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<CodeSystem xmlns="http://hl7.org/fhir"> <id value="v3-substanceAdminSubstitution"/> <language value="en"/> <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en"><h2>Substance Admin Substitution</h2><div><p>Identifies what sort of change is permitted or has occurred between the therapy that was ordered and the therapy that was/will be provided.</p> </div><p><b>Properties</b></p><table class="grid"><tr><td><b>Code</b></td><td><b>URL</b></td><td><b>Description</b></td><td><b>Type</b></td></tr><tr><td>Specializes</td><td/><td>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.</td><td>Coding</td></tr><tr><td>Generalizes</td><td/><td>Inverse of Specializes. Only included as a derived relationship.</td><td>Coding</td></tr><tr><td>internalId</td><td>http://terminology.hl7.org/CodeSystem/utg-concept-properties#v3-internal-id</td><td>The internal identifier for the concept in the HL7 Access database repository.</td><td>code</td></tr><tr><td>notSelectable</td><td>http://hl7.org/fhir/concept-properties#notSelectable</td><td>Indicates that the code is abstract - only intended to be used as a selector for other concepts</td><td>boolean</td></tr><tr><td>status</td><td>http://hl7.org/fhir/concept-properties#status</td><td>Designation of a concept's state. Normally is not populated unless the state is retired.</td><td>code</td></tr></table><p>This code system http://terminology.hl7.org/CodeSystem/v3-substanceAdminSubstitution defines the following codes:</p><table class="codes"><tr><td><b>Lvl</b></td><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td><td><b>internalId</b></td><td><b>Not Selectable</b></td><td><b>status</b></td></tr><tr><td>1</td><td style="white-space:nowrap">_ActSubstanceAdminSubstitutionCode<a name="v3-substanceAdminSubstitution-_ActSubstanceAdminSubstitutionCode"> </a></td><td>ActSubstanceAdminSubstitutionCode</td><td>**Description:** Substitution occurred or is permitted with another product that may potentially have different ingredients, but having the same biological and therapeutic effects.</td><td>21284</td><td>true</td><td>active</td></tr><tr><td>2</td><td style="white-space:nowrap"> E<a name="v3-substanceAdminSubstitution-E"> </a></td><td>equivalent</td><td>**Description:** Substitution occurred or is permitted with another bioequivalent and therapeutically equivalent product.</td><td>23107</td><td/><td>active</td></tr><tr><td>3</td><td style="white-space:nowrap"> EC<a name="v3-substanceAdminSubstitution-EC"> </a></td><td>equivalent composition</td><td>**Description:** Substitution occurred or is permitted with another product that is a: * pharmaceutical alternative containing the same active ingredient but is formulated with different salt, ester * pharmaceutical equivalent that has the same active ingredient, strength, dosage form and route of administration *Examples:* * *Pharmaceutical alternative:* Erythromycin Ethylsuccinate for Erythromycin Stearate * *Pharmaceutical equivalent:* Lisonpril for Zestril</td><td>23108</td><td/><td>active</td></tr><tr><td>4</td><td style="white-space:nowrap"> BC<a name="v3-substanceAdminSubstitution-BC"> </a></td><td>brand composition</td><td>**Description:** Substitution occurred or is permitted between equivalent Brands but not Generics *Examples:* * Zestril for Prinivil * Coumadin for Jantoven</td><td>23109</td><td/><td>active</td></tr><tr><td>4</td><td style="white-space:nowrap"> G<a name="v3-substanceAdminSubstitution-G"> </a></td><td>generic composition</td><td>**Description:** Substitution occurred or is permitted between equivalent Generics but not Brands *Examples:* * Lisnopril (Lupin Corp) for Lisnopril (Wockhardt Corp)</td><td>16623</td><td/><td>active</td></tr><tr><td>3</td><td style="white-space:nowrap"> TE<a name="v3-substanceAdminSubstitution-TE"> </a></td><td>therapeutic alternative</td><td>**Description:** Substitution occurred or is permitted with another product having the same therapeutic objective and safety profile. *Examples:* * ranitidine for Tagamet</td><td>16624</td><td/><td>active</td></tr><tr><td>4</td><td style="white-space:nowrap"> TB<a name="v3-substanceAdminSubstitution-TB"> </a></td><td>therapeutic brand</td><td>**Description:** Substitution occurred or is permitted between therapeutically equivalent Brands but not Generics > *Examples:* * Zantac for Tagamet</td><td>23105</td><td/><td>active</td></tr><tr><td>4</td><td style="white-space:nowrap"> TG<a name="v3-substanceAdminSubstitution-TG"> </a></td><td>therapeutic generic</td><td>**Description:** Substitution occurred or is permitted between therapeutically equivalent Generics but not Brands > *Examples:* * Ranitidine for cimetidine</td><td>23106</td><td/><td>active</td></tr><tr><td>2</td><td style="white-space:nowrap"> F<a name="v3-substanceAdminSubstitution-F"> </a></td><td>formulary</td><td>**Description:** This substitution was performed or is permitted based on formulary guidelines.</td><td>16625</td><td/><td>active</td></tr><tr><td>2</td><td style="white-space:nowrap"> N<a name="v3-substanceAdminSubstitution-N"> </a></td><td>none</td><td>No substitution occurred or is permitted.</td><td>16622</td><td/><td>active</td></tr></table></div> </text> <url value="http://terminology.hl7.org/CodeSystem/v3-substanceAdminSubstitution"/> <identifier> <system value="urn:ietf:rfc:3986"/> <value value="urn:oid:2.16.840.1.113883.5.1070"/> </identifier> <version value="2.0.0"/> <name value="SubstanceAdminSubstitution"/> <title value="Substance Admin Substitution"/> <status value="active"/> <date value="2019-03-20T00:00:00-04:00"/> <publisher value="Health Level 7"/> <contact> <name value="Health Level Seven"/> </contact> <description value="Identifies what sort of change is permitted or has occurred between the therapy that was ordered and the therapy that was/will be provided."/> <hierarchyMeaning value="is-a"/> <content value="complete"/> <property> <extension url="http://terminology.hl7.org/StructureDefinition/ext-mif-relationship-symmetry"> <valueCode value="antisymmetric"/> </extension> <extension url="http://terminology.hl7.org/StructureDefinition/ext-mif-relationship-transitivity"> <valueCode value="transitive"/> </extension> <extension url="http://terminology.hl7.org/StructureDefinition/ext-mif-relationship-reflexivity"> <valueCode value="irreflexive"/> </extension> <extension url="http://terminology.hl7.org/StructureDefinition/ext-mif-relationship-isNavigable"> <valueBoolean value="true"/> </extension> <extension url="http://terminology.hl7.org/StructureDefinition/ext-mif-relationship-relationshipKind"> <valueCode value="Specializes"/> </extension> <extension url="http://terminology.hl7.org/StructureDefinition/ext-mif-relationship-inverseName"> <valueString value="Generalizes"/> </extension> <code value="Specializes"/> <description value="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."/> <type value="Coding"/> </property> <property> <extension url="http://terminology.hl7.org/StructureDefinition/ext-mif-relationship-symmetry"> <valueCode value="antisymmetric"/> </extension> <extension url="http://terminology.hl7.org/StructureDefinition/ext-mif-relationship-transitivity"> <valueCode value="transitive"/> </extension> <extension url="http://terminology.hl7.org/StructureDefinition/ext-mif-relationship-reflexivity"> <valueCode value="irreflexive"/> </extension> <extension url="http://terminology.hl7.org/StructureDefinition/ext-mif-relationship-isNavigable"> <valueBoolean value="true"/> </extension> <extension url="http://terminology.hl7.org/StructureDefinition/ext-mif-relationship-relationshipKind"> <valueCode value="Generalizes"/> </extension> <extension url="http://terminology.hl7.org/StructureDefinition/ext-mif-relationship-inverseName"> <valueString value="Specializes"/> </extension> <code value="Generalizes"/> <description value="Inverse of Specializes. Only included as a derived relationship."/> <type value="Coding"/> </property> <property> <code value="internalId"/> <uri value="http://terminology.hl7.org/CodeSystem/utg-concept-properties#v3-internal-id"/> <description value="The internal identifier for the concept in the HL7 Access database repository."/> <type value="code"/> </property> <property> <code value="notSelectable"/> <uri value="http://hl7.org/fhir/concept-properties#notSelectable"/> <description value="Indicates that the code is abstract - only intended to be used as a selector for other concepts"/> <type value="boolean"/> </property> <property> <code value="status"/> <uri value="http://hl7.org/fhir/concept-properties#status"/> <description value="Designation of a concept's state. Normally is not populated unless the state is retired."/> <type value="code"/> </property> <concept> <code value="_ActSubstanceAdminSubstitutionCode"/> <display value="ActSubstanceAdminSubstitutionCode"/> <definition value="**Description:** Substitution occurred or is permitted with another product that may potentially have different ingredients, but having the same biological and therapeutic effects."/> <property> <code value="notSelectable"/> <valueBoolean value="true"/> </property> <property> <code value="status"/> <valueCode value="active"/> </property> <property> <code value="internalId"/> <valueCode value="21284"/> </property> <concept> <code value="E"/> <display value="equivalent"/> <definition value="**Description:** Substitution occurred or is permitted with another bioequivalent and therapeutically equivalent product."/> <property> <code value="status"/> <valueCode value="active"/> </property> <property> <code value="internalId"/> <valueCode value="23107"/> </property> <concept> <code value="EC"/> <display value="equivalent composition"/> <definition value="**Description:** Substitution occurred or is permitted with another product that is a: * pharmaceutical alternative containing the same active ingredient but is formulated with different salt, ester * pharmaceutical equivalent that has the same active ingredient, strength, dosage form and route of administration *Examples:* * *Pharmaceutical alternative:* Erythromycin Ethylsuccinate for Erythromycin Stearate * *Pharmaceutical equivalent:* Lisonpril for Zestril"/> <property> <code value="status"/> <valueCode value="active"/> </property> <property> <code value="internalId"/> <valueCode value="23108"/> </property> <concept> <code value="BC"/> <display value="brand composition"/> <definition value="**Description:** Substitution occurred or is permitted between equivalent Brands but not Generics *Examples:* * Zestril for Prinivil * Coumadin for Jantoven"/> <property> <code value="status"/> <valueCode value="active"/> </property> <property> <code value="internalId"/> <valueCode value="23109"/> </property> </concept> <concept> <code value="G"/> <display value="generic composition"/> <definition value="**Description:** Substitution occurred or is permitted between equivalent Generics but not Brands *Examples:* * Lisnopril (Lupin Corp) for Lisnopril (Wockhardt Corp)"/> <property> <code value="status"/> <valueCode value="active"/> </property> <property> <code value="internalId"/> <valueCode value="16623"/> </property> </concept> </concept> <concept> <code value="TE"/> <display value="therapeutic alternative"/> <definition value="**Description:** Substitution occurred or is permitted with another product having the same therapeutic objective and safety profile. *Examples:* * ranitidine for Tagamet"/> <property> <code value="status"/> <valueCode value="active"/> </property> <property> <code value="internalId"/> <valueCode value="16624"/> </property> <concept> <code value="TB"/> <display value="therapeutic brand"/> <definition value="**Description:** Substitution occurred or is permitted between therapeutically equivalent Brands but not Generics > *Examples:* * Zantac for Tagamet"/> <property> <code value="status"/> <valueCode value="active"/> </property> <property> <code value="internalId"/> <valueCode value="23105"/> </property> </concept> <concept> <code value="TG"/> <display value="therapeutic generic"/> <definition value="**Description:** Substitution occurred or is permitted between therapeutically equivalent Generics but not Brands > *Examples:* * Ranitidine for cimetidine"/> <property> <code value="status"/> <valueCode value="active"/> </property> <property> <code value="internalId"/> <valueCode value="23106"/> </property> </concept> </concept> </concept> <concept> <code value="F"/> <display value="formulary"/> <definition value="**Description:** This substitution was performed or is permitted based on formulary guidelines."/> <property> <code value="status"/> <valueCode value="active"/> </property> <property> <code value="internalId"/> <valueCode value="16625"/> </property> </concept> <concept> <code value="N"/> <display value="none"/> <definition value="No substitution occurred or is permitted."/> <property> <code value="status"/> <valueCode value="active"/> </property> <property> <code value="internalId"/> <valueCode value="16622"/> </property> </concept> </concept> </CodeSystem>