HL7 Terminology (THO)
5.2.0 - Publication International flag

This page is part of the HL7 Terminology (v5.2.0: Release) based on FHIR R4. This is the current published version in its permanent home (it will always be available at this URL). For a full list of available versions, see the Directory of published versions

ValueSet: ActCoverageConfirmationCode

Official URL: http://terminology.hl7.org/ValueSet/v3-ActCoverageConfirmationCode Version: 2.0.0
Active as of 2014-03-26 Computable Name: ActCoverageConfirmationCode
Other Identifiers: id: urn:oid:2.16.840.1.113883.1.11.17487

Response to an insurance coverage eligibility query or authorization request.

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:

This value set excludes codes based on the following rules:

 

Expansion

This value set contains 4 concepts

Expansion based on ActCode v8.0.1 (CodeSystem)

CodeSystemDisplayDefinition
  _ActCoverageAuthorizationConfirmationCodehttp://terminology.hl7.org/CodeSystem/v3-ActCodeActCoverageAuthorizationConfirmationCode

Indication of authorization for healthcare service(s) and/or product(s). If authorization is approved, funds are set aside.

  AUTHhttp://terminology.hl7.org/CodeSystem/v3-ActCodeAuthorized

Authorization approved and funds have been set aside to pay for specified healthcare service(s) and/or product(s) within defined criteria for the authorization.

  NAUTHhttp://terminology.hl7.org/CodeSystem/v3-ActCodeNot Authorized

Authorization for specified healthcare service(s) and/or product(s) denied.

  _ActCoverageEligibilityConfirmationCodehttp://terminology.hl7.org/CodeSystem/v3-ActCodeActCoverageEligibilityConfirmationCode

Indication of eligibility coverage for healthcare service(s) and/or product(s).

  ELGhttp://terminology.hl7.org/CodeSystem/v3-ActCodeEligible

Insurance coverage is in effect for healthcare service(s) and/or product(s).

  NELGhttp://terminology.hl7.org/CodeSystem/v3-ActCodeNot Eligible

Insurance coverage is not in effect for healthcare service(s) and/or product(s). May optionally include reasons for the ineligibility.

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
2022-10-18reviseMarc DuteauTSMGFixing missing metadata; up-349
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