HL7 Terminology (THO)
5.4.0 - Publication
This page is part of the HL7 Terminology (v5.4.0: 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-ActInvoiceDetailGenericProviderCode | Version: 3.0.0 | |||
Active as of 2014-03-26 | Responsible: Health Level Seven International | Computable Name: ActInvoiceDetailGenericProviderCode | ||
Other Identifiers: id: Uniform Resource Identifier (URI)#urn:oid:2.16.840.1.113883.1.11.19408 | ||||
Copyright/Legal: This material derives from the HL7 Terminology THO. THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license |
The billable item codes to identify provider supplied charges or changes to the total billing of a claim.
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 _ActInvoiceDetailGenericProviderCodeThis value set excludes codes based on the following rules:
http://terminology.hl7.org/CodeSystem/v3-ActCode
Code | Display | Definition |
_ActInvoiceDetailGenericProviderCode | ActInvoiceDetailGenericProviderCode | The billable item codes to identify provider supplied charges or changes to the total billing of a claim. |
This value set contains 13 concepts
Expansion based on codesystem ActCode v9.0.0 (CodeSystem)
Code | System | Display | Definition |
CANCAPT | http://terminology.hl7.org/CodeSystem/v3-ActCode | cancelled appointment | A charge to compensate the provider when a patient cancels an appointment with insufficient time for the provider to make another appointment with another patient. |
DSC | http://terminology.hl7.org/CodeSystem/v3-ActCode | discount | A reduction in the amount charged as a percentage of the amount. For example a 5% discount for volume purchase. |
ESA | http://terminology.hl7.org/CodeSystem/v3-ActCode | extraordinary service assessment | A premium on a service fee is requested because, due to extenuating circumstances, the service took an extraordinary amount of time or supplies. |
FFSTOP | http://terminology.hl7.org/CodeSystem/v3-ActCode | fee for service top off | Under agreement between the parties (payor and provider), a guaranteed level of income is established for the provider over a specific, pre-determined period of time. The normal course of business for the provider is submission of fee-for-service claims. Should the fee-for-service income during the specified period of time be less than the agreed to amount, a top-up amount is paid to the provider equal to the difference between the fee-for-service total and the guaranteed income amount for that period of time. The details of the agreement may specify (or not) a requirement for repayment to the payor in the event that the fee-for-service income exceeds the guaranteed amount. |
FNLFEE | http://terminology.hl7.org/CodeSystem/v3-ActCode | final fee | Anticipated or actual final fee associated with treating a patient. |
FRSTFEE | http://terminology.hl7.org/CodeSystem/v3-ActCode | first fee | Anticipated or actual initial fee associated with treating a patient. |
MARKUP | http://terminology.hl7.org/CodeSystem/v3-ActCode | markup or up-charge | An increase in the amount charged as a percentage of the amount. For example, 12% markup on product cost. |
MISSAPT | http://terminology.hl7.org/CodeSystem/v3-ActCode | missed appointment | A charge to compensate the provider when a patient does not show for an appointment. |
PERFEE | http://terminology.hl7.org/CodeSystem/v3-ActCode | periodic fee | Anticipated or actual periodic fee associated with treating a patient. For example, expected billing cycle such as monthly, quarterly. The actual period (e.g. monthly, quarterly) is specified in the unit quantity of the Invoice Element. |
PERMBNS | http://terminology.hl7.org/CodeSystem/v3-ActCode | performance bonus | The amount for a performance bonus that is being requested from a payor for the performance of certain services (childhood immunizations, influenza immunizations, mammograms, pap smears) on a sliding scale. That is, for 90% of childhood immunizations to a maximum of $2200/yr. An invoice is created at the end of the service period (one year) and a code is submitted indicating the percentage achieved and the dollar amount claimed. |
RESTOCK | http://terminology.hl7.org/CodeSystem/v3-ActCode | restocking fee | A charge is requested because the patient failed to pick up the item and it took an amount of time to return it to stock for future use. |
TRAVEL | http://terminology.hl7.org/CodeSystem/v3-ActCode | travel | A charge to cover the cost of travel time and/or cost in conjuction with providing a service or product. It may be charged per kilometer or per hour based on the effective agreement. |
URGENT | http://terminology.hl7.org/CodeSystem/v3-ActCode | urgent | Premium paid on service fees in compensation for providing an expedited response to an urgent situation. |
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 |
2023-11-14 | revise | Marc Duteau | TSMG | Add standard copyright and contact to internal content; up-476 |
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 |