HL7 Terminology (THO)
5.2.0 - Publication
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
Official URL: http://terminology.hl7.org/ValueSet/v3-ActCoverageLimitCode | Version: 2.0.0 | |||
Active as of 2014-03-26 | Computable Name: ActCoverageLimitCode | |||
Other Identifiers: id: urn:oid:2.16.840.1.113883.1.11.17496 |
Criteria that are applicable to the authorized coverage.
References
This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)
This value set includes codes based on the following rules:
http://terminology.hl7.org/CodeSystem/v3-ActCode
where concept is-a _ActCoverageLimitCodeThis value set excludes codes based on the following rules:
http://terminology.hl7.org/CodeSystem/v3-ActCode
Code | Display | Definition |
_ActCoverageLimitCode | ActCoverageLimitCode | Criteria that are applicable to the authorized coverage. |
This value set contains 7 concepts
Expansion based on ActCode v8.0.1 (CodeSystem)
Code | System | Display | Definition |
_ActCoverageQuantityLimitCode | http://terminology.hl7.org/CodeSystem/v3-ActCode | 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. |
COVPRD | http://terminology.hl7.org/CodeSystem/v3-ActCode | coverage period | Codes representing the time period during which coverage is available; or financial participation requirements are in effect. |
LFEMX | http://terminology.hl7.org/CodeSystem/v3-ActCode | 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. |
NETAMT | http://terminology.hl7.org/CodeSystem/v3-ActCode | Net Amount | Maximum net amount that will be covered for the product or service specified. |
PRDMX | http://terminology.hl7.org/CodeSystem/v3-ActCode | 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. |
UNITPRICE | http://terminology.hl7.org/CodeSystem/v3-ActCode | Unit Price | Maximum unit price that will be covered for the authorized product or service. |
UNITQTY | http://terminology.hl7.org/CodeSystem/v3-ActCode | Unit Quantity | Maximum number of items that will be covered of the product or service specified. |
COVMX | http://terminology.hl7.org/CodeSystem/v3-ActCode | coverage maximum | Definition: Codes representing the maximum coverate or financial participation requirements. |
_ActCoveredPartyLimitCode | http://terminology.hl7.org/CodeSystem/v3-ActCode | ActCoveredPartyLimitCode | Codes representing the types of covered parties that may receive covered benefits under a policy or program. |
_ActCoveragePartyLimitGroupCode | http://terminology.hl7.org/CodeSystem/v3-ActCode | ActCoveragePartyLimitGroupCode | Codes 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 |
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
Date | Action | Author | Custodian | Comment |
2022-10-18 | revise | Marc Duteau | TSMG | Fixing missing metadata; up-349 |
2020-05-06 | revise | Ted Klein | Vocabulary WG | Migrated to the UTG maintenance environment and publishing tooling. |
2014-03-26 | revise | Vocabulary (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 |