HL7 Terminology (THO)
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: Coverage Copay Type Codes - JSON Representation

Draft as of 2023-07-17 Maturity Level: 2

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{
  "resourceType" : "CodeSystem",
  "id" : "coverage-copay-type",
  "meta" : {
    "lastUpdated" : "2020-04-09T21:10:28.568+00:00",
    "profile" : [
      "http://hl7.org/fhir/StructureDefinition/shareablecodesystem"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p>This code system <code>http://terminology.hl7.org/CodeSystem/coverage-copay-type</code> defines the following codes:</p><table class=\"codes\"><tr><td style=\"white-space:nowrap\"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style=\"white-space:nowrap\">gpvisit<a name=\"coverage-copay-type-gpvisit\"> </a></td><td>GP Office Visit</td><td>An office visit for a general practitioner of a discipline.</td></tr><tr><td style=\"white-space:nowrap\">spvisit<a name=\"coverage-copay-type-spvisit\"> </a></td><td>Specialist Office Visit</td><td>An office visit for a specialist practitioner of a discipline</td></tr><tr><td style=\"white-space:nowrap\">emergency<a name=\"coverage-copay-type-emergency\"> </a></td><td>Emergency</td><td>An episode in an emergency department.</td></tr><tr><td style=\"white-space:nowrap\">inpthosp<a name=\"coverage-copay-type-inpthosp\"> </a></td><td>Inpatient Hospital</td><td>An episode of an Inpatient hospital stay.</td></tr><tr><td style=\"white-space:nowrap\">televisit<a name=\"coverage-copay-type-televisit\"> </a></td><td>Tele-visit</td><td>A visit held where the patient is remote relative to the practitioner, e.g. by phone, computer or video conference.</td></tr><tr><td style=\"white-space:nowrap\">urgentcare<a name=\"coverage-copay-type-urgentcare\"> </a></td><td>Urgent Care</td><td>A visit to an urgent care facility - typically a community care clinic.</td></tr><tr><td style=\"white-space:nowrap\">copaypct<a name=\"coverage-copay-type-copaypct\"> </a></td><td>Copay Percentage</td><td>A standard percentage applied to all classes or service or product not otherwise specified.</td></tr><tr><td style=\"white-space:nowrap\">copay<a name=\"coverage-copay-type-copay\"> </a></td><td>Copay Amount</td><td>A standard fixed currency amount applied to all classes or service or product not otherwise specified.</td></tr><tr><td style=\"white-space:nowrap\">deductible<a name=\"coverage-copay-type-deductible\"> </a></td><td>Deductible</td><td>The accumulated amount of patient payment before the coverage begins to pay for services.</td></tr><tr><td style=\"white-space:nowrap\">maxoutofpocket<a name=\"coverage-copay-type-maxoutofpocket\"> </a></td><td>Maximum out of pocket</td><td>The maximum amout of payment for services which a patient, or family, is expected to incur - typically annually.</td></tr></table></div>"
  },
  "extension" : [
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
      "valueCode" : "fm"
    },
    {
      "url" : "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
      "valueInteger" : 2
    }
  ],
  "url" : "http://terminology.hl7.org/CodeSystem/coverage-copay-type",
  "identifier" : [
    {
      "system" : "urn:ietf:rfc:3986",
      "value" : "urn:oid:2.16.840.1.113883.4.642.1.1149"
    }
  ],
  "version" : "0.1.0",
  "name" : "CoverageCopayTypeCodes",
  "title" : "Coverage Copay Type Codes",
  "status" : "draft",
  "experimental" : false,
  "date" : "2023-07-17T22:16:15-06:00",
  "publisher" : "Financial Management",
  "contact" : [
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://hl7.org/fhir"
        }
      ]
    },
    {
      "telecom" : [
        {
          "system" : "url",
          "value" : "http://hl7.org/fhir"
        }
      ]
    }
  ],
  "description" : "This value set includes sample Coverage Copayment Type codes.",
  "copyright" : "This is an example set.",
  "caseSensitive" : true,
  "valueSet" : "http://terminology.hl7.org/ValueSet/coverage-copay-type",
  "content" : "complete",
  "concept" : [
    {
      "code" : "gpvisit",
      "display" : "GP Office Visit",
      "definition" : "An office visit for a general practitioner of a discipline."
    },
    {
      "code" : "spvisit",
      "display" : "Specialist Office Visit",
      "definition" : "An office visit for a specialist practitioner of a discipline"
    },
    {
      "code" : "emergency",
      "display" : "Emergency",
      "definition" : "An episode in an emergency department."
    },
    {
      "code" : "inpthosp",
      "display" : "Inpatient Hospital",
      "definition" : "An episode of an Inpatient hospital stay."
    },
    {
      "code" : "televisit",
      "display" : "Tele-visit",
      "definition" : "A visit held where the patient is remote relative to the practitioner, e.g. by phone, computer or video conference."
    },
    {
      "code" : "urgentcare",
      "display" : "Urgent Care",
      "definition" : "A visit to an urgent care facility - typically a community care clinic."
    },
    {
      "code" : "copaypct",
      "display" : "Copay Percentage",
      "definition" : "A standard percentage applied to all classes or service or product not otherwise specified."
    },
    {
      "code" : "copay",
      "display" : "Copay Amount",
      "definition" : "A standard fixed currency amount applied to all classes or service or product not otherwise specified."
    },
    {
      "code" : "deductible",
      "display" : "Deductible",
      "definition" : "The accumulated amount of patient payment before the coverage begins to pay for services."
    },
    {
      "code" : "maxoutofpocket",
      "display" : "Maximum out of pocket",
      "definition" : "The maximum amout of payment for services which a patient, or family, is expected to incur - typically annually."
    }
  ]
}