HL7 Terminology (THO)
4.0.0 - Publication International flag

This page is part of the HL7 Terminology (v4.0.0: 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: ActInvoiceGroupCode

Official URL: http://terminology.hl7.org/ValueSet/v3-ActInvoiceGroupCode Version: 2.0.0
Active as of 2014-03-26 Computable Name: ActInvoiceGroupCode
Other Identifiers: : urn:oid:2.16.840.1.113883.1.11.19398

Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results.

Invoice elements of this type signify a grouping of one or more children (detail) invoice elements. They do not have intrinsic costing associated with them, but merely reflect the sum of all costing for it’s immediate children invoice elements.

References

Logical Definition (CLD)

This value set includes codes based on the following rules:

This value set excludes codes based on the following rules:

  • Exclude these codes as defined in http://terminology.hl7.org/CodeSystem/v3-ActCode
    CodeDisplayDefinition
    _ActInvoiceGroupCodeActInvoiceGroupCodeType of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results.

    Invoice elements of this type signify a grouping of one or more children (detail) invoice elements. They do not have intrinsic costing associated with them, but merely reflect the sum of all costing for it's immediate children invoice elements.

 

Expansion

This value set contains 22 concepts

Expansion based on ActCode v6.1.0 (CodeSystem)

CodeSystemDisplayDefinition
  _ActInvoiceInterGroupCodehttp://terminology.hl7.org/CodeSystem/v3-ActCodeActInvoiceInterGroupCode

Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results.

Invoice elements of this type signify a grouping of one or more children (detail) invoice elements. They do not have intrinsic costing associated with them, but merely reflect the sum of all costing for it's immediate children invoice elements.

The domain is only specified for an intermediate invoice element group (non-root or non-top level) for an Invoice.

  CPNDDRGINGhttp://terminology.hl7.org/CodeSystem/v3-ActCodecompound drug invoice group

A grouping of invoice element groups and details including the ones specifying the compound ingredients being invoiced. It may also contain generic detail items such as markup.

  CPNDINDINGhttp://terminology.hl7.org/CodeSystem/v3-ActCodecompound ingredient invoice group

A grouping of invoice element details including the one specifying an ingredient drug being invoiced. It may also contain generic detail items such as tax or markup.

  CPNDSUPINGhttp://terminology.hl7.org/CodeSystem/v3-ActCodecompound supply invoice group

A grouping of invoice element groups and details including the ones specifying the compound supplies being invoiced. It may also contain generic detail items such as markup.

  DRUGINGhttp://terminology.hl7.org/CodeSystem/v3-ActCodedrug invoice group

A grouping of invoice element details including the one specifying the drug being invoiced. It may also contain generic detail items such as markup.

  FRAMEINGhttp://terminology.hl7.org/CodeSystem/v3-ActCodeframe invoice group

A grouping of invoice element details including the ones specifying the frame fee and the frame dispensing cost that are being invoiced.

  LENSINGhttp://terminology.hl7.org/CodeSystem/v3-ActCodelens invoice group

A grouping of invoice element details including the ones specifying the lens fee and the lens dispensing cost that are being invoiced.

  PRDINGhttp://terminology.hl7.org/CodeSystem/v3-ActCodeproduct invoice group

A grouping of invoice element details including the one specifying the product (good or supply) being invoiced. It may also contain generic detail items such as tax or discount.

  _ActInvoiceRootGroupCodehttp://terminology.hl7.org/CodeSystem/v3-ActCodeActInvoiceRootGroupCode

Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results.

Invoice elements of this type signify a grouping of one or more children (detail) invoice elements. They do not have intrinsic costing associated with them, but merely reflect the sum of all costing for it's immediate children invoice elements.

Codes from this domain reflect the type of Invoice such as Pharmacy Dispense, Clinical Service and Clinical Product. The domain is only specified for the root (top level) invoice element group for an Invoice.

  CPINVhttp://terminology.hl7.org/CodeSystem/v3-ActCodeclinical product invoice

Clinical product invoice where the Invoice Grouping contains one or more billable item and is supported by clinical product(s).

For example, a crutch or a wheelchair.

  CPhttp://terminology.hl7.org/CodeSystem/v3-ActCodeclinical product invoice

Clinical product invoice where the Invoice Grouping contains one or more billable item and is supported by clinical product(s).

For example, a crutch or a wheelchair.

  CSINVhttp://terminology.hl7.org/CodeSystem/v3-ActCodeclinical service invoice

Clinical Services Invoice which can be used to describe a single service, multiple services or repeated services.

[1] Single Clinical services invoice where the Invoice Grouping contains one billable item and is supported by one clinical service.

For example, a single service for an office visit or simple clinical procedure (e.g. knee mobilization).

[2] Multiple Clinical services invoice where the Invoice Grouping contains more than one billable item, supported by one or more clinical services. The services can be distinct and over multiple dates, but for the same patient. This type of invoice includes a series of treatments which must be adjudicated together.

For example, an adjustment and ultrasound for a chiropractic session where fees are associated for each of the services and adjudicated (invoiced) together.

[3] Repeated Clinical services invoice where the Invoice Grouping contains one or more billable item, supported by the same clinical service repeated over a period of time.

For example, the same Chiropractic adjustment (service or treatment) delivered on 3 separate occasions over a period of time at the discretion of the provider (e.g. month).

  CShttp://terminology.hl7.org/CodeSystem/v3-ActCodeclinical service invoice

Clinical Services Invoice which can be used to describe a single service, multiple services or repeated services.

[1] Single Clinical services invoice where the Invoice Grouping contains one billable item and is supported by one clinical service.

For example, a single service for an office visit or simple clinical procedure (e.g. knee mobilization).

[2] Multiple Clinical services invoice where the Invoice Grouping contains more than one billable item, supported by one or more clinical services. The services can be distinct and over multiple dates, but for the same patient. This type of invoice includes a series of treatments which must be adjudicated together.

For example, an adjustment and ultrasound for a chiropractic session where fees are associated for each of the services and adjudicated (invoiced) together.

[3] Repeated Clinical services invoice where the Invoice Grouping contains one or more billable item, supported by the same clinical service repeated over a period of time.

For example, the same Chiropractic adjustment (service or treatment) delivered on 3 separate occasions over a period of time at the discretion of the provider (e.g. month).

  CSPINVhttp://terminology.hl7.org/CodeSystem/v3-ActCodeclinical service and product

A clinical Invoice Grouping consisting of one or more services and one or more product. Billing for these service(s) and product(s) are supported by multiple clinical billable events (acts).

All items in the Invoice Grouping must be adjudicated together to be acceptable to the Adjudicator.

For example , a brace (product) invoiced together with the fitting (service).

  FININVhttp://terminology.hl7.org/CodeSystem/v3-ActCodefinancial invoice

Invoice Grouping without clinical justification. These will not require identification of participants and associations from a clinical context such as patient and provider.

Examples are interest charges and mileage.

  OHSINVhttp://terminology.hl7.org/CodeSystem/v3-ActCodeoral health service

A clinical Invoice Grouping consisting of one or more oral health services. Billing for these service(s) are supported by multiple clinical billable events (acts).

All items in the Invoice Grouping must be adjudicated together to be acceptable to the Adjudicator.

  PAINVhttp://terminology.hl7.org/CodeSystem/v3-ActCodepreferred accommodation invoice

HealthCare facility preferred accommodation invoice.

  PAhttp://terminology.hl7.org/CodeSystem/v3-ActCodepreferred accommodation invoice

HealthCare facility preferred accommodation invoice.

  RXCINVhttp://terminology.hl7.org/CodeSystem/v3-ActCodeRx compound invoice

Pharmacy dispense invoice for a compound.

  RXChttp://terminology.hl7.org/CodeSystem/v3-ActCodeRx compound invoice

Pharmacy dispense invoice for a compound.

  RXDINVhttp://terminology.hl7.org/CodeSystem/v3-ActCodeRx dispense invoice

Pharmacy dispense invoice not involving a compound

  RXDhttp://terminology.hl7.org/CodeSystem/v3-ActCodeRx dispense invoice

Pharmacy dispense invoice not involving a compound

  SBFINVhttp://terminology.hl7.org/CodeSystem/v3-ActCodesessional or block fee invoice

Clinical services invoice where the Invoice Group contains one billable item for multiple clinical services in one or more sessions.

  VRXINVhttp://terminology.hl7.org/CodeSystem/v3-ActCodevision dispense invoice

Vision dispense invoice for up to 2 lens (left and right), frame and optional discount. Eye exams are invoiced as a clinical service invoice.


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
System 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

DateActionAuthorCustodianComment
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