HL7 Terminology (THO)
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This page is part of the HL7 Terminology (v6.0.2: Release) based on FHIR (HL7® FHIR® Standard) v5.0.0. 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

CodeSystem: ParticipationFunction

Official URL: http://terminology.hl7.org/CodeSystem/v3-ParticipationFunction Version: 3.0.0
Active as of 2019-03-20 Responsible: Health Level Seven International Computable Name: ParticipationFunction
Other Identifiers: OID:2.16.840.1.113883.5.88

Copyright/Legal: 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.html

This code is used to specify the exact function an actor had in a service in all necessary detail. This domain may include local extensions (CWE).

This Code system is referenced in the content logical definition of the following value sets:

Generated Narrative: CodeSystem v3-ParticipationFunction

Language: en

Properties

This code system defines the following properties for its concepts

NameCodeURITypeDescription
Specializes Specializes Coding The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric.
Generalizes Generalizes Coding Inverse of Specializes. Only included as a derived relationship.
internalId internalId http://terminology.hl7.org/CodeSystem/utg-concept-properties#v3-internal-id code The internal identifier for the concept in the HL7 Access database repository.
Not Selectable notSelectable http://hl7.org/fhir/concept-properties#notSelectable boolean Indicates that the code is abstract - only intended to be used as a selector for other concepts
Status status http://hl7.org/fhir/concept-properties#status code Designation of a concept's state. Normally is not populated unless the state is retired.

Concepts

This case-sensitive code system http://terminology.hl7.org/CodeSystem/v3-ParticipationFunction defines the following codes in a Is-A hierarchy:

LvlCodeDisplayDefinitioninternalIdNot SelectableStatus
1 _AuthorizedParticipationFunction AuthorizedParticipationFunction

This code is used to specify the exact function an actor is authorized to have in a service in all necessary detail.

22338 true active
2   _AuthorizedReceiverParticipationFunction AuthorizedReceiverParticipationFunction

This code is used to specify the exact function an actor is authorized to have as a receiver of information that is the subject of a consent directive or consent override.

22341 true active
3     AUCG caregiver information receiver

**Description:**Caregiver authorized to receive patient health information.

22900 active
3     AULR legitimate relationship information receiver

**Description:**Provider with legitimate relationship authorized to receive patient health information.

22901 active
3     AUTM care team information receiver

**Description:**Member of care team authorized to receive patient health information.

22902 active
3     AUWA work area information receiver

**Description:**Entities within specified work area authorized to receive patient health information.

22903 active
2   _ConsenterParticipationFunction ConsenterParticipationFunction

This code is used to specify the exact function an actor is authorized to have in authoring a consent directive.

22339 true active
3     GRDCON legal guardian consent author

**Description:**Legal guardian of the subject of consent authorized to author a consent directive for the subject of consent.

22894 active
3     POACON healthcare power of attorney consent author

**Description:**Person authorized with healthcare power of attorney to author a consent directive for the subject of consent.

22896 active
3     PRCON personal representative consent author

**Description:**Personal representative of the subject of consent authorized to author a consent directive for the subject of consent.

22895 active
3     PROMSK authorized provider masking author

**Definition:**Provider authorized to mask information to protect the patient, a third party, or to ensure that the provider has consulted with the patient prior to release of this information.

22897 active
3     SUBCON subject of consent author

**Description:**Subject of consent authorized to author a consent directive.

22893 active
2   _OverriderParticipationFunction OverriderParticipationFunction

This code is used to specify the exact function an actor is authorized to have in authoring a consent override.

22340 true active
3     AUCOV consent overrider

**Description:**Entity authorized to override a consent directive.

22898 active
3     AUEMROV emergency overrider

**Description:**Entity authorized to override a consent directive or privacy policy in an emergency.

22899 active
1 _CoverageParticipationFunction CoverageParticipationFunction

Definition: Set of codes indicating the manner in which sponsors, underwriters, and payers participate in a policy or program.

22222 true active
2   _PayorParticipationFunction PayorParticipationFunction

Definition: Set of codes indicating the manner in which payors participate in a policy or program.</

22223 true active
3     CLMADJ claims adjudication

Definition: Manages all operations required to adjudicate fee for service claims or managed care encounter reports.

22226 active
3     ENROLL enrollment broker

Definition: Managing the enrollment of covered parties.

22229 active
3     FFSMGT ffs management

Definition: Managing all operations required to administer a fee for service or indemnity health plan including enrolling covered parties and providing customer service, provider contracting, claims payment, care management and utilization review.

22228 active
3     MCMGT managed care management

Definition: Managing all operations required to administer a managed care plan including enrolling covered parties and providing customer service,, provider contracting, claims payment, care management and utilization review.

22227 active
3     PROVMGT provider management

Definition: Managing provider contracting, provider services, credentialing, profiling, performance measures, and ensuring network adequacy.

22230 active
3     UMGT utilization management

Definition: Managing utilization of services by ensuring that providers adhere to, e.g., payeraTMs clinical protocols for medical appropriateness and standards of medical necessity. May include management of authorizations for services and referrals.

22231 active
2   _SponsorParticipationFunction SponsorParticipationFunction

Definition: Set of codes indicating the manner in which sponsors participate in a policy or program. NOTE: use only when the Sponsor is not further specified with a SponsorRoleType as being either a fully insured sponsor or a self insured sponsor.

22224 true active
3     FULINRD fully insured

Definition: Responsibility taken by a sponsor to contract with one or more underwriters for the assumption of full responsibility for the risk and administration of a policy or program.

22232 active
3     SELFINRD self insured

Definition: Responsibility taken by a sponsor to organize the underwriting of risk and administration of a policy or program.

22233 active
2   _UnderwriterParticipationFunction UnderwriterParticipationFunction

Definition: Set of codes indicating the manner in which underwriters participate in a policy or program.

22225 true active
3     PAYORCNTR payor contracting

Definition: Contracting for the provision and administration of health services to payors while retaining the risk for coverage. Contracting may be for all provision and administration; or for provision of certain types of services; for provision of services by region; and by types of administration, e.g., claims adjudication, enrollment, provider management, and utilization management. Typically done by underwriters for sponsors who need coverage provided to covered parties in multiple regions. The underwriter may act as the payor in some, but not all of the regions in which coverage is provided.

22234 active
3     REINS reinsures

Definition: Underwriting reinsurance for another underwriter for the policy or program.

22235 active
3     RETROCES retrocessionaires

Definition: Underwriting reinsurance for another reinsurer.

22236 active
3     SUBCTRT subcontracting risk

Definition: Delegating risk for a policy or program to one or more subcontracting underwriters, e.g., a major health insurer may delegate risk for provision of coverage under a national health plan to other underwriters by region .

22237 active
3     UNDERWRTNG underwriting

Definition: Provision of underwriting analysis for another underwriter without assumption of risk.

22238 active
1 ADMPHYS admitting physician

A physician who admitted a patient to a hospital or other care unit that is the context of this service.

10278 active
1 ANEST anesthesist

In a typical anesthesia setting an anesthesiologist or anesthesia resident in charge of the anesthesia and life support, but only a witness to the surgical procedure itself. To clarify responsibilities anesthesia should always be represented as a separate service related to the surgery.

10274 active
1 ANRS anesthesia nurse

In a typical anesthesia setting the nurse principally assisting the anesthesiologist during the critical periods.

10275 active
1 ASSEMBLER assembly software

A device that operates independently of an author on custodian's algorithms for data extraction of existing information for purpose of generating a new artifact.

UsageConstraint: ASSEMBLER ParticipationFunction should be used with DEV (device) ParticipationType.

23655 active
1 ATTPHYS attending physician

A physician who is primarily responsible for a patient during the hospitalization, which is the context of the service.

10277 active
1 COMPOSER composer software

A device used by an author to record new information, which may also be used by the author to select existing information for aggregation with newly recorded information for the purpose of generating a new artifact.

UsageConstraint: COMPOSER ParticipationFunction should be used with DEV (device) ParticipationType.

Usage Note: This code will enable implementers to more specifically represent the manner in which a Device participated in and facilitated the generation of a CDA Clinical Document or a CDA Entry by the responsible Author, which is comprised of the Author's newly entered content, and may include the pre-existing content selected by the Author, for the purpose of establishing the provenance and accountability for these acts.

23722 active
1 DISPHYS discharging physician

A physician who discharged a patient from a hospital or other care unit that is the context of this service.

10279 active
1 FASST first assistant surgeon

In a typical surgery setting the assistant facing the primary surgeon. The first assistant performs parts of the operation and assists in others (e.g., incision, approach, electrocoutering, ligatures, sutures).

10269 active
1 MDWF midwife

A person (usually female) helping a woman deliver a baby. Responsibilities vary locally, ranging from a mere optional assistant to a full required participant, responsible for (normal) births and pre- and post-natal care for both mother and baby.

10276 active
1 NASST nurse assistant

In a typical surgery setting the non-sterile nurse handles material supply from the stock, forwards specimen to pathology, and helps with other non-sterile tasks (e.g., phone calls, etc.).

10273 active
1 PCP primary care physician

The healthcare provider that holds primary responsibility for the overall care of a patient.

10281 active
1 PRISURG primary surgeon

In a typical surgery setting the primary performing surgeon.

10268 active
1 REVIEWER reviewer

A verifier who is accountable for reviewing and asserting that the verification of an Act complies with jurisdictional or organizational policy.

UsageConstraint: UsageConstraint: Specifies the exact function that an actor is authorized to have as a verifier of an Act. Connotes that a specialized verifier asserts compliance for veracity of the review per jurisdictional or organizational policy. E.g., The Provider who takes responsibility for authenticity of a record submitted to a payer.

REVIEW ParticipationFunction should be used with VFR (verifier)

23656 active
1 RNDPHYS rounding physician

A physician who made rounds on a patient in a hospital or other care center.

10280 active
1 SASST second assistant surgeon

In a typical surgery setting the assistant who primarily holds the hooks.

10270 active
1 SNRS scrub nurse

In a typical surgery setting the nurse in charge of the instrumentation.

10271 active
1 TASST third assistant

In a typical surgery setting there is rarely a third assistant (e.g., in some Hip operations the third assistant postures the affected leg).

10272 active

History

DateActionAuthorCustodianComment
2023-11-14reviseMarc DuteauTSMGAdd standard copyright and contact to internal content; up-476
2022-10-18reviseMarc DuteauTSMGFixing missing metadata; up-349
2022-02-17 00:00:32+1100reviseGrahame GrieveVocabulary WGPopulate Missing caseSensitive property; UP-286
2020-05-06reviseTed KleinVocabulary WGMigrated to the UTG maintenance environment and publishing tooling.