of the specimen. It is recommended to use mMol/L of bilirubin

4       L:  (LIPEMIA) C14384 LIPEMIA Lipemia

An observation used to describe the Lipemia Index of the specimen. It is recommended to use the optical turbidity at 600 nm (in absorbance units).

3     S: ActSpecObsVolumeCode (VOLUME) S14369 VOLUME ActSpecObsVolumeCode

An observation that reports the volume of a sample.

4       L:  (AVAILABLE) C13963 AVAILABLE Available Volume

The available quantity of specimen. This is the current quantity minus any planned consumption (e.g., tests that are planned)

4       L:  (CONSUMPTION) C13965 CONSUMPTION Consumption Volume

The quantity of specimen that is used each time the equipment uses this substance

4       L:  (CURRENT) C13962 CURRENT Current Volume

The current quantity of the specimen, i.e., initial quantity minus what has been actually used.

4       L:  (INITIAL) C13964 INITIAL Initial Volume

The initial quantity of the specimen in inventory

2   A: ActSpecimenTreatmentCode A14040

Set of codes related to specimen treatments

3     L:  (ACID) C14044 ACID Acidification

The lowering of specimen pH through the addition of an acid

3     L:  (ALK) C14046 ALK Alkalization

The act rendering alkaline by impregnating with an alkali; a conferring of alkaline qualities.

3     L:  (DEFB) C14043 DEFB Defibrination

The removal of fibrin from whole blood or plasma through physical or chemical means

3     L:  (FILT) C14047 FILT Filtration

The passage of a liquid through a filter, accomplished by gravity, pressure or vacuum (suction).

3     L:  (LDLP) C14041 LDLP LDL Precipitation
3     L:  (NEUT) C14045 NEUT Neutralization

The act or process by which an acid and a base are combined in such proportions that the resulting compound is neutral.

3     L:  (RECA) C14042 RECA Recalcification

The addition of calcium back to a specimen after it was removed by chelating agents

3     L:  (UFIL) C14048 UFIL Ultrafiltration

The filtration of a colloidal substance through a semipermeable medium that allows only the passage of small molecules.

2   A: ActSubstanceAdminSubstitutionCode A16621
3     S: SubstanceAdminGenericSubstitution (G) S16623 G generic

Substitution occurred or is permitted with another product in the same generic ingredient.

4       L:  (TE) C16624 TE therapeutic

Substitution occurred with another product having the same therapeutic objective.

3     L:  (F) C16625 F formulary

This substitution must be performed based on formulary guidelines. Substitution occurred or is permitted with another product that may potentially have different ingredients, but having the same biological effect.

3     L:  (N) C16622 N none

No substitution occurred or is permitted.

2   A: ActSubstanceAdministrationCode A19708

Describes the type of substance administration being performed.

3     S: ActSubstanceAdministrationImmunizationCode (IMMUNIZ) S21519 IMMUNIZ Immunization

The introduction of ??? with the intent of stimulating an immune response, aimed at preventing subsequent infections by more viable agents.

4       L:  (BOOSTER) C21521 BOOSTER Booster Immunization

An additional immunization administration within a series intended to bolster or enhance immunity.

4       L:  (INITIMMUNIZ) C21520 INITIMMUNIZ Initial Immunization

The first immunization administration in a series intended to produce immunity

3     L:  (DRUG) C21518 DRUG Drug therapy

The introduction of a drug into a subject with the intention of altering its biologic state with the intent of improving its health status.

3     A: x_MedicationOrImmunization A19745
4       L:  (DRUG) C21518 DRUG Drug therapy

The introduction of a drug into a subject with the intention of altering its biologic state with the intent of improving its health status.

4       L:  (IMMUNIZ) C21519 IMMUNIZ Immunization

The introduction of ??? with the intent of stimulating an immune response, aimed at preventing subsequent infections by more viable agents.

2   A: CanadianActProcedureCode A19433

An identifying data string for healthcare procedures, for use in Canada.

2   A: HL7TriggerEventCode A19427

The trigger event referenced by the Control Act instance. Values are drawn from the available trigger events used in the release of HL7 identified by the versionCode.

2   A: ROIOverlayShape A16117

Shape of the region on the object being referenced

3     L:  (CIRCLE) C16118 CIRCLE circle

A circle defined by two (column,row) pairs. The first point is the center of the circle and the second point is a point on the perimeter of the circle.

3     L:  (ELLIPSE) C16119 ELLIPSE ellipse

An ellipse defined by four (column,row) pairs, the first two points specifying the endpoints of the major axis and the second two points specifying the endpoints of the minor axis.

3     L:  (POINT) C16120 POINT point

A single point denoted by a single (column,row) pair, or multiple points each denoted by a (column,row) pair.

3     L:  (POLY) C16121 POLY polyline

A series of connected line segments with ordered vertices denoted by (column,row) pairs; if the first and last vertices are the same, it is a closed polygon.

2   A: x_ActFinancialProductAcquisitionCode A17963

The method that a product is obtained for use by the subject of the supply act (e.g. patient), with financial compensation. Product examples are consumable or durable goods.

3     L:  (RENT) C17962 RENT Rent

Temporary supply of a product with financial compensation, without transfer of ownership for the product.

3     L:  (SALE) C17960 SALE Sale

Transfer of ownership for a product for financial compensation.

1 A: ObservationType A16226

Identifies the kinds of observations that can be performed

2   A: ActPrivilegeCategorizationType A19750

This domain includes observations used to characterize a privilege, under which this additional information is classified.

Examples:A privilege to prescribe drugs has a RESTRICTION that excludes prescribing narcotics; a surgical procedure privilege has a PRE-CONDITION that it requires prior Board approval.

2   L:  (ADVERSE_REACTION) C21510 ADVERSE_REACTION Adverse Reaction

Indicates that the observation is of an unexpected negative occurrence in the subject suspected to result from the subject's exposure to one or more agents. Observation values would be the symptom resulting from the reaction.

2   A: AnnotationType A19329
3     A: ECGAnnotationType A19330
4       A: ECGAnnotationTypeMDC A19335

ISO 11073-10101 Health informatics - Point-of-care device codes, restricted to ECG category names

2   A: CommonClinicalObservationType A19715

Used in a patient care message to report and query simple clinical (non-lab) observations.

2   A: DiagnosticImageCode A19737

Identifies the types of diagnostic image.

Examples: Echocardiogram, electocardiogram, X-ray.

2   L:  (_FDALabelData) C20920 _FDALabelData FDALabelData

FDA label data

2   A: IndividualCaseSafetyReportType A19622

A code that is used to indicate the type of case safety report received from sender. The current code example reference is from the International Conference on Harmonisation (ICH) Expert Workgroup guideline on Clinical Safety Data Management: Data Elements for Transmission of Individual Case Safety Reports. The unknown/unavailable option allows the transmission of information from a secondary sender where the initial sender did not specify the type of report.

Example concepts include: Spontaneous, Report from study, Other.

2   A: LogicalObservationIdentifierNamesAndCodes A16492

The LOINC database provides a set of universal names and ID codes for identifying laboratory and clinical test results. The purpose is to facilitate the exchange and pooling of results, such as blood hemoglobin, serum potassium, or vital signs, for clinical care, outcomes management, and research. The LOINC codes are not intended to transmit all possible information about a test or observation. They are only intended to identify the test result or clinical observation. http://www.regenstrief.org/LOINC/LOINC.htm

2   A: MedicationObservationType A19751
3     L:  (SPLCOATING) C21604 SPLCOATING coating

Definition: A characteristic of an oral solid dosage form of a medicinal product, indicating whether it has one or more coatings such as sugar coating, film coating, or enteric coating. Only coatings to the external surface or the dosage form should be considered (for example, coatings to individual pellets or granules inside a capsule or tablet are excluded from consideration).

Constraints: The Observation.value must be a Boolean (BL) with true for the presence or false for the absence of one or more coatings on a solid dosage form.

3     L:  (SPLCOLOR) C21608 SPLCOLOR color

Definition: A characteristic of an oral solid dosage form of a medicinal product, specifying the color or colors that most predominantly define the appearance of the dose form. SPLCOLOR is not an FDA specification for the actual color of solid dosage forms or the names of colors that can appear in labeling.

Constraints: The Observation.value must be a single coded value or a list of multiple coded values, specifying one or more distinct colors that approximate of the color(s) of distinct areas of the solid dosage form, such as the different sides of a tablet or one-part capsule, or the different halves of a two-part capsule. Bands on banded capsules, regardless of the color, are not considered when assigning an SPLCOLOR. Imprints on the dosage form, regardless of their color are not considered when assigning an SPLCOLOR. If more than one color exists on a particular side or half, then the most predominant color on that side or half is recorded. If the gelatin capsule shell is colorless and transparent, use the predominant color of the contents that appears through the colorless and transparent capsule shell. Colors can include: Black;Gray;White;Red;Pink;Purple;Green;Yellow;Orange;Brown;Blue;Turquoise.

3     L:  (SPLIMAGE) C21610 SPLIMAGE image

Description: A characteristic representing a single file reference that contains two or more views of the same dosage form of the product; in most cases this should represent front and back views of the dosage form, but occasionally additional views might be needed in order to capture all of the important physical characteristics of the dosage form. Any imprint and/or symbol should be clearly identifiable, and the viewer should not normally need to rotate the image in order to read it. Images that are submitted with SPL should be included in the same directory as the SPL file.

3     L:  (SPLIMPRINT) C21607 SPLIMPRINT imprint

Definition: A characteristic of an oral solid dosage form of a medicinal product, specifying the alphanumeric text that appears on the solid dosage form, including text that is embossed, debossed, engraved or printed with ink. The presence of other non-textual distinguishing marks or symbols is recorded by SPLSYMBOL.

Examples: Included in SPLIMPRINT are alphanumeric text that appears on the bands of banded capsules and logos and other symbols that can be interpreted as letters or numbers.

Constraints: The Observation.value must be of type Character String (ST). Excluded from SPLIMPRINT are internal and external cut-outs in the form of alphanumeric text and the letter 'R' with a circle around it (when referring to a registered trademark) and the letters 'TM' (when referring to a 'trade mark'). To record text, begin on either side or part of the dosage form. Start at the top left and progress as one would normally read a book. Enter a semicolon to show separation between words or line divisions.

3     L:  (SPLSCORING) C21606 SPLSCORING scoring

Definition: A characteristic of an oral solid dosage form of a medicinal product, specifying the number of equal pieces that the solid dosage form can be divided into using score line(s).

Example: One score line creating two equal pieces is given a value of 2, two parallel score lines creating three equal pieces is given a value of 3.

Constraints: Whether three parallel score lines create four equal pieces or two intersecting score lines create two equal pieces using one score line and four equal pieces using both score lines, both have the scoring value of 4. Solid dosage forms that are not scored are given a value of 1. Solid dosage forms that can only be divided into unequal pieces are given a null-value with nullFlavor other (OTH).

3     L:  (SPLSHAPE) C21609 SPLSHAPE shape

Description: A characteristic of an oral solid dosage form of a medicinal product, specifying the two dimensional representation of the solid dose form, in terms of the outside perimeter of a solid dosage form when the dosage form, resting on a flat surface, is viewed from directly above, including slight rounding of corners. SPLSHAPE does not include embossing, scoring, debossing, or internal cut-outs. SPLSHAPE is independent of the orientation of the imprint and logo. Shapes can include: Triangle (3 sided); Square; Round; Semicircle; Pentagon (5 sided); Diamond; Double circle; Bullet; Hexagon (6 sided); Rectangle; Gear; Capsule; Heptagon (7 sided); Trapezoid; Oval; Clover; Octagon (8 sided); Tear; Freeform.

3     L:  (SPLSIZE) C21605 SPLSIZE size

Definition: A characteristic of an oral solid dosage form of a medicinal product, specifying the longest single dimension of the solid dosage form as a physical quantity in the dimension of length (e.g., 3 mm). The length is should be specified in millimeters and should be rounded to the nearest whole millimeter.

Example: SPLSIZE for a rectangular shaped tablet is the length and SPLSIZE for a round shaped tablet is the diameter.

3     L:  (SPLSYMBOL) C21603 SPLSYMBOL symbol

Definition: A characteristic of an oral solid dosage form of a medicinal product, to describe whether or not the medicinal product has a mark or symbol appearing on it for easy and definite recognition. Score lines, letters, numbers, and internal and external cut-outs are not considered marks or symbols. See SPLSCORING and SPLIMPRINT for these characteristics.

Constraints: The Observation.value must be a Boolean (BL) with <u>true</u> indicating the presence and <u>false</u> for the absence of marks or symbols.

Example:

2   A: ObservationActContextAgeType A19757

Definition:The ways the age of an entity involved in an act can be measured, calculated or otherwise expressed in order to provide context for another act.

3     A: LOINCObservationActContextAgeType A19758

Definition:The set of LOINC codes for the act of determining the period of time that has elapsed since an entity was born or created.

4       L:  (30972-4) C21633 30972-4 age at onset of adverse event

Definition:Age at onset of associated adverse event; no implied method of determination.

4       L:  (29553-5) C21632 29553-5 age patient qn calc

Definition:Calculated age.

4       L:  (30525-0) C21629 30525-0 age patient qn definition

Definition:General specification of age with no implied method of determination.

4       L:  (21611-9) C21630 21611-9 age patient qn est

Definition:Estimated age.

4       L:  (21612-7) C21631 21612-7 age patient qn reported

Definition:Reported age.

2   A: ObservationAllergyTestType A19695

Indicates the type of allergy test performed or to be performed. E.g. the specific antibody or skin test performed

2   S: ObservationDiagnosisTypes (DX) S20927 DX ObservationDiagnosisTypes

An observation about the presence (or absence) of a particular disease state in a subject.

3     L:  (ADMDX) C16839 ADMDX admitting diagnosis

Admitting diagnosis are the diagnoses documented for administrative purposes as the basis for a hospital admission.

3     L:  (DISDX) C16840 DISDX discharge diagnosis

Discharge diagnosis are the diagnoses documented for administrative purposes as the time of hospital discharge.

3     L:  (INTDX) C16841 INTDX intermediate diagnosis

Intermediate diagnoses are those diagnoses documented for administrative purposes during the course of a hospital stay.

3     L:  (NOI) C20026 NOI nature of injury

The type of injury that the injury coding specifies.

2   A: ObservationIndicationType A19728

Includes all codes defining types of indications such as diagnosis, symptom and other indications such as contrast agents for lab tests

2   S: ObservationIntoleranceType (OINT) S21498 OINT intolerance

Hypersensitivity resulting in an adverse reaction upon exposure to an agent.

3     S: ObservationAllergyType (ALG) S21499 ALG Allergy

Hypersensitivity to an agent caused by an immunologic response to an initial exposure.

4       L:  (DALG) C21504 DALG Drug Allergy

An allergy to a pharmaceutical product.

4       L:  (EALG) C21506 EALG Environmental Allergy

An allergy to a substance other than a drug or a food. E.g. Latex, pollen, etc.

4       L:  (FALG) C21505 FALG Food Allergy

An allergy to a substance generally consumed for nutritional purposes.

3     S: ObservationDrugIntoleranceType (DINT) S21501 DINT Drug Intolerance

Hypersensitivity resulting in an adverse reaction upon exposure to a drug.

4       L:  (DALG) C21504 DALG Drug Allergy

An allergy to a pharmaceutical product.

4       L:  (DNAINT) C21507 DNAINT Drug Non-Allergy Intolerance

Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure

3     S: ObservationEnvironmentalIntoleranceType (EINT) S21503 EINT Environmental Intolerance

Hypersensitivity resulting in an adverse reaction upon exposure to environmental conditions.

4       L:  (EALG) C21506 EALG Environmental Allergy

An allergy to a substance other than a drug or a food. E.g. Latex, pollen, etc.

4       L:  (ENAINT) C21509 ENAINT Environmental Non-Allergy Intolerance

Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure

3     S: ObservationFoodIntoleranceType (FINT) S21502 FINT Food Intolerance

Hypersensitivity resulting in an adverse reaction upon exposure to food.

4       L:  (FALG) C21505 FALG Food Allergy

An allergy to a substance generally consumed for nutritional purposes.

4       L:  (FNAINT) C21508 FNAINT Food Non-Allergy Intolerance

Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure

3     S: ObservationNonAllergyIntoleranceType (NAINT) S21500 NAINT Non-Allergy Intolerance

Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure

4       L:  (DNAINT) C21507 DNAINT Drug Non-Allergy Intolerance

Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure

4       L:  (ENAINT) C21509 ENAINT Environmental Non-Allergy Intolerance

Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure

4       L:  (FNAINT) C21508 FNAINT Food Non-Allergy Intolerance

Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure

2   A: ObservationIssueTriggerCodedObservationType A19712

Distinguishes the kinds of coded observations that could be the trigger for clinical issue detection. These are observations that are not measurable, but instead can be defined with codes. Coded observation types include: Allergy, Intolerance, Medical Condition, Pregnancy status, etc.

2   A: ObservationIssueTriggerMeasuredObservationType A19713

Distinguishes between the kinds of measurable observations that could be the trigger for clinical issue detection. Measurable observation types include: Lab Results, Height, Weight.

2   A: ObservationSequenceType A19325
3     A: ECGObservationSequenceType A19328
4       A: ECGLeadTypeMDC A19334

ISO 11073-10101 Health informatics - Point-of-care device codes, restricted to ECG Lead Types

3     L:  (TIME_ABSOLUTE) C19326 TIME_ABSOLUTE absolute time sequence

A sequence of values in the "absolute" time domain. This is the same time domain that all HL7 timestamps use. It is time as measured by the Gregorian calendar

3     L:  (TIME_RELATIVE) C19327 TIME_RELATIVE relative time sequence

A sequence of values in a "relative" time domain. The time is measured relative to the earliest effective time in the Observation Series containing this sequence.

2   A: ObservationSeriesType A19321
3     A: ECGObservationSeriesType A19322
4       L:  (REPRESENTATIVE_BEAT) C19324 REPRESENTATIVE_BEAT ECG representative beat waveforms

This Observation Series type contains waveforms of a "representative beat" (a.k.a. "median beat" or "average beat"). The waveform samples are measured in relative time, relative to the beginning of the beat as defined by the Observation Series effective time. The waveforms are not directly acquired from the subject, but rather algorithmically derived from the "rhythm" waveforms.

4       L:  (RHYTHM) C19323 RHYTHM ECG rhythm waveforms

This Observation type contains ECG "rhythm" waveforms. The waveform samples are measured in absolute time (a.k.a. "subject time" or "effective time"). These waveforms are usually "raw" with some minimal amount of noise reduction and baseline filtering applied.

2   A: PatientCharacteristicObservationType A19714

Indicates the type of characteristics a patient should have for a given therapy to be appropriate. E.g. Weight, Age, certain lab values, etc.

2   A: PrescriptionObservationType A19616

Observations specific to a particular prescription to express concepts that cannot be expressed via other modeling approaches. Examples include: "Patient Medication On Hand Quantity", "Patient Medication On Hand Days Supply", "Patient Expected Supply Run-out Date", "Percentage Dispensed".

2   L:  (SEV) C16642 SEV Severity Observation

Indicates a subjective evaluation of the criticality associated with another observation.

2   A: SimpleMeasurableClinicalObservationType A19711

Types of measurement observations typically performed in a clinical (non-lab) setting. E.g. Height, Weight, Blood-pressure

1 A: x_LabProcessCodes A19656
2   A: ActInfoPersistCode A19659

The act of storing information to long term storage.

2   A: ActObservationVerificationCode A19658

The act of verifying an observations. The subject act related to the observation verification (act relationship SUBJ) must be an observation (OBS)

2   A: ActSpecimenAccessionCode A19662

The accession act related to a specimen or group of specimens.

2   A: ActSpecimenLabelCode A19660

The act of printing a specimen label. The printing of a label for a specimen container is a significant act in the workflow for collecting specimens.

2   A: ActSpecimenManifestCode A19661

The act of adding a specimen to a transportation manifest. For example a laboratory will pack together in a carton all the specimens to be shipped to a reference lab. An electronic manifest showing all the specimens in the shippment is communicated to the

2   A: ActSpecimenTransportCode A19663

Transportation of a specimen.


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