HL7.TERMINOLOGY\ActCoverageQuantityLimitCode

HL7 Terminology (THO)
3.0.0 - Publication

This page is part of the HL7 Terminology (v3.0.0: 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

ValueSet: ActCoverageQuantityLimitCode

Summary

Defining URL:

http://terminology.hl7.org/ValueSet/v3-ActCoverageQuantityLimitCode

Version:

2.0.0

Name:

ActCoverageQuantityLimitCode

Status:

Active as of 3/26/14

Definition:

Maximum 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.

OID:

2.16.840.1.113883.1.11.19933 (for OID based terminology systems)

Source Resource:

XML / JSON / Turtle

References

This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

Logical Definition (CLD)

This value set includes codes based on the following rules:

Include these codes as defined in http://terminology.hl7.org/CodeSystem/v3-ActCode

Code	Display	Definition
COVPRD	coverage period	Codes representing the time period during which coverage is available; or financial participation requirements are in effect.
NETAMT	Net Amount	Maximum net amount that will be covered for the product or service specified.
UNITPRICE	Unit Price	Maximum unit price that will be covered for the authorized product or service.
UNITQTY	Unit Quantity	Maximum number of items that will be covered of the product or service specified.

Include codes from http://terminology.hl7.org/CodeSystem/v3-ActCode where concept is-a _ActCoverageQuantityLimitCode

Expansion

This value set contains 6 concepts

Expansion based on ActCode v6.0.0 (CodeSystem)

All codes in this table are from the system http://terminology.hl7.org/CodeSystem/v3-ActCode

Code	Display	Definition
COVPRD	coverage period	Codes representing the time period during which coverage is available; or financial participation requirements are in effect.
NETAMT	Net Amount	Maximum net amount that will be covered for the product or service specified.
UNITPRICE	Unit Price	Maximum unit price that will be covered for the authorized product or service.
UNITQTY	Unit Quantity	Maximum number of items that will be covered of the product or service specified.
_ActCoverageQuantityLimitCode	ActCoverageQuantityLimitCode	Maximum 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.
LFEMX	life 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.
PRDMX	period 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.

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

History

Date

Action

Custodian

Author

Comment

2020-05-06

revise