HL7 Terminology
1.0.0 - Publication

This page is part of the HL7 Terminology (v1.0.0: Release) based on FHIR R4. The current version which supercedes this version is 5.2.0. For a full list of available versions, see the Directory of published versions



Defining URL:http://terminology.hl7.org/ValueSet/v3-ActCoverageLimitCode

Criteria that are applicable to the authorized coverage.

OID:2.16.840.1.113883.1.11.17496 (for OID based terminology systems)
Source Resource:XML / JSON / Turtle


This value set is not used

Content Logical Definition

Logical Definition (CLD)

This value set includes codes based on the following rules:



This value set contains 7 concepts

Expansion based on ActCode v2.0.0 (CodeSystem)

All codes from system http://terminology.hl7.org/CodeSystem/v3-ActCode

_ActCoverageQuantityLimitCodeActCoverageQuantityLimitCodeMaximum amount paid or maximum number of services/products covered; or maximum amount or number covered during a specified time period under the policy or program.
COVPRDcoverage periodCodes representing the time period during which coverage is available; or financial participation requirements are in effect.
LFEMXlife time maximum**Definition:** Maximum amount paid by payer or covered party; or maximum number of services or products covered under the policy or program during a covered party's lifetime.
NETAMTNet AmountMaximum net amount that will be covered for the product or service specified.
PRDMXperiod maximum**Definition:** Maximum amount paid by payer or covered party; or maximum number of services/products covered under the policy or program by time period specified by the effective time on the act.
UNITPRICEUnit PriceMaximum unit price that will be covered for the authorized product or service.
UNITQTYUnit QuantityMaximum number of items that will be covered of the product or service specified.
COVMXcoverage maximum**Definition:** Codes representing the maximum coverate or financial participation requirements.
_ActCoveredPartyLimitCodeActCoveredPartyLimitCodeCodes representing the types of covered parties that may receive covered benefits under a policy or program.
_ActCoveragePartyLimitGroupCodeActCoveragePartyLimitGroupCodeCodes representing the level of coverage provided under the policy or program in terms of the types of entities that may play covered parties based on their personal relationships or employment status.

Explanation of the columns that may appear on this page:

Level A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
Source The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code The code (used as the code in the resource instance)
Display The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition An explanation of the meaning of the concept
Comments Additional notes about how to use the code


2020-05-06reviseTed KleinVocabulary WGMigrated to the UTG maintenance environment and publishing tooling.
2014-03-26reviseVocabulary (Woody Beeler) (no record of original request)2014T1_2014-03-26_001283 (RIM release ID)Lock all vaue sets untouched since 2014-03-26 to trackingId 2014T1_2014_03_26