HL7 Terminology (THO)
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This page is part of the HL7 Terminology (v5.5.0: Release) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

: Benefit Category Codes - XML Representation

Draft as of 2024-03-09 Maturity Level: 1

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<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="ex-benefitcategory"/>
  <meta>
    <lastUpdated value="2020-04-09T21:10:28.568+00:00"/>
    <profile
             value="http://hl7.org/fhir/StructureDefinition/shareablecodesystem"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p>This case-sensitive code system <code>http://terminology.hl7.org/CodeSystem/ex-benefitcategory</code> defines the following codes:</p><table class="codes"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style="white-space:nowrap">1<a name="ex-benefitcategory-1"> </a></td><td>Medical Care</td><td>Medical Care.</td></tr><tr><td style="white-space:nowrap">2<a name="ex-benefitcategory-2"> </a></td><td>Surgical</td><td>Surgical.</td></tr><tr><td style="white-space:nowrap">3<a name="ex-benefitcategory-3"> </a></td><td>Consultation</td><td>Consultation.</td></tr><tr><td style="white-space:nowrap">4<a name="ex-benefitcategory-4"> </a></td><td>Diagnostic XRay</td><td>Diagnostic XRay.</td></tr><tr><td style="white-space:nowrap">5<a name="ex-benefitcategory-5"> </a></td><td>Diagnostic Lab</td><td>Diagnostic Lab.</td></tr><tr><td style="white-space:nowrap">14<a name="ex-benefitcategory-14"> </a></td><td>Renal Supplies</td><td>Renal Supplies excluding Dialysis.</td></tr><tr><td style="white-space:nowrap">23<a name="ex-benefitcategory-23"> </a></td><td>Diagnostic Dental</td><td>Diagnostic Dental.</td></tr><tr><td style="white-space:nowrap">24<a name="ex-benefitcategory-24"> </a></td><td>Periodontics</td><td>Periodontics.</td></tr><tr><td style="white-space:nowrap">25<a name="ex-benefitcategory-25"> </a></td><td>Restorative</td><td>Restorative.</td></tr><tr><td style="white-space:nowrap">26<a name="ex-benefitcategory-26"> </a></td><td>Endodontics</td><td>Endodontics.</td></tr><tr><td style="white-space:nowrap">27<a name="ex-benefitcategory-27"> </a></td><td>Maxillofacial Prosthetics</td><td>Maxillofacial Prosthetics.</td></tr><tr><td style="white-space:nowrap">28<a name="ex-benefitcategory-28"> </a></td><td>Adjunctive Dental Services</td><td>Adjunctive Dental Services.</td></tr><tr><td style="white-space:nowrap">30<a name="ex-benefitcategory-30"> </a></td><td>Health Benefit Plan Coverage</td><td>Health Benefit Plan Coverage.</td></tr><tr><td style="white-space:nowrap">35<a name="ex-benefitcategory-35"> </a></td><td>Dental Care</td><td>Dental Care.</td></tr><tr><td style="white-space:nowrap">36<a name="ex-benefitcategory-36"> </a></td><td>Dental Crowns</td><td>Dental Crowns.</td></tr><tr><td style="white-space:nowrap">37<a name="ex-benefitcategory-37"> </a></td><td>Dental Accident</td><td>Dental Accident.</td></tr><tr><td style="white-space:nowrap">49<a name="ex-benefitcategory-49"> </a></td><td>Hospital Room and Board</td><td>Hospital Room and Board.</td></tr><tr><td style="white-space:nowrap">55<a name="ex-benefitcategory-55"> </a></td><td>Major Medical</td><td>Major Medical.</td></tr><tr><td style="white-space:nowrap">56<a name="ex-benefitcategory-56"> </a></td><td>Medically Related Transportation</td><td>Medically Related Transportation.</td></tr><tr><td style="white-space:nowrap">61<a name="ex-benefitcategory-61"> </a></td><td>In-vitro Fertilization</td><td>In-vitro Fertilization.</td></tr><tr><td style="white-space:nowrap">62<a name="ex-benefitcategory-62"> </a></td><td>MRI Scan</td><td>MRI Scan.</td></tr><tr><td style="white-space:nowrap">63<a name="ex-benefitcategory-63"> </a></td><td>Donor Procedures</td><td>Donor Procedures such as organ harvest.</td></tr><tr><td style="white-space:nowrap">69<a name="ex-benefitcategory-69"> </a></td><td>Maternity</td><td>Maternity.</td></tr><tr><td style="white-space:nowrap">76<a name="ex-benefitcategory-76"> </a></td><td>Renal Dialysis</td><td>Renal dialysis.</td></tr><tr><td style="white-space:nowrap">F1<a name="ex-benefitcategory-F1"> </a></td><td>Medical Coverage</td><td>Medical Coverage.</td></tr><tr><td style="white-space:nowrap">F3<a name="ex-benefitcategory-F3"> </a></td><td>Dental Coverage</td><td>Dental Coverage.</td></tr><tr><td style="white-space:nowrap">F4<a name="ex-benefitcategory-F4"> </a></td><td>Hearing Coverage</td><td>Hearing Coverage.</td></tr><tr><td style="white-space:nowrap">F6<a name="ex-benefitcategory-F6"> </a></td><td>Vision Coverage</td><td>Vision Coverage.</td></tr></table></div>
  </text>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-wg">
    <valueCode value="fm"/>
  </extension>
  <extension
             url="http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm">
    <valueInteger value="1"/>
  </extension>
  <url value="http://terminology.hl7.org/CodeSystem/ex-benefitcategory"/>
  <identifier>
    <system value="urn:ietf:rfc:3986"/>
    <value value="urn:oid:2.16.840.1.113883.4.642.1.1175"/>
  </identifier>
  <version value="1.0.0"/>
  <name value="BenefitCategoryCodes"/>
  <title value="Benefit Category Codes"/>
  <status value="draft"/>
  <experimental value="false"/>
  <date value="2024-03-09T11:11:30-07:00"/>
  <publisher value="Health Level Seven International"/>
  <contact>
    <telecom>
      <system value="url"/>
      <value value="http://hl7.org"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="hq@HL7.org"/>
    </telecom>
  </contact>
  <description
               value="This value set includes examples of Benefit Category codes."/>
  <copyright
             value="This material derives from the HL7 Terminology (THO). THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license"/>
  <caseSensitive value="true"/>
  <valueSet value="http://terminology.hl7.org/ValueSet/ex-benefitcategory"/>
  <content value="complete"/>
  <concept>
    <code value="1"/>
    <display value="Medical Care"/>
    <definition value="Medical Care."/>
  </concept>
  <concept>
    <code value="2"/>
    <display value="Surgical"/>
    <definition value="Surgical."/>
  </concept>
  <concept>
    <code value="3"/>
    <display value="Consultation"/>
    <definition value="Consultation."/>
  </concept>
  <concept>
    <code value="4"/>
    <display value="Diagnostic XRay"/>
    <definition value="Diagnostic XRay."/>
  </concept>
  <concept>
    <code value="5"/>
    <display value="Diagnostic Lab"/>
    <definition value="Diagnostic Lab."/>
  </concept>
  <concept>
    <code value="14"/>
    <display value="Renal Supplies"/>
    <definition value="Renal Supplies excluding Dialysis."/>
  </concept>
  <concept>
    <code value="23"/>
    <display value="Diagnostic Dental"/>
    <definition value="Diagnostic Dental."/>
  </concept>
  <concept>
    <code value="24"/>
    <display value="Periodontics"/>
    <definition value="Periodontics."/>
  </concept>
  <concept>
    <code value="25"/>
    <display value="Restorative"/>
    <definition value="Restorative."/>
  </concept>
  <concept>
    <code value="26"/>
    <display value="Endodontics"/>
    <definition value="Endodontics."/>
  </concept>
  <concept>
    <code value="27"/>
    <display value="Maxillofacial Prosthetics"/>
    <definition value="Maxillofacial Prosthetics."/>
  </concept>
  <concept>
    <code value="28"/>
    <display value="Adjunctive Dental Services"/>
    <definition value="Adjunctive Dental Services."/>
  </concept>
  <concept>
    <code value="30"/>
    <display value="Health Benefit Plan Coverage"/>
    <definition value="Health Benefit Plan Coverage."/>
  </concept>
  <concept>
    <code value="35"/>
    <display value="Dental Care"/>
    <definition value="Dental Care."/>
  </concept>
  <concept>
    <code value="36"/>
    <display value="Dental Crowns"/>
    <definition value="Dental Crowns."/>
  </concept>
  <concept>
    <code value="37"/>
    <display value="Dental Accident"/>
    <definition value="Dental Accident."/>
  </concept>
  <concept>
    <code value="49"/>
    <display value="Hospital Room and Board"/>
    <definition value="Hospital Room and Board."/>
  </concept>
  <concept>
    <code value="55"/>
    <display value="Major Medical"/>
    <definition value="Major Medical."/>
  </concept>
  <concept>
    <code value="56"/>
    <display value="Medically Related Transportation"/>
    <definition value="Medically Related Transportation."/>
  </concept>
  <concept>
    <code value="61"/>
    <display value="In-vitro Fertilization"/>
    <definition value="In-vitro Fertilization."/>
  </concept>
  <concept>
    <code value="62"/>
    <display value="MRI Scan"/>
    <definition value="MRI Scan."/>
  </concept>
  <concept>
    <code value="63"/>
    <display value="Donor Procedures"/>
    <definition value="Donor Procedures such as organ harvest."/>
  </concept>
  <concept>
    <code value="69"/>
    <display value="Maternity"/>
    <definition value="Maternity."/>
  </concept>
  <concept>
    <code value="76"/>
    <display value="Renal Dialysis"/>
    <definition value="Renal dialysis."/>
  </concept>
  <concept>
    <code value="F1"/>
    <display value="Medical Coverage"/>
    <definition value="Medical Coverage."/>
  </concept>
  <concept>
    <code value="F3"/>
    <display value="Dental Coverage"/>
    <definition value="Dental Coverage."/>
  </concept>
  <concept>
    <code value="F4"/>
    <display value="Hearing Coverage"/>
    <definition value="Hearing Coverage."/>
  </concept>
  <concept>
    <code value="F6"/>
    <display value="Vision Coverage"/>
    <definition value="Vision Coverage."/>
  </concept>
</CodeSystem>