Acknowledgement Condition codes describe the conditions under which accept or application level acknowledgements are required to be returned in response to the message send operation.

A site specific code indicating the specific problem being reported by this Ack Detail.

Refelects rejections because elements of the communication are not supported in the current context.

Reflects errors in the syntax or structure of the communication.

A code identifying the specific message to be provided.

A textual value may be specified as the print name, or for non-coded messages, as the original text.*Discussion:*

'Required attribute xxx is missing', 'System will be unavailable March 19 from 0100 to 0300'*Examples:*

Acknowledgement code as described in HL7 message processing rules.

Identifies the the kind of information specified in the acknowledgement message. Options are: Error, Warning or Information.

Description:Types of representation groupings of financial transactions that are tracked and reported together with a single balance.Examples:

* Patient billing accounts * Cost center * Cash

Explanatory codes that provide information derived by an Adjudicator during the course of adjudicating an Invoice. Codes from this domain are purely information and do not materially affect the adjudicated Invoice. That is, codes do not impact or explain financial adjustments to an Invoice.

A companion domain (ActAdjudicationReason) includes information reasons which have a financial impact on an Invoice (claim).

Example adjudication information code is 54540 - Patient has reached Plan Maximum for current year.

Codes from this domain further rationalizes ActAdjudicationCodes (e.g. AA - Adjudicated with Adjustment), which are used to describe the process of adjudicating an Invoice.

Explanatory codes that describe reasons why an Adjudicator has financially adjusted an invoice (claim).

A companion domain (ActAdjudicationInformationCode) includes information reasons which do not have a financial impact on an invoice (claim).

Example adjudication reason code is AA-CLAIM-0011 - Only Basic Procedure/Test Eligible.

Codes from this domain further rationalizes ActAdjudicationCodes (e.g. AA - Adjudicated with Adjustment), which are used to describe the process of adjudicating an invoice. For AS - Adjudicated as Submitted, there should be no specification of ActAdjudicationReason codes, as there are no financial adjustments against the invoice.

Description:Actions to be carried out by the recipient of the Adjudication Result information. Description:Types of responses that will occur as a result of the adjudication of an electronic invoice at a summary level and provides guidance on interpretation of the referenced adjudication results.Examples:

* adjudicated with adjustments * adjudicated as refused * adjudicated as submitted

Description:Describe why an antigen is considered to be invalid for use. Description:Types of acts that can be scheduled.Examples:

* Follow-up appointment * New referral appointment * Consultation appointment * Specimen Collection appointment * Procedure appointment

Description:May be sent to indicate one or more reasons for the performance of a billable clinical service or product, and not related or specified by a diagnosis.Examples:

* Duplicate Therapy * Care protocol * Insurance requirement

Description:Maybe sent to indicate one or more reasons for the performance of a non clinical service or product, and not related or specified by diagnosis.Examples:

* Fraudulent prescription * Patient's preference * Physiotherapy equipment

Definition:An identifying code for billable services, as opposed to codes for similar services used to identify them for functional purposes.OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode. Definition:This domain is used to document reasons for providing a billable service; the billable services may include both clinical services and social services. OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode. Description:Types of provision(s) made for reimbursing for the deliver of healthcare services and/or goods provided by a Provider for one or more occurrence or over a specified period.Examples:

* Contract * Rostering * Capitation

Description:Sites used for blood donation.Examples:

* arm * leg * heel

Description:Defines the type of blood donation.Examples:

* autologous * directed * volunteer

**Description:**The type and scope of responsibility taken-on by the performer of the Act for a specific subject of care.

**Description:**Concepts identifying different types of referral requests. These concepts identify the general type of care or category of services requested. They are not used to represent the indication or diagnosis which triggered the need for the referral. E.g. Anger management service, Intensive Care service, Orthodontics service.

**Description:**Contrains the type of attachment (document, XRAY, bit map image, etc.) included to support a healthcare claim. Vocabulary bound to this domain should be a specification for the type of document (i.e. WCB First Report of Acccident - Form 8).

A code specifying the major type of Act that this Act-instance represents.

Constraints:The classCode domain is a tightly controlled vocabulary, not an external or user-defined vocabulary.

Every Act-instance must have a classCode. If the act class is not further specified, the most general Act.classCode (ACT) is used.

The Act.classCode must be a generalization of the specific Act concept (e.g., as expressed in Act.code), in other words, the Act concepts conveyed in an Act must be specializations of the Act.classCode. Especially, Act.code is not a "modifier" that can alter the meaning of a class code. (See Act.code for contrast.)

**Description:**The interaction of entities whereupon a subject entity is brought into proximity to a physical, chemical or biological agent. This includes intended exposure (e.g. administering a drug product) as well as accidental or environmental exposure. (Note: This class deals only with proximity and not the effectiveness of the exposure, i.e. not all exposed will suffer actual harm or benefit.)

**Examples:**Exposure to radiation, drug administration, inhalation of peanut aerosol or viral particles.

**Description:**An observation of genomic phenomena.

**Description:**A mandate, regulation, obligation, requirement, rule, or expectation unilaterally imposed by one party on:

* The activity of another party * The behavior of another party * The manner in which an act is executed

An Act whose immediate and primary outcome (post-condition) is the alteration of the physical condition of the subject.

Examples:: Procedures may involve the disruption of some body surface (e.g. an incision in a surgical procedure), but they also include conservative procedures such as reduction of a luxated join, chiropractic treatment, massage, balneotherapy, acupuncture, shiatsu, etc. Outside of clinical medicine, procedures may be such things as alteration of environments (e.g. straightening rivers, draining swamps, building dams) or the repair or change of machinery etc.

The act of putting something away for safe keeping. The "something" may be physical object such as a specimen, or information, such as observations regarding a specimen.

The table that provides the detailed or rich codes for the Act classes.

Open Issue:The hierarchy has issues and several of the existing domains may be moved under this new one; this must be examined and a proposal to clean up the hierarncy in the near future is neededOpen Issue:The description of this domain seems odd and may be a leftover from long ago and needs improvement.
Description:Codes for general process steps.Examples:

* lab process steps * diagnostic imaging process steps * etc. *(Missing third example)*

Denotes the specific service that has been performed. This is obtained from the professional service catalog pertaining to the discipline of the health service provider. Professional services are generally cognitive in nature and exclude surgical procedures. E.g. Provided training, Provided drug therapy review, Gave smoking-cessation counseling, etc.

**Description:**Lists of high-level categorizations for clinical coded observations that do not require numeric values with a specific unit of measure.

Examples:

* Symptoms * History * Observations

A context representing a grouped commitment of information to the EHR. It is considered the unit of modification of the record, the unit of transmission in record extracts, and the unit of attestation by authorizing clinicians.

Examples:document; authentication unit; transmission unit.

**Description:**Specifies the type of consent directive indicated by an ActClassPolicy e.g., a 3rd party authorization to disclose or consent for a substitute decision maker (SDM) or a notice of privacy policy. Sibling to ActPrivacyPolicyType and Child of ActPolicyType.

To perform one or more operations on information to which the patient has not consented as deemed necessary by authorized entities for providing care in the best interest of the patient; providing immediately needed health care for an emergent condition; or for protecting public or third party safety.

Usage Notes:Used to convey the reason that a provider or other entity may or has accessed personal healthcare information. Typically, this involves overriding the subject's consent directives.
Used to convey the reason that a provider or other entity may or has accessed personal healthcare information. Typically, this involves overriding the subject's consent directives.
Definition:The type of consent directive, e.g., to consent or dissent to collect, access, or use in specific ways within an EHRS or for health information exchange; or to disclose health information for purposes such as research. Description:Code specifying the level within a hierarchical Act composition structure and the kind of contextual information attached to composite Acts ("containers") and propagated to component Acts within those containers. The levelCode signifies the position within such a containment hierarchy and the applicable constraints.Examples:The "extract level" and the "folder level" must contain data about a single individual, whereas the "multiple subject level" may contain data about multiple individuals. While "extract" can originate from multiple sources, a "folder" should originate from a single source. The "composition" level usually has a single author.Constraints:The constraints applicable to a particular level may include differing requirements for participations (e.g. patient, source organization, author or other signatory), relationships to or inclusion of other Acts, documents or use of templates. The constraints pertaining to a level may also specify the permissible levels that may be contained as components of that level. Several nested levels with the same levelCode may be permitted, prohibited (or limited). Instance of the next subordinate level are usually permitted within any level but some levels may be omitted from a model and it may be permissible to skip several layers.Discussion:The levelCode concepts have been defined to meet specific health record transfer requirements. While these concepts are known to be applicable to some other types of transactions, they are not intended to a be a complete closed list. Options exist for other sets of orthogonal levels where required to meet a business purpose (e.g. a multiple patient communication may be subdivided by a super-ordinate level of subject areas).

Identifies the heading under which a document is to appear in a pre-defined, pro forma table of contents for a collection of documents within a regulatory category.

Examples:

* m1-1-forms (eCTD module 1, forms) * m1-1-1-fda-form-1571 (eCTD. Module 1, specific FDA form) * m3-2-s-drug-substance (eCTD module 3, section 2, drug substance by substance)

Usage Note:This usage is confined to a specific set of requirements related to regulatory documents in the context of RPS documents.

An agreement of obligation between two or more parties that is subject to contractual law and enforcement.

Examples:approvals granted by a regulatory agency; contracts measured in financial terms; insurance coverage contracts.

Codes specify the category of observation, evidence, or document used to assess for services, e.g., discharge planning, or to establish eligibility for coverage under a policy or program. The type of evidence is coded as observation values.

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

**Description:**Represents the reason for 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.

Criteria that are applicable to the authorized coverage.

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.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

**Description:**Identifies the reason or rationale for coverage of a service or product based on characteristics of the provider, e.g., contractual relationship to payor, such as in or out-of-network; relationship of the covered party to the provider.

**Example:**In closed managed care plan, a covered party is assigned a primary care provider who provides primary care services and authorizes referrals and ancillary and non-primary care services.

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.

**Description:**Codes used to specify reasons or criteria relating to coverage provided under a policy or program. May be used to convey reasons pertaining to coverage contractual provisions, including criteria for eligibility, coverage limitations, coverage maximums, or financial participation required of covered parties.

**Description:**Identifies the reason or rationale for coverage of a service or product based on clinical efficacy criteria or practices prescribed by the payor.

Definition:Set of codes indicating the type of insurance policy or program that pays for the cost of benefits provided to covered parties.

Codes representing the types of covered parties that may receive covered benefits under a policy or program.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

**Description:**The type and scope of legal and/or professional responsibility taken-on by the performer of the Act for a specific subject of care as described by a credentialing agency, i.e. government or non-government agency. Failure in executing this Act may result in loss of credential to the person or organization who participates as performer of the Act. Excludes employment agreements.

**Example:**Hospital license; physician license; clinic accreditation.

**Description:**The type and scope of legal and/or professional responsibility taken-on by the performer of the Act for a specific subject of care as described by an agency for credentialing individuals.

**Description:**The type and scope of legal and/or professional responsibility taken-on by the performer of the Act for a specific subject of care as described by an agency for credentialing programs within organizations.

Description:Types of operations that may accomplish access of information. Here, objects are broadly understood as information system-related entities (e.g., devices, files, records, tables, processes, programs, domains) containing or receiving information.Examples:

* Query * Search * Transport * Send * Receive

Description:Types of operations that may accomplish collection or related management of information. Here, objects are broadly understood as information system-related entities (e.g., devices, files, records, tables, processes, programs, domains) containing or receiving information.Examples:

* Create * Store * Archive

**Description:**The type of data consent directive.

Description:Types of operations that may accomplish disclosure of information. Here, objects are broadly understood as information system-related entities (e.g., devices, files, records, tables, processes, programs, domains) containing or receiving information.Examples:

* Disclose * Forward * Publish

Description:Types of operations that may be performed on objects. Here, objects are broadly understood as information system-related entities (e.g., devices, files, records, tables, processes, programs, domains) containing or receiving information.Examples:

* Create * Update * Delete

Open Issue:This is too restrictive to deal with what CBCC wants.
Description:Types of operations that may accomplish usage of information. Here, objects are broadly understood as information system-related entities (e.g., devices, files, records, tables, processes, programs, domains) containing or receiving information.Examples:

* Activate * Release * Execute Read * Display * Update * Append * Amend

**Definition:**Identifies what type of issue detected during occurrence of an act (e.g. unrecognized identifiers, drug-drug contraindications, drug-allergy alerts).

Examples:

* High dosage alert * Conditional element missing * Timing detected issue

Description:Issue management types that dealing with detected issue observations.Rationale:Allows for consistent specification and interpretation of issue management.

Includes coded types of actions that can be taken by a supervising entity in response to inappropriate action (or inaction) on the part of a supervised entity.

**Definition:**A comprehensive term for health care provided in a healthcare facility (e.g. a practitioneraTMs office, clinic setting, or hospital) on a nonresident basis. The term ambulatory usually implies that the patient has come to the location and is not assigned to a bed. Sometimes referred to as an outpatient encounter.

**Definition:**A patient encounter that takes place at a dedicated healthcare service delivery location where the patient receives immediate evaluation and treatment, provided until the patient can be discharged or responsibility for the patient's care is transferred elsewhere (for example, the patient could be admitted as an inpatient or transferred to another facility.)

**Definition:**A patient encounter that takes place both outside a dedicated service delivery location and outside a patient's residence. Example locations might include an accident site and at a supermarket.

**Definition:**Healthcare encounter that takes place in the residence of the patient or a designee

**Definition:**A patient encounter where a patient is admitted by a hospital or equivalent facility, assigned to a location where patients generally stay at least overnight and provided with room, board, and continuous nursing service.

Description:Types of priorities to determine start of an encounter. Description:Administration reasons for patient encounters.

**Definition:**An encounter where the patient is admitted to a health care facility for a predetermined length of time, usually less than 24 hours.

Concepts representing types of patient encounter such as ambulatory encounter, inpatient encounter or emergency encounter.

**Definition:**A patient encounter where the patient and the practitioner(s) are not in the same physical location. Examples include telephone conference, email exchange, robotic surgery, and televideo conference.

Description:Types of Sensitivity policies that may apply to a sensitive attribute on an Entity. Description:List of broad catagorizations of clinical event records.Examples:

* Allergies * Drugs * Referrals

Description:Describes types of criteria used when making observations, conducting procedures, and substance administrations.Examples:

* medications * immunizations

Concepts that identify the type or nature of exposure interaction. Examples include "household", "care giver", "intimate partner", "common space", "common substance", etc. to further describe the nature of interaction.

A qualitative measure of the degree of exposure to the causative agent. This includes concepts such as "low", "medium" and "high". This quantifies how the quantity that was available to be administered to the target differs from typical or background levels of the substance.

A type of Act representing a contract whose value is measured in monetary terms.

Examples:

* insurance policy * providercontract * billing arrangement

Identifies types of detected issues for Act class "ALRT" for the financial acts domain.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

Codes dealing with the management of Detected Issue observations for the financial acts domain.

**Description:**The type of financial participation consent directive.

Examples:The Advanced Beneficiary Notice that Medicare patients consent or dissent to prior to receiving health services in the U.S. \\ Current values include consent to financial responsibility (1) if the service is not deemed medically necessary; (2) will self pay for a service; or (3) requests that payer be billed.

Code specifying financial indicators used to assess or establish eligibility for coverage under a policy or program; e.g., pay stub; tax or income document; asset document; living expenses.

**Description:**Identifies the type of document that was attached to support the processing of claims, adjudication decision determination or extensions to coverage.

A type of Act representing any transaction between two accounts whose value is measured in monetary terms.

Examples:

* patient account transaction * encounter accounttransaction * cost center transaction

Description:Further defines the type of grouping of orders or events. This concept domain is intended to be used with the GROUPER Act class code.Examples:

* requisition * pre-coordinated order set * custom order set

Description:The rationale or purpose for an act relating to health information management, such as archiving information for the purpose of complying with an organization policy or jurisdictional law relating to data retention. Description:The rationale or purpose for an act relating to the management of personal health information, such as collecting personal health information for research or public health purposes.

Reason for performing one or more operations on information, which may be permitted by source system's security policy in accordance with one or more privacy policies and consent directives.

Usage Notes:The rationale or purpose for an act relating to the management of personal health information, such as collecting personal health information for research or public health purposes.
The rationale or purpose for an act relating to the management of personal health information, such as collecting personal health information for research or public health purposes.
Definition:Set of codes indicating the type of health insurance policy that covers health services provided to covered parties. A health insurance policy is a written contract for insurance between the insurance company and the policyholder, and contains pertinent facts about the policy owner (the policy holder), the health insurance coverage, the insured subscribers and dependents, and the insurer. Health insurance is typically administered in accordance with a plan, which specifies (1) the type of health services and health conditions that will be covered under what circumstances (e.g., exclusion of a pre-existing condition, service must be deemed medically necessary; service must not be experimental; service must provided in accordance with a protocol; drug must be on a formulary; service must be prior authorized; or be a referral from a primary care provider); (2) the type and affiliation of providers (e.g., only allopathic physicians, only in network, only providers employed by an HMO); (3) financial participations required of covered parties (e.g., co-pays, coinsurance, deductibles, out-of-pocket); and (4) the manner in which services will be paid (e.g., under indemnity or fee-for-service health plans, the covered party typically pays out-of-pocket and then file a claim for reimbursement, while health plans that have contractual relationships with providers, i.e., network providers, typically do not allow the providers to bill the covered party for the cost of the service until after filing a claim with the payer and receiving reimbursement). Description:A type of document that has information related to the investigation of an adverse event or product problem report.Examples:

* Autopsy report * toxicology report * clinical journal article

Description:A type of concept that is used within adverse event and product problem reporting to organize data - often clinical in nature - provided for an investigative subject or other party within the scope of the investigation.Examples:

* Medical history * previous drug reactions * immunization history

Code identifying the type of identification document (e.g. passport, drivers license)

**Implementation Note:**The proposal called for a domain, but a code was also provided. When codes are available for the value set the code IDENTDOC (identity document) will be used as the headcode for the specializable value set.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

Reasons why an immunization was administered.

Definition:Set of codes indicating the type of incident or accident.

The act of storing information to long term storage.

Description:Information type for which a provider is requesting routing of health information. This could include messaging of results or documents especially in the context of a specific service delivery location.Examples:

* Diagnostic Image Interpretations * Lab Test Results * Electrocardiogram Reports

Description:The type of health information to which the subject of the information or the subject&\#039;s delegate consents or dissents.Examples:

* allergy information * medication information * professional services information

Description:Use to convey the reason that a provider may or has accessed personal healthcare information. Typically, this involves overriding the subject's consent directives.

**Definition:**Indicates the set of information types which may be manipulated or referenced, such as for recommending access restrictions.

Description:The rationale or purpose for an act relating to information management, such as archiving information for the purpose of complying with an enterprise data retention policy. Description:The rationale or purpose for an act relating to the management of personal information, such as disclosing personal tax information for the purpose of complying with a court order. Description:Types of sensitivity policies that apply to Acts. Description:Conveyance of the type of information transfer protocol. Description:Types of insurance coverage legal documentation to cover healthcare costs.Examples:

* Automobile * Extended healthcare * Worker's compensation

Definition:Set of codes indicating the type of insurance policy. Insurance, in law and economics, is a form of risk management primarily used to hedge against the risk of potential financial loss. Insurance is defined as the equitable transfer of the risk of a potential loss, from one entity to another, in exchange for a premium and duty of care. A policy holder is an individual or an organization enters into a contract with an underwriter which stipulates that, in exchange for payment of a sum of money (a premium), one or more covered parties (insureds) is guaranteed compensation for losses resulting from certain perils under specified conditions. The underwriter analyzes the risk of loss, makes a decision as to whether the risk is insurable, and prices the premium accordingly. A policy provides benefits that indemnify or cover the cost of a loss incurred by a covered party, and may include coverage for services required to remediate a loss. An insurance policy contains pertinent facts about the policy holder, the insurance coverage, the covered parties, and the insurer. A policy may include exemptions and provisions specifying the extent to which the indemnification clause cannot be enforced for intentional tortious conduct of a covered party, e.g., whether the covered parties are jointly or severably insured.Discussion:In contrast to programs, an insurance policy has one or more policy holders, who own the policy. The policy holder may be the covered party, a relative of the covered party, a partnership, or a corporation, e.g., an employer. A subscriber of a self-insured health insurance policy is a policy holder. A subscriber of an employer sponsored health insurance policy is holds a certificate of coverage, but is not a policy holder; the policy holder is the employer. See CoveredRoleType. Description:Types of grouping of invoice elements (totals, sub-totals), reported through a Payment Advice or a Statement of Financial Activity (SOFA). The code can represent summaries by day, location, payee and other cost elements such as bonus, retroactive adjustment and transaction fees.

\*\*\*\* MISSING DEFINITIONS \*\*\*\*

An identifying data string for healthcare procedures.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

Codes representing a service or product that is being invoiced (billed). The code can represent such concepts as "office visit", "drug X", "wheelchair" and other billable items such as taxes, service charges and discounts.

Description:Types of tax associated with billable services or products.Examples:

* Provincial or State sales tax * Harmonized sales tax * Federal sales tax

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.

Processing consideration and clarification codes.

Description:Types of summary information that can be reported by queries dealing with Statement of Financial Activity (SOFA). The summary information is generally used to help resolve balance discrepancies between providers and payors.Examples:

* number and total value of payable items; * number and value of same period nullify items; * number and value of prior nullify; * number of non-payable nullify items; * number of pending items; * number of rejected items; * number of adjudicated to zero items; * reimbursement items (e.g., pay patient) * Adjudicated non-payee payable prior-period electronic amount * Adjudicated nullified prior-period electronic amount * Adjudicated refused prior-period electronic amount

Description:Types 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 its immediate children invoice elements.

Examples:

* CPINV - Clinical product invoice * CSINV- Clinical service invoice * RXDINV - Drug invoice * RXCINV - Compound invoice * CSPINV - Combined service and clinical product invoice

Description:Types of responses that will occur as a result of the adjudication of an electronic invoice at a summary level and provides guidance on interpretation of the referenced adjudication results.Examples:

* Re-bill for the professional fee * Good faith override * Wasted Drug

Indicates the importance or priority associated with a detected issue.

Codes for additional metadata to be assigned to document or context of use instances to organize a group of documents within the same table of contents heading. These external code systems specify the category or type of keyword (e.g. Species) and the applicable values.

Examples:

* Species code system * Species code * Sponsor's manufacturing site code system

Usage Note:This usage is confined to a specific set of requirements related to regulatory documents in the context of RPS documents.

Codes for general laboratory process steps.

Provides codes associated with ActClass value of LIST (working list)

Definition:An identifying code for billable medical services, as opposed to codes for similar services to identify them for clinical purposes.OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

Indicates the types of documents that can be associated with a medication or group of medications.

Examples include:Patient monographs, Provider monographs, Drug protocols, etc.

**Definition:**A collection of concepts that identifies different types of 'duration-based' mediation working lists.

**Examples:**"Continuous/Chronic" "Short-Term" and "As Needed"

Chemical reactions in the widest sense of the word.

Examples:Transcription (creating mRNA from a DNA gene), translation (creating a protein from mRNA), cleavage (hydrolysis of a peptide), substitution (replacing an element or residue with another, such as in glycosylation, phosphorylation), addition (adding a residue to a double bond), receptor binding.
Description:Identifies types of monitoring programs such as tracking specified medication prescribing e.g. narcotic(s), identifying investigational studies or identifying programs regarding reimbursement or prescribing privileges.

A code distinguishing whether an Act is conceived of as a factual statement or in some other manner as a command, possibility, goal, etc.

Constraints:An Act-instance must have one and only one moodCode value.

The moodCode of a single Act-instance never changes. Mood is not state.

To describe the progression of a business activity from defined to planned to executed, etc. one must instantiate different Act-instances in the different moods and link them using ActRelationship of general type "sequel". (See ActRelationship.type.)

Discussion:The Act.moodCode includes the following notions: (1) event, i.e., factual description of an actions that occurred; (2) definition of possible actions and action plans (the master file layer); (3) intent, i.e., an action plan instantiated for a patient as a care plan or order; (4) goal, i.e., an desired outcome attached to patient problems and plans; and (5) criterion, i.e., a predicate used as

The Act.moodCode modifies the meaning of the Act class in a controlled way, just as in natural language, grammatical form of a verb modify the meaning of a sentence in defined ways. For example, if the mood is factual (event,) then the entire act object represents a known fact. If the mood expresses a plan (intent,) the entire act object represents the expectation of what should be done. The mood does not change the meaning of individual act properties in peculiar ways.

Since the mood code is a determining factor for the meaning of an entire Act object, the mood must always be known. This means, whenever an act object is instantiated, the mood attribute must be assigned to a valid code, and the mood assignment can not change throughout the lifetime of an act object.

As the meaning of an act object is factored in the mood code, the mood code affects the interpretation of the entire Act object and with it every property (attributes and associations.) Note that the mood code affects the interpretation of the act object, and the meaning of the act object in turn determines the meaning of the attributes. However, the mood code does not arbitrarily change the meaning of individual attributes.

Inert vs. descriptive properties of Acts:Acts have two kinds of act properties, inert and descriptive properties. Inert properties are not affected by the mood, descriptive properties follow the mood of the object. For example, there is an identifier attribute Act.id, which gives a unique identification to an act object. Being a unique identifier for the object is in no way dependent on the mood of the act object. Therefore, the "interpretation" of the Act.id attribute is inert with respect to the act object's mood.

By contrast, most of the Act class' attributes are descriptive for what the Act statement expresses. Descriptive properties of the Act class give answer to the questions who, whom, where, with what, how and when the action is done. The questions who, whom, with what, and where are answered by Participatons, while how and when is answered by descriptive attributes and ActRelationships. The interpretation of a descriptive attribute is aligned to the interpretation of the entire act object, and controlled by the mood.

Examples:To illustrate the effect of mood code, consider a "blood glucose" observation:

The DEFINITION mood specifies the Act of "obtaining blood glucose". Participations describe in general the characteristics of the people who must be involved in the act, and the required objects, e.g., specimen, facility, equipment, etc. involved. The Observation.value specifies the absolute domain (range) of the observation (e.g., 15-500 mg/dl.)

In INTENT mood the author of the intent expresses the intent that he or someone else "should obtain blood glucose". The participations are the people actually or supposedly involved in the intended act, especially the author of the intent or any individual assignments for group intents, and the objects actually or supposedly involved in the act (e.g., specimen sent, equipment requirements, etc.) The Observation.value is usually not specified, since the intent is not to measure blood glucose, not to measure blood glucose in a specific range. (But compare with GOAL below.)

In ORDER mood, a kind of intent, the author requests to "please obtain blood glucose". The Participations are the people actually and supposedly involved in the act, especially the placer and the designated filler, and the objects actually or supposedly involved in the act (e.g., specimen sent, equipment requirements, etc.) The Observation.value is usually not specified, since the order is not to measure blood glucose in a specific range.

In EVENT mood, the author states that "blood glucose was obtained". Participations are the people actually involved in the act, and the objects actually involved (e.g., specimen, facilities, equipment.) The Observation.value is the value actually obtained (e.g., 80 mg/dL, or <15 mg/dL.)

In event-CRITERION mood, an author considers a certain class of "obtaining blood glucose" possibly with a certain value (range) as outcome. The Participations constrain the criterion, for instance, to a particular patient. The Observation.value is the range in which the criterion would hold (e.g. > 180 mg/dL or 200?300 mg/dL.)

In GOAL mood (a kind of criterion) the author states that "our goal is to be able to obtain blood glucose with the given value (range)". The Participations are similar to intents, especially the author of the goal and the patient for whom the goal is made. The Observation.value is the range which defined when the goal is met (e.g. 80?120 mg/dl.)

Rationale:The notion of "mood" is borrowed from natural language grammar, the mood of a verb (lat. modus verbi).

The notion of mood also resembles the various extensions of the logic of facts in modal logic and logic with modalities, where the moodCode specifies the modality (fact, possibility, intention, goal, etc.) under which the Act-statement is judged as appropriate or defective.

A non-mandated intent to perform an act. Used to record intents that are explicitly not Orders. Professional responsibility for the 'proposal' may or may not be present.

Reasons why a patient did not receive an immunization.

Definition:An identifying code for billable services that are not medical procedures, such as social services or governmental program services.Example:Building a wheelchair ramp, help with groceries, giving someone a ride, etc.OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

**Description:**Concepts representing indications (reasons for clinical action) other than diagnosis and symptoms.

Conveys the mandated workflow action that an information custodian, receiver, or user must perform.

Usage Note:Per ISO 22600-2, ObligationPolicy instances "are event-triggered and define actions to be performed by manager agent". Per HL7 Composite Security and Privacy Domain Analysis Model: This value set refers to the action required to receive the permission specified in the privacy rule. Per OASIS XACML, an obligation is an operation specified in a policy or policy that is performed in conjunction with the enforcement of an access control decision.

The act of verifying an observations. The subject act related to the observation verification (act relationship SUBJ) must be an observation (OBS)

Identifies the type of verification investigation being undertaken with respect to the subject of the verification activity.

Examples:
  • Verification of eligibility for coverage under a policy or program - aka enrolled/covered by a policy or program

  • Verification of record - e.g., person has record in an immunization registry

  • Verification of enumeration - e.g. NPI

  • Verification of Board Certification - provider specific

  • Verification of Certification - e.g. JAHCO, NCQA, URAC

  • Verification of Conformance - e.g. entity use with HIPAA, conformant to the CCHIT EHR system criteria

  • Verification of Provider Credentials

  • Verification of no adverse findings - e.g. on National Provider Data Bank, Health Integrity Protection Data Base (HIPDB)

**Description:**An identifying code for oral health interventions/procedures.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

The type of order that was fulfilled by the clinical service

Description:Concept domain which includes those ActProcedureCodes which are appropriate for ordering.Examples:

* physical therapies * excisions * surgery

**Description:**Provides a categorization for annotations recorded directly against the patient

Definition:A code specifying the particular kind of Patient Safety Incident that the Incident class instance represents.

**Examples:**"Medication incident", "slips, trips and falls incident".The actual value set for the domain will be determined by each (realm) implementation, whose Patient Safety terminology will be specific, although probably linked to the WHO Patient Safety Taxonomy that is currently under development

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

Definition: Characterizes how a patient was or will be transported to the site of a patient encounter.

Examples:Via ambulance, via public transit, on foot.

\*\*\*\* MISSING DEFINITIONS \*\*\*\*

**Definition:**Identifies types of dispensing events.

**Description:**Types of policies that further specify the ActClassPolicy value set.

Reasons why a preference has been specified.

Examples:

* Side Effects * Religious * Request

Concepts representing a type of preference that can be specified.

Examples:

* Food * Drug * Vegetarian * Sweets

A code or set of codes (e.g., for routine, emergency,) specifying the urgency under which the Act happened, can happen, is happening, is intended to happen, or is requested/demanded to happen.

Discussion:This attribute is used in orders to indicate the ordered priority, and in event documentation it indicates the actual priority used to perform the act. In definition mood it indicates the available priorities.
Description:Types of jurisdictional mandates relating to privacy.

**Description:**Types of privacy policies that further specify the ActClassPolicy value set e.g. override policy, minor's rights to mask sensitive information policy, opt-in, opt-out policy.

An Act which characterizes a Privilege can have additional observations to provide a finer definition of the requested or conferred privilege. This domain describes the categories under which this additional information is classified.

This domain includes observations used to characterize a privilege, under which this additional information is classified.

*Examples:*A privilege to prescribe drugs has a RESTRICTION that excludes prescribing narcotics; a surgical procedure privilege has a PRE-CONDITION that it requires prior Board approval.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

**Description:**Describes the high level classification of professional services for grouping.

**Examples:**Education, Counseling, Surgery, etc.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.
Description:An identifying code for healthcare interventions/procedures.Examples:

* immunization * appendectomy * physiotherapy

Description:of procedure used for evaluating a precondition, goal, or trigger.Examples:

* some radiology procedures * respiratory therapy * physical therapy

Description:Financial Acquisition Terms: categorizations of acquisition terms for a product.

Types of method a product can be obtained for use by the subject of the supply act (e.g. patient). Product examples are consumable or durable goods.

Examples:

* Loan * Rent * Sale

Description:A type of application made in order to obtain a product approval from a regulatory agency or other government body.Examples:

* Application for new approval * Application for renewal of approval * Application for variation of approval

Description:A type of approval process by which a product approval is obtained from a regulatory agency or other government body.Examples:

* Centralized process approval * Mutual recognition process approval * National process approval

Description:An approval granted to a product by a regulatory agency or other government body.Examples:

* Approval to sell * Approval to initiate clinical trial * Approval to market (i.e., advertise)

Description:

A type of documentation that is used to convey information about a product or an aspect of its life as a product - ranging from production to disposition.

Examples:

* Bill of lading * product label * Report of Product Disposal

Description:A type of activity that takes place during the life of a product as it moves from the point of production to the point of consumption, use, or disposition (most notably in the case of contaminated products). It will be possible for concepts at different levels of granularity to be included.Examples:

* Manufacture * paint * wholesale * dispose

DESCRIPTION

Identifies the nature (or type) of transformation that a (medicinal) product may undergo, prior to its administration to a patient.

Examples:

* Dilution * Dissolution * Suspension

Description:Denotes the specific professional service that has been performed. This is obtained from the professional service catalog pertaining to the discipline of the health service provider.Examples:

* adjustment of hearing aid * excision of skin lesion * stitching skin lacerations

Definition:A set of codes used to indicate coverage under a program. A program is an organized structure for administering and funding coverage of a benefit package for covered parties meeting eligibility criteria, typically related to employment, health, financial, and demographic status. Programs are typically established or permitted by legislation with provisions for ongoing government oversight. Regulations may mandate the structure of the program, the manner in which it is funded and administered, covered benefits, provider types, eligibility criteria and financial participation. A government agency may be charged with implementing the program in accordance to the regulation. Risk of loss under a program in most cases would not meet what an underwriter would consider an insurable risk, i.e., the risk is not random in nature, not financially measurable, and likely requires subsidization with government funds.Discussion:Programs do not have policy holders or subscribers. Program eligibles are enrolled based on health status, statutory eligibility, financial status, or age. Program eligibles who are covered parties under the program may be referred to as members, beneficiaries, eligibles, or recipients. Programs risk are underwritten by not for profit organizations such as governmental entities, and the beneficiaries typically do not pay for any or some portion of the cost of coverage. See CoveredPartyRoleType.

Types of state an act may exist in.

A type of document used to represent a health quality measure (aka eMeasure).

A type of document section within a health quality measure (aka eMeasure), used to cluster the various parts of the eMeasure into a more human navigable format.

Identifies the document type from a regulator-defined set of codes similar to the ICH-defined File Tags used on clinical study documents in an eCTD.

Examples:

* Pre-clinical study report * Study report * Sample CRF

Usage Note:This usage is confined to a specific set of requirements related to regulatory documents in the context of RPS documents.

Identifies the legal or administrative category assigned to a regulated product that determines or influences the way in which its submission is reviewed.

Examples:

* New active ingredients * New ethical combination drug * New administrative route

Usage Note:This usage is confined to a specific set of requirements related to regulatory documents in the context of RPS documents.

Identifies different classes of regulatory policy that can be applied within a Regulated Product Submission.

Usage Note:This Domain is used to administratively group its subdomains specifically for usage in the RPS model, and is not intended to participate in any binidngs.

Identifies the reason for citing a related application.

Examples:

* Data protection period expiry reference * Bioequivalence reference * Drug Master File reference

Usage Note:This usage is confined to a specific set of requirements related to regulatory documents in the context of RPS documents.

Identifies the time period in which a submission of a given type is to be reviewed as established by law or practice in the particular regulatory realm.

Examples:

* 30 days, reduced time * 60 days, regular time * 90 days, extended time

Usage Note:This usage is confined to a specific set of requirements related to regulatory documents in the context of RPS documents.
Description:A type of act that indicates the action taken by a practitioner or other responsible party in response to the reaction/event that is reported in the ICSR.Examples:

* failing device replaced * medication stopped * medication dose adjusted

A code specifying the motivation, cause, or rationale of an Act, when such rationale is not reasonably representable as an ActRelationship of type "has reason" linking to another Act.

Examples:Example reasons that might qualify for being coded in this field might be: "routine requirement", "infectious disease reporting requirement", "on patient request", "required by law".

Discussion

Most reasons for acts can be clearly expressed by linking the new Act to another prior Act using an ActRelationship of type "has reason". This simply states that the prior Act is a reason for the new Act (see ActRelationship.) The prior act can then be a specific existing act or a textual explanation. This works for most cases, and the more specific the reason data is, the more should this reason ActRelationship be used instead of the reasonCode.

The reasonCode remains as a place for common reasons that are not related to a prior Act or any other condition expressed in Acts. Indicators that something was required by law or was on the request of a patient etc. may qualify. However, if that piece of legislation, regulation, or the contract or the patient request can be represented as an Act (and they usually can), the reasonCode should not be used.

Description:Container of clinical statements. Navigational. No semantic content. Knowledge of the section code is not required to interpret contained observations. Represents a heading in a heading structure, or "container tree".Examples:category; document section; document body. Description:A code further classifying the type of record organizer. Used with the ActClassRecordOrganizer ActClass concept domain.Examples:

* CDA R2 * * Electrolytes Battery * Specimen Cluster

Conveys prohibited actions which an information custodian, receiver, or user is not permitted to perform unless otherwise authorized or permitted under specified circumstances.

Usage Notes:ISO 22600-2 species that a Refrain Policy "defines actions the subjects must refrain from performing". Per HL7 Composite Security and Privacy Domain Analysis Model: May be used to indicate that a specific action is prohibited based on specific access control attributes e.g., purpose of use, information type, user role, etc.
ISO 22600-2 species that a Refrain Policy "defines actions the subjects must refrain from performing". Per HL7 Composite Security and Privacy Domain Analysis Model: May be used to indicate that a specific action is prohibited based on specific access control attributes e.g., purpose of use, information type, user role, etc.

This is the domain of registry types. Examples include Master Patient Registry, Staff Registry, Employee Registry, Tumor Registry.

Identifies the regulatory processes and/or submission contents specified in law or practice for a particular realm used to organize submitted materials.

Examples:

* Application Type: NDA * Submission Type: Efficacy Supplement * Submission Unit Type: Amendment

Usage Note:This usage is confined to a specific set of requirements related to regulatory documents in the context of RPS documents.

Identifies a temporary or final legal status assigned to a submission by a particular regulatory realm based on the laws and practices of the realm.

Examples:

* Active (as authorized by section abc) * Approved (under section xyz) * Withdrawn (under section pqr)

Usage Note:This usage is confined to a specific set of requirements related to regulatory documents in the context of RPS documents.

A code specifying when in the course of an Act a precondition for the Act is evaluated (e.g., before the Act starts for the first time, before every repetition, after each repetition but not before the first, or throughout the entire time of the Act.)

Discussion:This attribute is part of the workflow control suite of attributes. An action plan is a composite Act with component Acts. In a sequential plan, each component has a sequenceNumber that specifies the ordering of the plan steps. Before each step is executed and has preconditions these conditions are tested and if the test is positive, the Act has clearance for execution. The repeatNumber may indicate that an Act may be repeatedly executed. The checkpointCode is specifies when the precondition is checked and is analogous to the various conditional statements and loop constructs in programming languages "while-do" vs. "do-while" or "repeat-until" vs. "loop-exit".

For all checkpointCodes, except "end", preconditions are being checked at the time when the preceding step of the plan has terminated and this step would be next in the sequence established by the sequenceNumber attribute.

When the checkpointCode for a criterion of a repeatable Act is "end", the criterion is tested only at the end of each repetition of that Act. When the condition holds true, the next repetition is ready for execution.

When the checkpointCode is "entry" the criterion is checked at the beginning of each repetition (if any) whereas "beginning" means the criterion is checked only once before the repetition "loop" starts.

The checkpointCode "through" is special in that it requires the condition to hold throughout the execution of the Act, even throughout a single execution. As soon as the condition turns false, the Act should receive an interrupt event (see interruptibleInd) and will eventually terminate.

The checkpointCode "exit" is only used on a special plan step that represents a loop exit step. This allows an action plan to exit due to a condition tested inside the execution of this plan. Such exit criteria are sequenced with the other plan components using the ActRelationship.sequenceNumber.

Used to enumerate the relationships between a CDA section and its contained entries.

Description still needed

A code specifying how concurrent Acts are resynchronized in a parallel branch construct.

Discussion:This attribute is part of the workflow control suite of attributes. An action plan is a composite Act with component Acts. In a sequential plan, each component has a sequenceNumber that specifies the ordering of the plan steps. Branches exist when multiple components have the same sequenceNumber. Branches are parallel if the splitCode specifies that more than one branch can be executed at the same time. The joinCode then specifies if and how the braches are resynchronized.

The principal re-synchronization actions are (1) the control flow waits for a branch to terminate (wait-branch), (2) the branch that is not yet terminated is aborted (kill-branch), (3) the branch is not re-synchronized at all and continues in parallel (detached branch).

A kill branch is only executed if there is at least one active wait (or exclusive wait) branch. If there is no other wait branch active, a kill branch is not started at all (rather than being aborted shortly after it is started.) Since a detached branch is unrelated to all other branches, active detached branches do not protect a kill-branch from being aborted.

Description still needed

A code specifying how branches in an action plan are selected among other branches.

Discussion:This attribute is part of the workflow control suite of attributes. An action plan is a composite Act with component Acts. In a sequential plan, each component has a sequenceNumber that specifies the ordering of the plan steps. Branches exist when multiple components have the same sequenceNumber. The splitCode specifies whether a branch is executed exclusively (case-switch) or inclusively, i.e., in parallel with other branches.

In addition to exlusive and inclusive split the splitCode specifies how the pre-condition (also known as "guard conditions" on the branch) are evaluated. A guard condition may be evaluated once when the branching step is entered and if the conditions do not hold at that time, the branch is abandoned. Conversely execution of a branch may wait until the guard condition turns true.

In exclusive wait branches, the first branch whose guard conditions turn true will be executed and all other branches abandoned. In inclusive wait branches some branches may already be executed while other branches still wait for their guard conditions to turn true.

Used to indicate that the target of the relationship will be a filtered subset of the total related set of targets.

Used when there is a need to limit the number of components to the first, the last, the next, the total, the average or some other filtered or calculated subset.

A code specifying the meaning and purpose of every ActRelationship instance. Each of its values implies specific constraints to what kinds of Act objects can be related and in which way.

Discussion:The types of act relationships fall under one of 5 categories:

1.) (De)-composition, with composite (source) and component (target)

2.) Sequel which includes follow-up, fulfillment, instantiation, replacement, transformation, etc. that all have in common that source and target are Acts of essentially the same kind but with variances in mood and other attributes, and where the target exists before the source and the source refers to the target that it links back to.

3.) Pre-condition, trigger, reason, contraindication, with the conditioned Act at the source and the condition or reason at the target.

4.) Post-condition, outcome, goal and risk, with the Act at the source having the outcome or goal at the target.

5.) A host of functional relationships including support, cause, derivation, etc. generalized under the notion of "pertinence".

Description:Types of sensitivity policies that apply to Roles.

**Description:**An access control object used to manage permissions and capabilities of users within information systems. (See HL7 RBAC specification fo examples of thes objects.)

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

Types of security policies that further specify the ActClassPolicy value set.

A sensitivity policy is adopted by an enterprise or group of enterprises (a "policy domain") through a formal data use agreement that stipulates the value, importance, and vulnerability of information. A sensitivity code representing a sensitivity policy may be associated with criteria such as categories of information or sets of information identifiers (e.g., a value set of clinical codes or branch in a code system hierarchy). These criteria may in turn be used for the Policy Decision Point in a Security Engine. A sensitivity code may be used to set the confidentiality code used on information about Acts and Roles to trigger the security mechanisms required to control how security principals (i.e., a person, a machine, a software application) may act on the information (e.g., collection, access, use, or disclosure). Sensitivity codes are never assigned to the transport or business envelope containing patient specific information being exchanged outside of a policy domain as this would disclose the information intended to be protected by the policy. When sensitive information is exchanged with others outside of a policy domain, the confidentiality code on the transport or business envelope conveys the receiver's responsibilities and indicates the how the information is to be safeguarded without unauthorized disclosure of the sensitive information. This ensures that sensitive information is treated by receivers as the sender intends, accomplishing interoperability without point to point negotiations.

**Description:**Concepts representing the categorization of health services available at a particular delivery location site.

Examples:

* anesthetic service * colonoscopy service * orthopedic service

Concepts identifying the general type of care or category of services being documented.

Examples:

* Colonoscopy * appendectomy * laboratory test

Description:of high-level categorization for clinical non-laboratory and non-diagnostic image measured observations with numeric values and specific units of measure.Examples:

* Vital Signs * Physiological Measurements * Procedure Results

An anatomical location on an organism which can be the focus of an act.

**Description:**Identifies the type of document that is used to support a request which requires special authorization. Example values in this concept domain could be: coverage extensions, step therapy, medical report, lab result, etc.

**Description:**Constrains vocabulary to that which describes the type of documents that can be attached to a financial transaction such as a Special Authorization Request.

Example values under this concept domain could be: drug, device, service, etc.

The accession act related to a specimen or group of specimens.

Description:Used to further classify the type of specimen collection procedure being documented.Examples:

* Venipuncture * Swab * Biopsy

The act of printing a specimen label. The printing of a label for a specimen container is a significant act in the workflow for collecting specimens.

The act of adding a specimen to a transportation manifest. For example a laboratory will pack together in a carton all the specimens to be shipped to a reference lab. An electronic manifest showing all the specimens in the shippment is communicated to the reference lab.

Transportation of a specimen.

Concepts representing the states in the state-machine of the RIM Act class.

**Definition:**Identifies the types of substitution that may be permitted when ordering a medication, as well as those which have actually occurred during the act of dispensing.

Describes the type of substance administration being performed. This should not be used to carry codes for identification of products. Use an associated role or entity to carry such information.

Describes the type of substance administration being performed. This should not be used to carry codes for identification of products. Use an associated role or entity to carry such information.

Description:Type of substance administration used for evaluating a precondition, goal, or trigger.Examples:

* other substance administrations * respiratory therapy * immunizations

The introduction of ??? with the intent of stimulating an immune response, aimed at preventing subsequent infections by more viable agents.

Acts of producing a substance by processing input material in any way thus deriving the product substance from the inputs

Examples:Fermentation, filtration, separation, extraction, or any complex procedure involving multiple such steps.UsageNotes:This domain may involve molecular interactions as components, but substance derivation - even if implementing a single defined reaction on the molecular level - implies not only that reaction but the methods and devices by which to induce that reaction.
This domain may involve molecular interactions as components, but substance derivation - even if implementing a single defined reaction on the molecular level - implies not only that reaction but the methods and devices by which to induce that reaction.
Description:In addition to the class code, further defines the type of substance extraction.Examples:

* excision * surgical * passive

Indicates why a fulfiller refused to fulfill a supply order, and considered it important to notify other providers of their decision. E.g. "Suspect fraud", "Possible abuse", "Contraindicated".

(used when capturing 'refusal to fill' annotations)

Description:Further defines the type of supply for order or distribution.Examples:

* central supply * materials management * nurse station supply

Description:A task or action that a user may perform in a clinical information systemExamples:

* medication order entry * laboratory test results review * problem list entry

Codes used to identify different types of 'duration-based' working lists. Examples include "Continuous/Chronic", "Short-Term" and "As-Needed".

Characterizes how a transportation act was or will be carried out.

Examples:Via private transport, via public transit, via courier.

A mandate, obligation, requirement, rule, or expectation conveyed as security metadata between senders and receivers required to establish the reliability, authenticity, and trustworthiness of their transactions.

Trust security metadata are observation made about aspects of trust applicable to an IT resource (data, information object, service, or system capability).

Trust applicable to IT resources is established and maintained in and among security domains, and may be comprised of observations about the domain's trust authority, trust framework, trust policy, trust interaction rules, means for assessing and monitoring adherence to trust policies, mechanisms that enforce trust, and quality and reliability measures of assurance in those mechanisms. \[Based on ISO IEC 10181-1 and NIST SP 800-63-2\]

For example, identity proofing level of assurance and Trust Framework.

A code indicating whether the Act statement as a whole, with its subordinate components has been asserted to be uncertain in any way.

Examples:Patient might have had a cholecystectomy procedure in the past (but isn't sure).Constraints:Uncertainty asserted using this attribute applies to the combined meaning of the Act statement established by all descriptive attributes (e.g., Act.code, Act.effectiveTime, Observation.value, SubstanceAdministration.doseQuantity, etc.), and the meanings of any components.

*Discussion:*This is not intended for use to replace or compete with uncertainty associated with a Observation.values alone or other individual attributes of the class. Such pointed indications of uncertainty should be specified by applying the PPD, UVP or UVN data type extensions to the specific attribute. Particularly if the uncertainty is uncertainty of a quantitative measurement value, this must still be represented by a PPD<PQ> in the value and NOT using the uncertaintyCode. Also, when differential diagnoses are enumerated or weighed for probability, the UVP<CD> or UVN<CD> must be used, not the uncertaintyCode. The use of the uncertaintyCode is appropriate only if the entirety of the Act and its dependent Acts is questioned.

Note that very vague uncertainty may be thought related to negationInd, however, the two concepts are really independent. One may be very uncertain about an event, but that does not mean that one is certain about the negation of the event.

Any substance which, when combined with other ingredients, delivers all or part of the therapeutic benefit associated with a medication.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

A molecular structure (molecule or part of a molecule) which is the part of the molecule causing the intended pharmacological action. The value set for ActiveMoietySubstanceType may often be a subset of a SubstanceType value set. Candidate value sets are subsets of ChEBI, PubChem CID, CAS Number, InChi Key, and UNII.

Examples:

* Metoprolol (without the succinate or tartrate) * Amoxicillin (anhydrous) * Heparin (ion, without the matching Na or K cation)

Discussion: The hierarchical nature of these concepts shows composition. E.g. "Street Name" is part of "Street Address Line"

Indicates the form in which the drug product should be administered.

This element only needs to be specified when (a) the form in which the drug is measured for dispensing differs from the form in which the drug is administered; and (b) the form in which the quantity of the administered drug being administered is not expressed as a discrete measured mass or volume, e.g. the dose is to be measured in "number of actuations."

Indicates the form in which the drug product should be administered.

This element only needs to be specified when (a) the form in which the drug is measured for dispensing differs from the form in which the drug is administered; and (b) the form in which the quantity of the administered drug being administered is not expressed as a discrete measured mass or volume, e.g. the dose is to be measured in "number of actuations."

**Description:**Indicates the role an entity (player) is playing as the appropriate contact on behalf of another entity (scoper).

The gender of a person used for adminstrative purposes (as opposed to clinical gender)

OpenIssue:This concept domain has **no valid description**. Description:

Represents types of consent that patient must sign prior to receipt of service, which is required for billing purposes.

Examples:

* Advanced beneficiary medically necessity notice. * Advanced beneficiary agreement to pay notice. * Advanced beneficiary requests payer billed.

Description:Different types that are used to organize and classify product related investigations.Examples:

* Original source investigation * Secondary party investigation * Report to regulatory authority

Definition:Indicates the class of actions taken with regard to a substance administration related adverse event. This characterization offers a judgment of the practitioner"s response to the patient"s problem.Examples:Example values include dose withdrawn, dose reduced, dose not changed.NOTE:The concept domain is currently supported by a value set created by the International Conference on HarmonizationOpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

Concepts characterizing the type of association formed by player and scoper when there is a recognized Affiliate role by which the two parties are related.

Examples:Business Partner, Business Associate, Colleague

Observation value of a person's age group (e.g., newborn infant, child preschool, young adult).

Categorization of types of observation that captures a person's age as a numeric quantity.

An entity (player) that acts or is authorized to act on behalf of another entity (scoper).

Examples:next of kin; assigned entity; contact.

**Description:**Provides additional methodology information not present in the associated AllergyTestCode term.

Indicates the result of a particular allergy test. E.g. Negative, Mild, Moderate, Severe

An anatomical location on a non-human animal which can be the focus of an act.

Description:A categorizing and grouping mechanism for different types of animal in order to support treatment and reporting. The categories are expected to correspond to a single animal species, or to a related group of species.Examples:

* Dog * Reptile * Deer

\*\*\*\* MISSING DEFINITIONS \*\*\*\*

A role type that is used to further qualify an inanimate subject playing a role where the playing entity acts or is authorized to act on behalf of a scoping entity.

Examples:

* Assistive device for impaired or challenged person * Non-living entities that may participate as assigned therapeutic agents * Entities that may be provided to patients to improve general mood, decrease depression and loneliness, and distract from stress-inducing concerns to improve quality of life.

**Description:**A role type that is used to further qualify a non-person subject playing a role where the role class attribute is set to RoleClass AssignedEntity

Open Issue:The definition should be modified to clarify the fact that it is a living non-person subject. (AK 11/2014 cycle)
Description:A role type that is used to further qualify an entity playing a role where the role class attribute is set to RoleClass AssignedEntity. The suggested values from V2.x include clinic receptionist, referral agent, staff physician, courtesy physician, resident, physician assistant, physical therapist, psychiatrist, psychologist, pharmacist, registered nurse, licensed practical nurse, licensed vocational nurse, nurse practitioner, etc.Examples:

* Janitor * Chief of Staff * Referral Agent * Security Guard * ICU Runner * Visiting professor

Open Issue:There needs to be work undertaken to clean up the hierarchy under this Domain as there seems to be some muddling between D:ProductLifecycleAssginedRoleType and D:ClinicalOrganizationRoleType and this new D:AssignedNonLivingSubjectRoleType. There may be other issues that need improvement in this hierarchy, and there may be some issue with the corresponding hierarchy in the code system. (identified in 11/2014 cycle)

A general association between two entities that is neither partitive nor ontological.

Examples:affiliate; agent; birthplace.

Provides coded key words for attribute AttentionLine.keyWordText, which has data type SC.

**Definition:**The domain of possible values used as the value of attention line specifications in AttentionLine directives.

This code is used to specify the exact function an actor is authorized to have in a service in all necessary detail.

This code is used to specify the exact function an actor is authorized to have as a receiver of information that is the subject of a consent directive or consent override.

Provides coded names for attribute Batch.name, which has data type SC.

Description:Specific method used to extract the blood from the donor subject.Examples: No examples supplied with proposal.

**Description:**Physicians Current Procedural Terminology (CPT) Manual is a listing of descriptive terms and identifying codes for reporting medical services and procedures performed by physicians. Available for the AMA at the address listed for CPT above. These codes are found in Appendix A of CPT 2000 Standard Edition. (CPT 2000 Standard Edition, American Medical Association, Chicago, IL).

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

**Description:**Physicians Current Procedural Terminology (CPT) Manual is a listing of descriptive terms and identifying codes for reporting medical services and procedures performed by physicians. Available for the AMA at the address listed for CPT above. These codes are found in Appendix A of CPT 2000 Standard Edition. (CPT 2000 Standard Edition, American Medical Association, Chicago, IL).

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

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One letter calendar cycle abbreviations (Temporary - remove when RoseTree is fixed)

Two letter calendar cycle abbreviations (Temporary - remove when RoseTree is fixed)

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Code for the method by which the public health department was made aware of the case. Includes provider report, patient self-referral, laboratory report, case or outbreak investigation, contact investigation, active surveillance, routine physical, prenatal testing, perinatal testing, prison entry screening, occupational disease surveillance, medical record review, etc.

Code that indicates whether the disease was likely acquired outside the jurisdiction of observation, and if so, the nature of the inter-jurisdictional relationship. Possible values include not imported, imported from another country, imported from another state, imported from another jurisdiction, and insufficient information to determine.

A code that provides information on the overall effect or outcome of the adverse reaction/adverse event reported in the ICSR. Note the criterion applies to the case as a whole and not to an individual reaction.

Example concepts are: death, disability, hospitalization, congenital anomaly/ birth defect, and other medically important condition.

Code for the mechanism by which disease was acquired by the living subject involved in the public health case. Includes sexually transmitted, airborne, bloodborne, vectorborne, foodborne, zoonotic, nosocomial, mechanical, dermal, congenital, environmental exposure, indeterminate.

OpenIssue: Consider moving this attribute to Observation.

Defines types of certifications for all entities

Internet Assigned Numbers Authority (IANA) Charset Types

A role type used to qualify a person's legal status within a country or nation.

Examples:

* Full citizen * Asylum seeker * Permit card holder

Identifies types of issues detected regarding the performance of a clinical action on a patient.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

Any substance or mixture of substances manufactured, sold or represented for use in: (a) the diagnosis, treatment, mitigation or prevention of a disease, disorder, abnormal physical state, or its symptoms, in human beings or animals; (b) restoring, correcting or modifying organic functions in human beings or animals.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

A role of an organization that further classifies the clincial responsibility for the healthcare care delivered during an encounter. E.g. cardiology service, pediatric service, nursing services.

**Definition:**Specifies the reason that an event occurred in a clinical research study.

**Definition:**SSpecifies the reason that a test was performed or observation collected in a clinical research study.

**Note:**This set of codes are not strictly reasons, but are used in the currently Normative standard. Future revisions of the specification will model these as ActRelationships and thes codes may subsequently be retired. Thus, these codes should not be used for new specifications.

**Definition:**Contains domains for act reasons used in clinical research.

Identifies how to interpret the instance of the code, codeSystem value in a set of translations. Since HL7 (or a government body) may mandate that codes from certain code systems be sent in conformant messages, other synonyms that are sent in the translation set need to be distinguished among the originally captured source, the HL7 specified code, or some future role. When this code is NULL, it indicates that the translation is an undefined type. When valued, this property must contain one of the following values:

SRC - Source (or original) code HL7 - HL7 Specified or Mandated SH - both HL7 mandated and the original code (precoordination)

There may be additional values added to this value set as we work through the use of codes in messages and determine other Use Cases requiring special interpretation of the translations.

The description of this is: "Identifies, as a single concept, a combination dose form description for those products that contain two or more manufactured items in a single authorized product".

Usage Notes:This element needs only to be specified when the product entity describes a complete product that contains two or more manufactured items (sometimes called a combination product or a kit product); it should not be valued for (normal) products which consist of a single manufactured item with a single dose form. The combined dose form describes the orderable (manufactured) dose form of each manufactured item and (if appropriate, separately) the administrable dose form of the pharmaceutical product (as in example one below).Examples:

* Powder and solvent for solution for injection * Pessary and vaginal cream * Tablets and capsules

This element needs only to be specified when the product entity describes a complete product that contains two or more manufactured items (sometimes called a combination product or a kit product); it should not be valued for (normal) products which consist of a single manufactured item with a single dose form. The combined dose form describes the orderable (manufactured) dose form of each manufactured item and (if appropriate, separately) the administrable dose form of the pharmaceutical product (as in example one below).

**Description:**Indicates why the prescription should be suspended.

OpenIssue:This concept domain has **no valid description**. Definition:The non-laboratory, non-DI (diagnostic imaging) coded observation if no value is also required to convey the full meaning of the observation. This may be a single concept code or a complex expression. Description:Represents observations for components of a clinical observation whose value is expressed as a code.Examples:

* results for individual components of an APGAR score * aberrant * ABO incompatibility reaction

**Description:**Used in a patient care message to value simple clinical (non-lab) observation methods, such as found in SOAP (subjective, objective, assessment, plan) progress notes: subjective section (used for history from patient and other informants); objective section (used for physical exam, lab, and other common results), and assessment section (used for the clinicians assessment of the implications of subjective and objective sections).

Definition:The non-laboratory, non-diagnostic imaging coded result of the coded observable or "question" represented by the paired concept from the the NonLabDICodedObservationType domain.

\]

**Examples:**An APGAR result, a functional assessment, etc. The value must not require a specific unit of measure.

Used in a patient care message to report and query simple clinical (non-lab) observations.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

**Description:**Used in a patient care message to value simple clinical (non-lab) observations.

Description:Represents the components of a coded clinical observation.Examples:

* ability to articulate * ability to chop food * ability to crouch

Description:Identifies the type for a clinical observation whose value is expressed as a code.Examples:

* Home support level * Tumor staging * abdominal pain characteristic

Describes the type of communication function that the associated entity plays in the associated transmission.

**Definition:**A container intended to contain sufficient material for more than one use, but grouped or organized to provide individual access to sufficient material for a single use. Often used to ensure that the proper type and amount of material is consumed/expended for each use.

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Types of privacy metadata classifying an IT resource (data, information object, service, or system capability) according to its level of sensitivity, which is based on an analysis of applicable privacy policies and the risk of financial, reputational, or other harm to an individual or entity that could result if made available or disclosed to unauthorized individuals, entities, or processes.

Usage Note:Confidentiality codes may be used in security labels and privacy markings to classify IT resources based on sensitivity to indicate the obligation of a custodian or receiver to ensure that the protected resource is not made available or disclosed to individuals, entities, or processes (security principals) unless authorized per applicable policies. Confidentiality codes may also be used in the clearances of initiators requesting access to protected resources.Map:Definition aligns with ISO 7498-2:1989 - Confidentiality is the property that information is not made available or disclosed to unauthorized individuals, entities, or processes.

**Description:**Identifies reasons for nullifying (retracting) a particular control act.

**Examples:**"Entered in error", "altered decision", etc.

This code is used to specify the exact function an actor is authorized to have in authoring a consent directive.

Description:Identifies functions appropriate to consultant participations.Examples:

* cardiologist * anesthetist * dietician

Description:A role type that is used to further qualify or describe the role of the contact person or organization.Examples:

* Legal representative * Primary contact * Alternative contact

The type of cap associated with a container

**Definition:**An object used to hold other entities.

Examples:

* Test tube * Shoe box * Drinking glass

Describes the nature (or type) of the container.

Examples:

* Carton * Bottle * Vial

**DesignNote:**The material of the container should be separately specified (e.g. the "cardboard" part of cardboard carton or the "glass" part of glass vial should be described elsewhere).

**OpenIssue:**This usage of material form is used in Common Product Model,but it is at variance of what has been done in Specimen where the same information is captured in the Entity.code values. These differences need further study.

A material in a blood collection container that facilites the separation of of blood cells from serum or plasma

**Description:**Identifies the order in which content should be processed.

The styles of context conduction usable by relationships within a static model derived from tyhe HL7 Reference Information Model.

Identifies the control codes that are used to manage the propagation and scope of a particular ActRelationship or Participation within a set of Acts.

**Description:**Identifies reasons for nullifying (retracting) a particular control act.

**Examples:**"Entered in error", "altered decision", etc.

Description:Indicates why a specific transaction which was requested to be undone; was not undone. Description:Indicates the motivation, cause or rationale of an Act which results in a trigger event. Indicates why the ConditionaTMs status was changed to Nullified.Examplesadministrative error, diagnostic error.

Countries of the world. ISO 3166, part 1, alpha-3 set.

Definition:The category of addiction used for coverage purposes that may refer to a substance, the consumption of which may result in physical or emotional harm.

Definition: Identifies the reason or rational for why a person is eligibile for benefits under an insurance policy or progam.

Examples:A person is a claimant under an automobile insurance policy are client deceased & adopted client has been given a new policy identifier. A new employee is eligible for health insurance as an employment benefit. A person meets a government program eligibility criteria for financial, age or health status.

**Description:**Identifies the reason or rationale for coverage of a service or product based on coverage exclusions related the risk of adverse selection by covered parties.

**Description:**Identifies the reason or rationale for coverage of a service or product based on financial participation responsibilities of the covered party.

**Description:**Coded observation values for types or instances of items for which coverage is provided under a policy or program, e.g., a type of vehicle or a named work of art.

**Description:**Coded observation values for types of covered parties under a policy or program based on their personal relationships or employment status.

**Description:**Coded observation values for coverage limitations, for e.g., types of claims or types of parties covered under a policy or program.

**Description:**Identifies the reason or rationale for limitations on the coverage of a service or product based on coverage contract provisions.

**Example:**The maximum cost per unit; or the maximum number of units per period, which is typically the policy or program effective time.

**Description:**Coded observation values for types or instances of locations for which coverage is provided under a policy or program, e.g., in the covered party home, in state or in the country.

Definition:Set of codes indicating the manner in which sponsors, underwriters, and payers participate in a policy or program.

**Description:**Codes that indicate a specific type of sponsor. Used when the sponsor's role is only either as a fully insured sponsor or only as a self-insured sponsor. NOTE: Where a sponsor may be either, use the SponsorParticipationFunction.code (fully insured or self insured) to indicate the type of responsibility. (CO6-0057)

A role recognized through the eligibility of an identified living subject for benefits covered under an insurance policy or a program. Eligibility as a covered party may be conditioned on a relationship with (1) the policy holder such as the policy holder who is covered as an individual under a poliy or as a party sponsored for coverage by the policy holder.

**Example:**An employee as a subscriber; or (2) on being scoped another covered party such as the subscriber, as in the case of a dependent.

Discussion:The Abstract Value Set "CoverageRoleType", which was developed for use in the Canadian realm "pre-coordinate" coverage roles with other roles that a covered party must play in order to be eligible for coverage, e.g., "handicapped dependent". Other codes in the Abstract Value Set CoveredPartyRoleType domain can be "post-coordinated" with the EligiblePartyRoleType codes to denote comparable concepts. Decoupling the concepts is intended to support a wider range of concepts and semantic comparability of coded concepts.

Values that represent a clinical judgment as to the worst case result of a future exposure (including substance administration).

Examples:

* High criticality * Low criticality * Unable to assess criticality

**Description:**To be used to code and identify the Microbiology laboratory orderable and resultable observation question.

Examples:

* Urine; Culture * Deep Wound; Aerobic Culture * Microscopic Examination; Gram Stain

**Description:**Used to code and identify the Microbiology laboratory result value when a result is reported.

Examples:

* Gram Positive Rods * Epithelial Cells * Polymorphonuclear Leukocyte

The currency unit as defined in ISO 4217

DEA schedule for a drug.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

Provides codes for decision methods, initially for assessing the causality of events.

A role of a place that further classifies a setting that is intended to house the provision of services.

Description:Specimen types which further classify the types of specimens that are derived from other specimens.Examples:Examples include specimen sections and specimen components.

Domain values for the Device.Alert\_levelCode

Identifies characteristics (physical, visual, clinical) that may be observed for a particular device or device type.

Examples:

* Height * Sterility * External diameter

Includes the set of codes used to identify a device that may be referred to in an ICSR report. Example code set reference is the FDA Center for Devices and Radiological Health product code list.

Example product codes include: FOZ = Catheter, Intravascular, Therapeutic, short-term less than 30 days, MOP = Rotator, Prosthetic Heart Valve.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

A code set that includes codes that are used to characterize the outcome of the device evaluation process. The code defines the manufacturer's conclusions following the evaluation.

Examples include: inadequate alarms, device maintenance contributed to event, device failed just prior to use, user error caused event

Code assigned to indicate a relevant fact within the context of the evaluation of a reported product. There are a number of concept types including the status of the evaluation, the type of evaluation findings, and the type of activity carried out as part of the evaluation process.

Examples include: Actual device involved in incident was evaluated, electrical tests performed, visual examination.

Code assigned to indicate an outcome of the manufacturer's investigation of a product for which a defect has been reported.

Examples include:.component/subassembly failure: air cleaner, computer-, imaging system-, microprocessor-controlled device problem: cache memory, design -- not fail safe.

Indicates the type of person that is responsible for operating the device related to the incident reported in ICSR.

Examples include: Physician, Nurse, Medical Technician, Respiratory Technician.

Set of codes depicting clinical disease and conditions

Diagnosis Value

Identifies the types of diagnostic image.

Examples:Echocardiogram, electocardiogram, X-ray.

Identifies the type of diagnostic image report.

Examples:

* Echocardiogram Report * Ultrasound Report * Nuclear Medicine Imaging Report

A set of concepts that identifies any texture modifications that should be made to a diet order.

Examples:

* Pudding Thick * Pureed * Easy to Chew

Description:An observation that categorizes an existing observation of a disease, symptom or condition.Usage Note:The act being categorized should be an observation of a disease, symptom or condition; the categorizing act should be an observation of the category of that disease, symptom or condition, and the relationship between the two acts should be a "has generalization" relationship.Examples:

* \[Observation of\] "thrombocytopenia" is categorized as an observation of "Haematologic system" category * \[Observation of\] "duodenal ulcer" is categorized as an observation of "Gastro-intestinal system" category * \[Observation of\] "eczema" is categorized as an observation of "Dermatologic system" category

**Description:**Codes that further characterize the distribution of a material. Used only with the DST (distributed material) role classCode.

**Examples:**Intensive distribution, Selective distribution and Exclusive distribution.

Identifies the current completion state of a clinical document.

A type of document section (specialization of ActClass "DOCSECT").

Identifies the storage status of a document.

The kind of document. Possible values: discharge summary, progress note, Oncology note, etc.

**Description:**The physical manifestation "entity" that contains the active and/or inactive ingredients that deliver a dose of medicine (i.e., drug). The key defining characteristics of the dose form can be the state of matter, delivery method, release characteristics, and the administration site or route for which the product is formulated. (Derived from ISO IDMP specification, and SNOMED CT).

Examples:

* Tablet * Capsule * Oral solution

Proposed therapy may be contraindicated or ineffective based on an existing or recent drug therapy

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

A substance whose therapeutic effect is produced by chemical action within the body.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.
OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

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Identifies types of observations about the parameters required for acquisition and processing of ECG data.

Examples:

* item byte order * sample rate * displayed sweep rate

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode. Description:Highest level of education a person has achieved.Examples:

* Elementary School * College or baccalaureate degree complete * High School

Rationale:These are levels, not numeric years

Provides coded names for attribute SortControl.elementName , which has data type SC.

Identifies the reason or rational for why a person is eligibile for benefits under an insurance policy or progam.

Examples:A person is a claimant under an automobile insurance policy are client deceased & adopted client has been given a new policy identifier. A new employee is eligible for health insurance as an employment benefit. A person meets a government program eligibility criteria for financial, age or health status.

A code specifying the job performed by the employee for the employer. For example, accountant, programmer analyst, patient care associate, staff nurse, etc.

A code qualifying the employment in various ways, such as, full-time vs. part time, etc.

Industry and/or jurisdictional classification system for kind-of-work performed by an employee.

Occupation codes are intended primarily as work descriptions that are suitable for a multitude of public uses e.g., job matching, employment counseling, occupational and career guidance, and labor market information services.

Description:A role type that is used to further qualify an entity playing a role where the role class attribute is set to RoleClass Employee. This specifies the relationship the staff person has with the institution for whom he/she provides services.Examples:

* Employee * Volunteer * Consultant

A value representing the method used by an employer to compute an employee's salary or wages.

Examples:Hourly, annual, commission

A code used to define the employment status of the insured individual identified in UB-92 FL 58. UB-92 Form locator 64:Employment Status Code of the Insured. Can be used with Employee\_Employer\_statusCode in HL7. Values include Employed Full Time, Employed Part Time, Not Employed, Retired, On Active Military Duty

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A code depicting the acuity (complexity of patient care, resource intensiveness of the patient care) of a patient's medical condition upon arrival. Values may be derived from formal acuity coding schemes such as RBS.

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A code indicating patient status as of the ending service date of the period covered on this bill, as reported in FL6, Statement Covers Period. Values such as: Discharged to home or self care; Discharged/transferred to SNF, Discharged/transferred to an intermediate care facility (ICF); Expired; Hospice-medical facility. NUBC Form Locator 22

A code used to define the place or organization responsible for the patient immediately prior to their admission; for example, in the United States, as this is identified in UB-92 Form Locator 20, Source of Adm(ission).

A code identifying special courtesies extended to the patient. For example, no courtesies, extended courtesies, professional courtesy, VIP courtesies.

A concept that conveys how a material will be administered enterally.

Examples:

* Continuous Tube Feeding * Gravity Drip * Bolus Feeding

Classifies the Entity class and all of its subclasses. The terminology is hierarchical. At the top is this HL7-defined domain of high-level categories (such as represented by the Entity subclasses). Each of these terms must be harmonized and is specializable.

The value sets beneath are encoded in Entity.code and are drawn from multiple, frequently external, domains that reflect much more fine-grained typing.

A value representing the specific kind of Entity the instance represents.

Examples:A medical building, a Doberman Pinscher, a blood collection tube, a tissue biopsy.Rationale:For each Entity, the value for this attribute is drawn from one of several coding systems depending on the Entity classCode, such as living subjects (animal and plant taxonomies), chemical substance (e.g., IUPAC code), organizations, insurance company, government agency, hospital, park, lake, syringe, etc. It is possible that Entity.code may be so fine grained that it represents a single instance. An example is the CDC vaccine manufacturer code, modeled as a concept vocabulary, when in fact each concept refers to a single instance.

EntityDeterminer in natural language grammar is the class of words that comprises articles, demonstrative pronouns, and quantifiers. In the RIM, determiner is a structural code in the Entity class to distinguish whether any given Entity object stands for some, any one, or a specific thing.

**Description:**The specific kind of location-tracking tag.

Examples:

* RFID * WiFi * Infrared

A type of manufactured material used in an activity, without being substantially changed through that activity.

Special handling requirements for an Entity.

*Example:*Keep at room temperature; Keep frozen below 0 C; Keep in a dry environment; Keep upright, do not turn upside down.

Description:The qualifier is a set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type. For example, a given name may be flagged as a nickname, a family name may be a pseudonym or a name of public records.

**Description:**The qualifier is a set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type. For example, a given name may be flagged as a nickname, a family name may be a pseudonym or a name of public records.

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**Description:**Indicates whether the name part is a given name, family name, prefix, suffix, etc.

A name intended for use in searching or matching

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**Description:**A set of codes advising a system or user which name in a set of names to select for a given purpose.

**Description:**Risk associated with the handling of the material.

The status of an instance of the RIM Entity class.

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A code specifying in what way two products are considered equivalent. One example for a value set in the US can be found in U.S. FDA "Orange Book" at the FDA website but the concept is universal and not a U.S. only issue.

Examples:

* No known or suspected bioequivalence problems * Potential bioequivalence problems have been resolved with evidence supporting bioequivalence * Bioequivalence problems have not been fully resolved

In the United States, federal standards for classifying data on ethnicity determine the categories used by federal agencies and exert a strong influence on categorization by state and local agencies and private sector organizations. The federal standards do not conceptually define ethnicity, and they recognize the absence of an anthropological or scientific basis for ethnicity classification. Instead, the federal standards acknowledge that ethnicity is a social-political construct in which an individual's own identification with a particular ethnicity is preferred to observer identification. The standards specify two minimum ethnicity categories: Hispanic or Latino, and Not Hispanic or Latino. The standards define a Hispanic or Latino as a person of "Mexican, Puerto Rican, Cuban, South or Central America, or other Spanish culture or origin, regardless of race." The standards stipulate that ethnicity data need not be limited to the two minimum categories, but any expansion must be collapsible to those categories. In addition, the standards stipulate that an individual can be Hispanic or Latino or can be Not Hispanic or Latino, but cannot be both.

OpenIssue:This concept domain definition does not align with current vocabulary practices and is much too US-centric to be appropriate as a "universal" domain.
Description:Identifies types of observations that describe or categorize an observation in terms of the frequency of the observed event occurring.Examples:

* Very common * Uncommon * Rare

Indicates the material to which the patient was exposed which is believed to be related to the adverse reaction

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

Code for the mechanism by which the exposure agent was exchanged or potentially exchanged by the participants involved in the exposure.

FDA label data

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

The type of familial relationship between a living subject and another living subject.

Examples:

* Father * Mother * Uncle

A manufactured material that is used during the nutrition process but is not changed via the process.

Examples:

* Disposable Utensils * Plate Guard * Sippy Cup

**Description:**Describes the supporting information for financial transactions such as a Special Authorization Request.

Example values under this concept domain could be: height, weight, duration of disease, site of fistula, etc.

This concept domain is intended to be used as part of a code/value pair within a generic structure that would convey ANY sort of information or proof of criteria that is needed to support a special authorization request.

**Description:**Contains the supporting information values for financial transactions such as a Special Authorization Request.

This concept domain is intended to be used as the "value" part of a code/value pair within a generic structure that would convey any sort of information or proof of criteria that is needed to support a special authorization request. For example:

One wishes to convey a patient's DSM IV diagnosis to support a special authorization request. One code/value pair is used:

ActSupportingInformationCode1 = DSM IV Diagnosis, value= 315.4

Concepts that identify raw, cooked or edible substances or ingredients that are intended for consumption by humans or animals to supply nourishment.

Examples:

* Orange * Meat * Milk

A relationship between two entities that is formally recognized, frequently by a contract or similar agreement.

Examples:agent; guarantor; patient.
Description:Categorizes the accuracy of spatial data assignment utilizing a variety of tools for capturing coordinates including digitizers, geocoding software and global positioning system devices.

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A value representing whether the primary reproductive organs of NonPersonLivingSubject are present.

**Description:**Identifies why a change is being made to a record.

Concepts that specify interpretation of genetic analysis.

Examples:

* positive * negative * carrier * responsive

A code that provides additional detail about the means or technique used to ascertain the genetic analysis. Example, PCR, Micro Array.

Description:Identifies the kinds of genetic observations that can be performed. Description:The domain contains genetic analysis specific observation values, e.g. Homozygote, Heterozygote, etc. Description:The specific kinds of organizational roles that issue information privacy grants that permit or prohibit potential actions on information artifacts.Examples:

* Clearinghouse * Billing Service * Health Information Exchange

Description:The specific kinds of person roles that issue information privacy grants that permit or prohibit potential actions on information artifacts.Examples:

* Self * Parent * Legal Guardian

Description:The specific kinds of roles that issue information privacy grants that permit or prohibit potential actions on information artifacts.Examples:

* Parent * Legal Guardian * Health Information Exchange

Qualify the holder or scope of a guardianship relationship over a living subject.

Examples:

* Guardianship held jointly by separated parents * Guardianship held jointly by parent and another person * Natural guardian * Special guardian * Guardian of property

**Description:**Health Care Financing Administration Common Procedural Coding System (HCPCS) Codes are procedure identifying codes. HCPCS is Health Care Finance AdministrationaTMs (HFCA) coding scheme to group procedures performed for payment to providers. contains codes for medical equipment, injectable drugs, transportation services, and other services not found in CPT4.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

**Description:**External value set for accommodation types used in the U.S. Health Care Financing Administration (HCFA) Common Procedure Coding System (HCPCS) including modifiers.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

**Description:**Accommodation type. In Intent mood, represents the accommodation type requested. In Event mood, represents accommodation assigned/used. In Definition mood, represents the available accommodation type.

HL7 implementation technology specification versions. These codes will document the ITS type and version for message encoding. The code will appear in the instances based upon rules expressed in the ITS, and do not appear in the abstract message, either as it is presented to received from the ITS.

This is the domain of HL7 version codes for the Version 3 standards. Values are to be determined by HL7 and added with each new version of the HL7 Standard.

The trigger event referenced by the Control Act instance. Values are drawn from the available trigger events used in the release of HL7 identified by the versionCode.

The possible modes of updating that occur when an attribute is received by a system that already contains values for that attribute.

Open Issue:From April 2008 harmonization: "Definition needs to be modified. Make contents to HL7 content mode code system match contents in this table" Clear that this needs to be revisited.

A role type that is used to categorize an entity that delivers health care in an expected and professional manner to a subject in need of health care services.

Examples:

* Registered Nurse * Physician * Custodial Care Clinic

A set of concepts representing locations and settings where healthcare services are provided.

Description:Holders are containers that hold other containers or holders.Examples:

* Tube rack * Specimen carrier * Tray

HtmlLinkType values are drawn from HTML 4.0 and describe the relationship between the current document and the anchor that is the target of the link

An anatomical location on a human which can be the focus of an act.

Description:To be used to code the anatomic component of the human-sourced specimen that the lab observation relates to.Examples:

* Endometrial biopsy * Thyroid fine needle aspirate * Urine

Codes for the representation of the names of human languages.

Description:The set of body locations to or through which a substance or product may be administered.Examples:

* buttock * left upper arm * bilateral eyes

**Description:**International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS) are procedure identifying codes. ICD-10-PCS describes the classification of inpatient procedures for statistical purposes.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

**Description:**International Classification of Diseases, 9th Revision, Procedure Coding System (ICD-9-PCS) are procedure identifying codes. ICD-9-PCS describes the classification of inpatient procedures for statistical purposes.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.
Description:A type of observation on an investigative subject or a related entity that might be collected to provide the medical and social context for an adverse event report.Examples:

* Diagnosis * laboratory result * autopsy determined cause of death

**Description:**Different types of qualification that could be applicable for a party involved in sending or receiving a case safety report, providing the original notification or report of an adverse event or product problem.

Examples:

* Physician * Veterinarian * Lawyer * Member of the public

Description:A role that is played by a party which is involved in the process originating or managing reports of adverse events or product problems.Examples:

* Marketing Authorization Holder * Regulatory Agency * Healthcare Practitioner

Description:Concepts that define the primary orientation of a product related investigation.Examples:

* Product defect * adverse event

Provides a set of values for defining the type of Pharmaceutical Product that is related to a PhPID. This in turn determines the type of information that may be conveyed when using the Common Product Model as a vehicle for IDMP model data.

Examples:

* Chemical Type * Radionuclides (radioactive) Type * Biological Substance

Provides a set of values for defining the relationship between different concepts when using the Common Product Model as a vehicle for IDMP model data

Examples:

* Medicinal identifier * Pharmaceutical identifier * Underlying pharmaceutical concept identifier

Defines elements of the IDMP model, whether concepts defined by role, or relationships between concepts defined by role, that cannot otherwise easily be distinguished within the Common Product Model structures and associated vocabulary. This domain is a collector for the different types of semantics associated with the IDMP role concept spaces.

Definition:A code representing the type of identifier that has been assigned to the identified entity (IDENT).Examples:Example values include Social Insurance Number, Product Catalog ID, Product Model Number. Description:The identifier was issued by the system responsible for constructing the instance. Description:Codes to specify the scope in which the identifier applies to the object with which it is associated, and used in the datatype property II.

A code specifying qualitatively the spatial relation between imaged object and imaging film or detector.

Specifies the type of date that is specified in an immunization forecast. The immunization forecast defines the schedule for a vaccine based on variables like the subject's age, the type of vaccine, and the supply unit. The immunization forecast may involve multiple administrations in a series or just one administration. Each of the administrations has one or more recommended dates.

Examples:

* Earliest recommended date * Recommended date * Latest acceptable date * Overdue date (date after which to start sending reminders)

Used to represent the patient's status with respect to their immunization guideline as of an evaluation date.

Description:Types of observations which describe characteristics of the immunization material.

Types of locations,that are not designed for the purpose of providing health care services but where care provision takes place.

Examples:

* Accident site * Patient's residence * School * Work site

Indicates the specific observation result which is the reason for the action (prescription, lab test, etc.). E.g. Headache, Ear infection, planned diagnostic image (requiring contrast agent), etc.

Description:Includes those concepts that are provided to justify the fact that an adverse event or product problem is required to be reported in an expedited fashion. Description:Includes relevant pieces of information about a product or its process of creation. The vocabulary domain is used to characterize products when they are cited in adverse event or product problem reports.

**Examples:**Weight, color, dimensions.

A code that is used to indicate the type of organization which is originating and sending the ICSR. The current code example reference is from the International Conference on Harmonisation (ICH) Expert Workgroup guideline on Clinical Safety Data Management: Data Elements for Transmission of Individual Case Safety Reports.

Example concepts are: Pharmaceutical Company, Regulatory Authority, Health Professional, Regional Pharmacovigilence Center, World Health Organization Collaborating Center for International Drug Monitoring.

Types of case safety report received from sender. The current code example reference is from the International Conference on Harmonization (ICH) Expert Workgroup guideline on Clinical Safety Data Management: Data Elements for Transmission of Individual Case Safety Reports. The unknown/unavailable option allows the transmission of information from a secondary sender where the initial sender did not specify the type of report.

This domain is established as a parent to a variety of value domains being defined to support the communication of Individual Case Safety Reports to regulatory bodies. Arguably, this aggregation is not taxonomically pure, but the grouping will facilitate the management of these domains.

North American Industry Classification System(NAICS) for the United States, a new economic classification system that replaces the 1987 Standard Industrial Classification (SIC) for statistical purposes. NAICS is a system for classifying establishments by type of economic activity. Its purposes are: (1) to facilitate the collection, tabulation, presentation, and analysis of data relating to establishments, and (2) to promote uniformity and comparability in the presentation of statistical data describing the economy. NAICS will be used by Federal statistical agencies that collect or publish data by industry. http://www.census.gov/epcd/www/naicsusr.html

An anatomical location on a human of an injury or disease which is the focus of an act.

Values for observations of injuries.

\*\*\*\* MISSING DEFINITIONS \*\*\*\*

Codes identifying pariticular groupings of allergens and other agents which cause allergies and intolerances. E.g. the drug, allergen group, food or environmental agent which triggers the intolerance

Description:A code further classifying the type of investigated subject role. Used with the INVSBJ role class code.Examples:

* Case subject * Suspect * Person of interest

Designates a modifier to the code attribute to provide additional information about the invoice element.

Examples:Isolation allowance; After-hours serviceRationale:This is not pre-coordinated into the CD attribute because the modifier code set may not be specifically designed for use with the Act.code code set. This violates the constraint for using the 'modifier' property that the modifier code set must be defined as part of, or specifically for the base code set.

**Description:**To be used in the message when there is a requirement to communicate a result observation code that relates to a specific isolate.

Examples:

* Colony count * Colony count; Viability count FDA method * Growth rate; Visual method

**Description:**Used to code and identify the Isolate observation result value when a coded result is reported.

Examples:

* Heavy growth * Scant growth * Moderate growth

**Description:**Indicates how result sets should be filtered based on whether they have associated issues.

The combined domain for different types of coded observation issue triggers, such as diagnoses, allergies, etc.

Provides coded names for attribute Employee.jobTitleName, which has data type SC.

Categorization of types of observation that capture a knowledge subtopic which might be treatment, etiology, or prognosis.

Observation values that document the types of observations belonging to the domain KnowledgeSubTopicObservationType.

Categorization of types of observation that capture the main clinical knowledge subject which may be a medication, a laboratory test, a disease.

Observation values that document the types of observations belonging to the domain KnowledgeSubjectObservationType.

Description:Used to code and identify the laboratory result value when a coded result is reported.Examples:

* Sickle cell trait * Hereditary Spherocytosis * Deficiency of butyryl-CoA dehydrogenase

**Definition:**Used to identify if a lab result is reported as preliminary, final, or corrected. Provides a consistent way to distinguish the business or reporting status of the lab result.

**Description:**Providers used in Laboratory messaging.

Description:Trigger events associated with laboratory results.Examples:

* Lab result activate * Lab result complete * Lab result abort

A value representing the method of expression of the language.

*Example:*Expressed spoken, expressed written, expressed signed, received spoken, received written, received signed.

A value representing the level of proficiency in a language.

*Example:*Excellent, good, fair, poor.

OpenIssue:This concept domain has **no valid description**.

A dynamic list of individual instances of Act which reflect the needs of an individual worker, team of workers, or an organization to view roups of Acts for clinical or administrative reasons.

Discussion:The grouped Acts are related to the WorkingList via an ActRelationship of type 'COMP' component).Examples:Problem lists, goal lists, allergy lists, to-do lists, etc.Design note:This physical class contains but a single attribute, other than those that it inherits from Act. Use of that attribute in the design of RIM-based static models has beenDEPRECATEDin HL7 RIM Harmonization, effective November 2005. This action was based on ecommendations from the Patient Care Technical Committee.

As a consequence, this class will cease to be shown as a physical class in the RIM, once the attribute is retired. Nevertheless, use of this class via an Act.classCode value of 'LIST' is entirely appropriate so long as only the attibutes inherited from Act are used.

A code depicting the living arrangements of a person

Anything that essentially has the property of life, independent of current state (a dead human corpse is still essentially a living subject).

Examples:persons, animals, trees .

Types of language sourced from an entity that is a living subject.

Usage Note:Intended to be used for CD or CV data types. Use HumanLanguage concept domain to convey languages represented in ED.Language or other CS data types.

Tells a receiver to ignore just the local markup tags (local\_markup, local\_header, local\_attr) when value="markup", or to ignore the local markup tags and all contained content when value="all"

A value representing the current state of control associated with the device.

Examples:A device can either work autonomously (localRemoteControlStateCode="Local") or it can be controlled by another system (localRemoteControlStateCode="Remote").Rationale:The control status of a device must be communicated between devices prior to remote commands being transmitted. If the device is not in "Remote" status then external commands will be ignored.
Description:Constrains the concepts used to further characterize the association between an entity and itaTMs location. Used only with the LOCE (located entity) role classCode.Example:home, business and vacation home.

**Description:**Describes types of identifiers other than the primary location registry identifier for a service delivery location. Identifiers may be assigned by a local service delivery organization, a formal body capable of accrediting the location for the capability to provide specific services or the identifier may be assigned at a jurisdictional level.

The status of an instance of the RIM Participation class.

Identifies a drug or the use of a drug as produced by a specific manufacturer

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

An Entity or combination of Entities transformed for a particular purpose by a manufacturing process.

Examples:Processed food products, disposable syringes, chemistry analyzer, saline for infusion
Description:A specimen that is manufactured or a specimen from a manufactured material. This may be a quality control specimen or a manufactured substance.Examples:

* Quality control specimen * Aspirin * Breakfast sausage

**Description:**A role type that is used to further qualify an entity playing a role where the role class attribute is set to RoleClass ManufacturedProduct.

Description:The activity of businesses operating in the manufacture and distribution of products.Examples:

* manufacture * repack * import

Provides coded names for attribute Device.manufacturerModelName, which has data type SC.

The closeness or quality of the mapping between the HL7 concept (as represented by the HL7 concept identifier) and the source coding system. The values are patterned after the similar relationships used in the UMLS Metathesaurus. Because the HL7 coding sy

The domestic partnership status of a person.

*Example:*Married, separated, divorced, widowed, common-law marriage.

Description:The broad activity of businesses operating in the distribution of products, the general act of making a product available to the public.Examples:

* Marketing, (this is required as a singleton value set, as there may be no other use case for this than to distinguish one Act of handling products from other Acts, such as manufacturing.)

Description:Indicates the types of products whose associated records are allowed to be masked.

Types of Material for EntityClass "MAT"

This identifies the physical state, nature or manifestation of the material.

Usage Notes:When the Material class is specialised to Manufactured Material, which it is to routinely to describe Medicinal products and ingredient Substances, and to Containers and Devices, the Material Form attribute is used more explicitly to describe the form and manifestation of these types of concepts - for example for medicinal products, the formCode describes their dose form (tablet, ointment); and for containers, it is their physical type (box, carton, vial).

Examples:

* Powder * Liquid * Gas

When the Material class is specialised to Manufactured Material, which it is to routinely to describe Medicinal products and ingredient Substances, and to Containers and Devices, the Material Form attribute is used more explicitly to describe the form and manifestation of these types of concepts - for example for medicinal products, the formCode describes their dose form (tablet, ointment); and for containers, it is their physical type (box, carton, vial). Examples: Powder Liquid Gas

Observation values used for an items counted measure attribute in a health quality measure (eMeasure).

Observation values used for a jurisdiction measure attribute in a health quality measure (eMeasure).

Examples:

* ISO Country codes * State and County codes * FIPS value sets of postal codes * districts * regions

Observation values used for various types of coded measure attributes in a health quality measure (eMeasure).

Observation values used for a reporter type measure attribute in a health quality measure (eMeasure).

Examples:

* Laboratory * Healthcare Providers * Hospitals * Healthcare facilities that are NOT hospitals * Schools * Pharmacists * Veterinary lab * Veterinarian * Prison/Jail * Institutions * Employers

Observation values used for a service delivery location measure attribute in a health quality measure (eMeasure).

Internet Assigned Numbers Authority (IANA) Mime Media Types

**Definition:**A device with direct or indirect therapeutic purpose.

Definition:This domain is used to document why the procedure is a duplicate of one ordered/charged previously for the same patient within the same date of service and has been determined to be medically necessary.Example:A doctor needs a different view in a chest X-Ray.

Identifies the specific hierarchical relationship between the playing and scoping medications.

Examples:Generic, Generic Formulation, Therapeutic Class, etc.
Description:Any type of issue that identifies a potential adverse situation that would or might occur with the described substance administration.Examples:

* adverse effect * drug interaction * drug-food interaction

Identifies types of observations that can be made about a particular drug or medication.

**Description:**Indicates the reason the medication order should be aborted.

**Definition:**A collection of concepts that indicate why the prescription should be released from suspended state.

Description:Identifies types of observations about the Safety Reports required for a particular medication.Examples:

* \[Observation of\] International Birth Date * \[Observation of\] Data Lock Point * \[Observation of\] Frequency of Safety Report Submission

A classification for further qualifying an entity playing a Member RoleClass.

Examples:

* tribal member * elected member * *ex officio* member * part-time member

Indicates the highest importance level of the set of messages the acknowledging application has waiting on a queue for the receiving application.

Discussion:These messages would need to be retrieved via a query. This facilitates receiving applications that cannot receive unsolicited messages (i.e. polling). The specific code specified identifies how important the most important waiting message is (and may govern how soon the receiving application is required to poll for the message).

Priority may be used by local agreement to determine the timeframe in which the receiving application is expected to retrieve the messages from the queue.

**Description:**To be used to identify a microorganism when required by an act.

Examples:

* Escherichia coli * Caulimoviridae * Pseudomonas aeruginosa

Indicates whether the subscription to a query is new or is being modified.

Types of reason why a prescription is revised.

The nature of the bonds by which two molecular parts may be connected.

Examples:(1) simple bonds such as, single bond, double bond, triple bond, (2) specialized bonds such as peptide bond, disulfide bond, etc., (3) weak bonds such as van-der-Waals, chelate, and ion-associations.

The generalization of molecular parts (partitive role) and molecular bonds (associative role), or possibly any other role type used for the expression of structural molecular features.

Examples:(1) acetyl group (a moiety), (2) disulfide bond (a bond), (3) O-linked glycosylation (a moiety).

Specific functiona that a participant may have in a molecular interaction.

Examples:Receptor, allosteric inhibitor, co-factor, catalyst, co-enzyme, competitive inhibitor, etc.

The senses in which a molecule may be conceptually or actually divided into parts.

Examples:
  • sub-unit of a protein (i.e., sequences held together usually by disulfide bonds);

  • domain of a protein or component of a nucleic acid sequence (i.e., a sub-sequence identified to have a certain folding structure or function, e.g. signaling peptide of a protein precursor or promoter and open reading frame of a nucleic acid);

  • residue on a molecular base skeleton; atom of a molecule (e.g., to identify substitution with a radioactive isotope);

  • dissociable ion.

UsageNotes:The specific code system and concepts are left to be externally defined. However, when the positionNumber attribute is to be used with the part role to indicate where the part is placed, the part role code must specify how the position number vector is to be interpreted. For example, for subunits of a protein oligomer (such as fibrinogen) held together by disulfide bonds, the part relationship would need to specify the position of the links
The specific code system and concepts are left to be externally defined. However, when the positionNumber attribute is to be used with the part role to indicate where the part is placed, the part role code must specify how the position number vector is to be interpreted. For example, for subunits of a protein oligomer (such as fibrinogen) held together by disulfide bonds, the part relationship would need to specify the position of the links

**Description:**Concepts which further characterizing the type of mutual relationships. Used only with the abstract code\_RoleClassMutualRelationship.

NDC Regulated Drug Entity Type

Codes identifying nation states. Allows for finer grained specification of Entity with classcode <= NAT

*Example:*ISO3166 country codes.

Description:A duplicate non-clinical service or product is being re-billed.Examples:

* Duplicate transportation required for physician visit * Wrong size of a product * Rebuilding wheel chair ramp due to a weather condition

Indicates types of allergy and intolerance agents which are non-drugs. (E.g. foods, latex, etc.)

The reason the action was not performed, e.g. why the medication was not taken. If an action was not performed, it is often clinically important to know why the action was not taken.

*Examples:*Patient refused, clinically inappropriate, absolute contraindication etc.

**Description:**Types of NonPersonLivingSubjects for the EntityClass "NLIV"

Indication or reason why a valid value is not present.

Concepts that identify the component source substance (e.g., chemical compound class and/or element) that supply nourishment by providing energy or metabolic support.

Examples:

* Carbohydrates * Protein * Fat * Calcium * Vitamin D * Fiber

Concepts that are used to convey modifications to the food or serving utensils that should be given in a diet order. These can be derived from patient allergies, intolerances, or preferences. They can also be specific to the order and not have any relationship to the allergies, intolerances, or preferences.

Examples:

* Vegetarian * Liquids separate from solids * Small Portions * disposable utensils (for psych or isolation rooms)

Concepts that identify a type of natural or manufactured food product, typically liquid or powder mixed with water, for complete or supplemental feeding.

Examples:

* Milk-based * Breast-milk * Soy-based * Peptide-based * Elemental

A material that is used to provide nutritional value.

Examples:

* Food * Formula * Supplements

Concepts that identify a type of natural or manufactured food product used to provide additional nutrients or nourishment replacements beyond those consumed in the normal diet.

Examples:

* High-calorie * High-protein * Clear liquid * Oral electrolyte Replacement

**Description:**To allow queries to specify useful information about the age of the patient without disclosing possible protected health information.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

**Description:**Dianostic procedures ordered or performed to evaluate whether a sensitivity to a substance is present. This test may be associated with specimen collection and/or substance administration challenge actiivities.

**Example:**Skin tests and eosinophilia evaluations.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

Indicates the type of allergy test performed or to be performed. E.g. the specific antibody or skin test performed

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.
Description:A code used to further identify the type of case status observation. Used with the OBS ActClass.Examples:

* Clinical status * Administrative status * Reporting status

Description:A code used to identify the status of a case. Used with the OBS ActClass.Examples:

* Suspect * Confirmed * Probable

**Description:**A kind of observation that allows a Secondary Observation (source act) to assert (at various levels of probability) that the target act of the association (which may be of any type of act) is implicated in the etiology of another observation that is named as the subject of the Secondary Observation

**Example:**Causality assertions where an accident is the cause of a symptom; predisposition assertions where the genetic state plus environmental factors are implicated in the development of a disease; reaction assertions where a substance exposure is associated with a finding of wheezing.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.
Description:Identifies the individual coordinate in the coordinate system inclusive of any transformations or projections.Examples:meridian, range, township, longitude, latitude, lot, block, etc. Description:Identifies the coordinate system inclusive of any transformation projections.

**Description:**Type of coded observation values in evaluating reference ranges.

Examples:

* Surgically transgendered transsexual, female-to-male * AIDS-associated disorder * Asian race

Definition:

The set of observation type concepts that can be used to express pre-conditions to a particular dosage definition.

Rationale: Used to constrain the set of observations to those related to the applicability of a dosage, such as height, weight, age, pregnancy, liver function, kidney function, etc. For example, in drug master-file type records indicating when a specified dose is applicable.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.
Description:of observation used for evaluating a precondition, goal, or trigger.Examples:

* age-based criteria * diagnostic-based criteria * simple observation-based criteria (vital signs)

Description:Type of observation used in lab for evaluating reference ranges.Examples:

* age-based criteria * sex-based criteria * condition-based criteria

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

Includes all codes defining types of indications such as diagnosis, symptom and other indications such as contrast agents for lab tests

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

The domain of possible values for a categorical assessment of an observation value.

Discussion:These interpretation codes are sometimes called "abnormal flags", however, the judgment of normalcy is just one of the common rough interpretations, and is often not relevant. For example, the susceptibility interpretations are not about "normalcy", and for any observation of a pathologic condition, it does not make sense to state the normalcy, since pathologic conditions are never considered "normal."

Interpretations of change of quantity and/or severity.

Examples:

* better * worse * increased

Interpretations of the presence or absence of a component / analyte or organism in a test or of a sign in a clinical observation. In keeping with laboratory data processing practice, this provides a categorical interpretation of the "meaning" of the quantitative value for the same observation.

Technical exceptions resulting in the inability to provide an interpretation, such as "off scale". Does not include normality or severity.

Interpretation of the observed result taking into account additional information (contraindicators) about the patient's situation. Concepts in this category are mutually exclusive, i.e., at most one is allowed.

Interpretations of normality or degree of abnormality (including critical or "alert" level). Concepts in this category are mutually exclusive, i.e., at most one is allowed.

Interpretations of anti-microbial susceptibility testing results (microbiology). At most one allowed.

Description:Types of sensitivity caused by an exposure to a substance which results in an abnormal immunologic or non-immunologic response.Examples:

* Food allergy * Environmental allergy * Fod intolerance

Description:Used to further classify the type of investigation being documented. This concept domain is intended to be used with the INVSTG Act class code.Examples:

* Public health case investigation * Safety investigation * Surveillance investigation

Distinguishes the kinds of coded observations that could be the trigger for clinical issue detection. These are observations that are not measurable, but instead can be defined with codes. Coded observation types include: Allergy, Intolerance, Medical Condition, Pregnancy status, etc.

Distinguishes between the kinds of measurable observations that could be the trigger for clinical issue detection. Measurable observation types include: Lab Results, Height, Weight.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.
Description:A set of codes specifying the type of Laboratory Report.Examples:

* Hematology reports * Chemistry reports * Blood gas reports

Observation values used to indicate the type of scoring (e.g. proportion, ratio) used by a health quality measure.

Observation values used to indicate whether a health quality measure is used to sample a process or outcome over time.

A code that provides additional detail about the means or technique used to ascertain the observation.

Examples:Blood pressure measurement method: arterial puncture vs. sphygmomanometer (Riva-Rocci), sitting vs. supine position, etc.Constraints:In all observations the method is already partially specified by the Act.code. In this case, the methodCode NEED NOT be used at all. The methodCode MAY still be used to identify this method more clearly in addition to what is implied from the Act.code. However, an information consumer system or process SHOULD NOT depend on this methodCode information for method detail that is implied by the Act.code.

If the methodCode is used to express method detail that is also implied by the Act.code, the methodCode MUST NOT be in conflict with the implied method of the Act.code.

Discussion:In all observations the method is already partially specified by simply knowing the kind of observation (observation definition, Act.code) and this implicit information about the method does not need to be specified in Observation.methodCode. Particularly, most LOINC codes are defined for specific methods as long as the method makes a practical difference in interpretation. For example, the difference between susceptibility studies using the "minimal inhibitory concentration" (MIC) or the "agar diffusion method" (Kirby-Baur) are specifically assigned to different LOINC codes. The methodCode therefore is only an additional qualifier to specify what may not be known already from the Act.code.

Also, some variances in methods may be tied to the particular device used. The methodCode should not be used to identify the specific device or test-kit material used in the observation. Such information about devices or test-kits should be associated with the observation as "device" participations.

Description:Identifies the ordered lab test. Also known as the lab order code or test code.Examples:

* red blood cell count * components of a chemistry panel * microbiology sensitivity testing

Description:Identifies the type of observations that can be ordered.Examples:

* lab tests * diagnostic imaging * device summary

Description:A code used to further identify the type of Outbreak Extent Observation. Used with the OBS ActClass.Examples:

* Geographic extent * Jurisdictional extent

Description:A code used to identify the extent of an outbreak. Used with the OBS.Examples:

* Local * Regional * National

Observation values used to assert that a subject falls into a particular population.

Examples:

* Included in denominator * Included in numerator

This element was deprecated as of the release indicated.

Description:Identifies the type of position accuracy carried in observation value.

**Definition:**Identifies the kinds of public health cases. Used only with the CASE Act class code.

Examples of types of public health cases includes reportable disease cases, radiation exposure cases and chemical exposure cases.

Description:

Used to further classify the type of Outbreak being documented. This concept domain is intended to be used with the OUTB Act class code.

Examples:

* Epidemic * Pandemic * Endemic

Codes used to define various metadata aspects of a health quality measure (specialization of ActClass "OBS").

Definition:An observation related to a query response.

**Example:**The degree of match or match weight returned by a matching algorithm in a response to a query.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.
Description:The type of lab observation being resulted. There are some lab tests which are not ordered and are performed and resulted when the outcome of an ordered test meets some criteria.Examples:

* red blood cell count * results of micro sensitivity testing * *Missing third example*

Description:Identifies the type of observation that can be resulted. There are some labs which are not ordered and are performed and resulted when the outcome of an ordered test meets some criteria.Examples:

* outcomes of lab tests * device summary * therapeutic drug level testing

Identifies the kinds of observations that can be performed

This domain is the root domain to which all HL7-recognized value sets for the Observation.value attribute will be linked when Observation.value has a coded data type.

Definition:Identifies the type of Vision Prescription Observation that is being described.OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

A relationship in which the scoping Entity defines or specifies what the playing Entity is. Thus, the player's "being" (Greek: ontos) is specified.

Examples:sameness; instance; generalization.

Concepts representing diets that can be taken via the mouth.

Examples:

* General * Pureed * Easy to Chew

**Description:**Indicates the form in which the drug product must be, or has been manufactured, or extemporaneous/magistral prepared .

**Description:**To be used to code and identify the Microbiology laboratory observation code that relates to the microorganism identification.

Examples:

* Bacteria identified * Bacteria identified in tissue * Fungus identified

Further classifies entities of EntityClass ORG.

Examples:

* HL7 workgroup * corporation * fraternal organization

Domain provides classification systems for industries.

Concepts which further characterize the association between two Entities which are organizations where the playing Entity (the part) is a component of the whole (scoper). Used only with the PART (part) role classCode.

Examples:

* business unit * department * executive team

Indicates an observed reason for a medical action other than an indication or symptom. E.g. Need for a contrast agent prior to a diagnostic image, need for anesthesia prior to surgery, etc.

Description:The OutbreakObservationValue is used to identify the primary condition or disease associated with an Outbreak. This concept domain is intended to be used with the OUTB Act class code and the ObservationPublicHealthOutbreakType ActCode concept domain.Examples:

* Tuberculosis * Lyme Disease * SARS

This code is used to specify the exact function an actor is authorized to have in authoring a consent override.

A drug product identified at the level of the package in which it is commonly distributed. Code systems such as UPC (Universal Product Code), NDC (National Drug Code), GTIN(Global Trade Item Number) might be bound to this domain in a given realm.

Description:Identifies products such as (1) the GS1 (was UPC and EAN); (2) the U.S., the National Drug Code, which is the U.S. version of what is internationally named the (3) "Medicinal Product Identifier" (MPID). For device products such product code is also known as the "Unique Device Identifier" and may or may not use the GS1 system of product codes. In local contexts the product code can come from local coding systems also, as long as it is a code that denotes to a description of a manufactured product.Examples:

* 0049-3980-41 (NDC for Geodon Roerig 80 mg capsules 10 capsules x 8 blister packs in a carton)

A code indicating the name of a parameter item. ParameterItem classes are defined in the RIM as name-value pairs and this domain provides the name part of the ParameterItem.

Examples:Patient Name, Drug Code, Order Effective Date
Description:Concepts which further characterizing the association two Entities where the playing Entity (the part) is a component of the whole (scoper). Used only with the PART (part) role classCode.

Example: Body part, organization part and moiety.

This code is used to specify the exact function an actor had in a service in all necessary detail. This domain may include local extensions (CWE).

Identifies a means by which an Entity participates in an Act.

A code specifying whether and how the participant has attested his participation through a signature and or whether such a signature is needed.

Examples:A surgical Procedure act object (representing a procedure report) requires a signature of the performing and responsible surgeon, and possibly other participants. (See also: Participation.signatureText.)

Used to indicate that the participation is a filtered subset of the total participations of the same type owned by the Act.

Used when there is a need to limit the participations to the first, the last, the next or some other filtered subset.

A code specifying the kind of Participation or involvement the Entity playing the Role associated with the Participation has with regard to the associated Act.

Constraints:The Participant.typeCode contains only categories that have crisp semantic relevance in the scope of HL7. It is a coded attribute without exceptions and no alternative coding systems allowed.

An association between two Entities where the playing Entity is considered in some way "part" of the scoping Entity, e.g., as a member, component, ingredient, or content. Being "part" in the broadest sense of the word can mean anything from being an integral structural component to a mere incidental temporary association of a playing Entity with a (generally larger) scoping Entity.

Examples:part; member; ingredient.

An association for a playing Entity that is used, known, treated, handled, built, or destroyed, etc. under the auspices of the scoping Entity. The playing Entity is passive in these roles (even though it may be active in other roles), in the sense that the kinds of things done to it in this role happen without an agreement from the playing Entity.

Examples:birthplace; owned entity; used entity.

Indicates the type of characteristics a patient should have for a given therapy to be appropriate. E.g. Weight, Age, certain lab values, etc.

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.
Description:Reporting codes that are related to an immunization event.

Patient VIP code

**Definition:**A collection of concepts identifying why the patient's profile is being queried.

Describes payment terms for a financial transaction, used in an invoice.

This is typically expressed as a responsibility of the acceptor or payor of an invoice.

Definition:Set of codes indicating the manner in which payors participate in a policy or program.</

**Description:**PayorRoleType for a particular type of policy or program benefit package or plan where more detail about the coverage administration role of the Payor is required. The functions performed by a Payor qualified by a PayorRoleType may be specified by the PayorParticpationFunction value set.

**Examples:**A Payor that is a TPA may administer a managed care plan without underwriting the risk.

Description:Identifies functions appropriate to performer participations.Examples:

* surgeon * lab technician * janitor

A code identifying a person's disability.

Types of identifiers for persons.

Examples:

* Social insurance number * Passport number * Drivers license number * Jurisdiction health number

A "personal and legal" assigned relationship records the role of a person in relation to another person, or a person to himself or herself. These concepts are to be used when recording relationships based on personal or family ties or through legal assignment of responsibility.

Description:Types of personal relationships between two living subjects.Examples:

* Parent * sibling * unrelated friend * neighbor

A code to capture the reporter's assessment of the extent to which the reaction is related to the suspect product reported in the ICSR.

Example concepts include: related, not related, possibly related and unlikely related.

**Definition:**Identifies why the dispense event was not completed

**Definition:**A collection of concepts that indicates the reason for a "bulk supply" of medication.

**Definition:**Indicates why the request to transfer a prescription from one dispensing facility to another has been refused.

Identifies the reason why a request for a prescription renewal has been refused.

Identifies physical characteristics that may be observed for a particular medicinal product or medicinal product package of types thereof.

Examples:

* Height * Imprint * Shape * Color

A physical place or site with its containing structure. May be natural or man-made. The geographic position of a place may or may not be constant.

Examples:dam; city; state.

Observation types for specifying criteria used to assert that a subject is included in a particular population.

Examples:

* denominator * numerator * initial population

\*\*\*\* MISSING DEFINITIONS \*\*\*\*

A relationship between two people in which one person authorizes another to act for him in a manner which is a legally binding upon the person giving such authority as if he or she personally were to do the acts.

Defines types of certifications for practitioners

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

Values that indicate how important a preference is to the target of the reporter.

Examples:

* Very Important * Important * Suggested

A "helper" vocabulary used to construct complex query filters based on how and whether a prescription has been dispensed.

Observations specific to a particular prescription to express concepts that cannot be expressed via other modeling approaches.

Examples:"Patient Medication On Hand Quantity", "Patient Medication On Hand Days Supply", "Patient Expected Supply Run-out Date", "Percentage Dispensed".

\*\*\*\* MISSING DEFINITIONS \*\*\*\*

**Description:**A concept whose description/definition provides additional detail about the means or technique used for the procedure.

Examples:

* neuromuscular reeducation * functional activity * Laparoscopic Gastric Bypass Roux-en-Y

This attribute defines whether the message is part of a production, training, or debugging system.

This attribute defines whether the message is being sent in current processing, archive mode, initial load mode, restore from archive mode, etc.

A code that characterizes the role that the primary reporter felt that the suspect intervention -- either a substance administration or a device related procedure - played in the incident being reported. This code will capture the primary reporter's assessment of the role that the suspect product played in the incident reported in the ICSR.

Examples include: Suspect, Concomitant, Interacting, Re-challenge.

An identifying data string for healthcare products.

Example code sets include Healthcare Common Procedure Coding System (HCPCS) and Universal Product Code (UPC).

Description:A type of substance that is used as an ingredient within a product.Examples:

* Morphine * wheat germ * calcium

A code specifying a type of responsibility that an entity may take on with respect the lifecycle of a product.

Examples:

* Manufacturer * Distributor * Retailer

Description:Indicates the role that an organization takes in the process by which a product goes from an original manufacturer to the eventual consumer.

**Examples:**Manufacturer, re-processor

**Note:**These two values are currently used in adverse event and product problem reporting.

Description:Provides the description of the role of a place in terms of its provision of services and functions in the product regulatory domain.Examples:

* pharmacovigilance masterfile location * COSHH (Control of Substances Hazardous to Health) masterfile location * regulatory dossier storage location * batch release masterfile location

**Description:**Concepts characterizing product related roles.

**Description:**Captures the different roles that are recorded to characterize the qualifications or stations in life of persons or organizations who participate as senders or as receivers of adverse event or product problem reports.

**Example:**Example values may include: physician, healthcare facility, attorney, family member, regulatory agency. Initial effort to find defined concepts for this value set will focus on the HIPAA provider taxonomy.

A role type, which indicates the type of device that authors or in some manner contributes to the generation, management, and/or transmission of health information, the use of which may be tracked for purposes of determining the provenance of health information. The playing device acts or is authorized to act on behalf of a scoping entity..

Examples:

* Patient selected home monitoring device e.g., to detect and report falls * Provider selected medication adherence monitoring, reporting, and alerting device * Provider designated EKG measuring and reporting device

A role type, which indicates the type of device that in some manner contributes to the generation, management, and/or transmission of health information, the use of which may be tracked for purposes of determining the provenance of health information. The playing device is passive in these roles in the sense that the device is not authorized to act on behalf of a scoping entity.

Examples:

* Software that aggregates pre-existing content to facilitate the authorship of a new artifact by an assigned entity * Software that translates pre-existing content to facilitate the management of that content by an assigned entity * Software that transmits content to facilitate the exchange of that content by an assigned entity * Privacy protective software that facilitates privacy protection and security enforcement by filtering health information and applying protections such as de-identification, masking, or redaction, and privacy marking.

Healthcare Provider Taxonomy Codes

Description:The PublicHealthCaseObservationValue is used to identify the primary condition or disease associated with a Public Health Case.. This concept domain is intended to be used with the CASE Act class code and the ObservationInvestigationType ActCode concept domain.Examples:

* Tuberculosis * Lyme Disease * SARS * Lung Cancer

Description:A category to which a person can be assigned on the basis of professional qualification, experience, and/or job assignment.Examples:

* Physician * Registered Nurse * Product Quality Manager

The domain of coded values used as parameters within QueryByParameter queries.

Identifies the time frame in which the response is expected.

Defines the units associated with the magnitude of the maximum size limit of a query response that can be accepted by the requesting application

Values in this domain allow a query response system to return a precise response status.

State attributes for Query event

In the United States, federal standards for classifying data on race determine the categories used by federal agencies and exert a strong influence on categorization by state and local agencies and private sector organizations. The federal standards do not conceptually define race, and they recognize the absence of an anthropological or scientific basis for racial classification. Instead, the federal standards acknowledge that race is a social-political construct in which an individual's own identification with one more race categories is preferred to observer identification. The standards use a variety of features to define five minimum race categories. Among these features are descent from "the original peoples" of a specified region or nation. The minimum race categories are American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander, and White. The federal standards stipulate that race data need not be limited to the five minimum categories, but any expansion must be collapsible to those categories.

OpenIssue:This concept domain definition does not align with current vocabulary practices and is much too US-centric to be appropriate as a "universal" domain.

Interpretations of the presence and level of reactivity of the specified component / analyte with the reagent in the performed laboratory test.

Description:All binding realms allowed for linking concept domains to value sets.

Code assigned to indicate the rationale for not performing an evaluation investigation on a device for which a defect has been reported.

Examples include: device received in a condition that made analysis impossible, device evaluation anticipated but not yet begun, device not made by company.

The reason a referral was made.

*Examples:*Specialized Medical Assistance, Other Care Requirements.

Description:Identifies why a request to add (or activate) a record is being refused. Examples include the receiving system not able to match the identifier and find that record in the receiving system, having no permission, or a detected issue exists which precludes the requested action.

**Description:**Codes that further characterize a regulated product role. Used only with the RGPR (regulated product) role classCode.

Example:Regulated drug and regulated device.
Description:A rule set by regulators of product that somehow constrain the use of products. Regulator may be any organization with a mandate to issue such rules, regardless of level, regional, country, state, and local (e.g., an institutional Pharmaceutical and Treatment Committee.)Examples:

* Prescription Only * Controlled Substance Schedule II * Standard of Practice

Provides coded names for attribute RelationalExpression.elementName, which has data type SC.

Identifies common relational operators used in selection criteria.

A code specifying the logical conjunction of the criteria among all the condition-links of Acts (e.g., and, or, exclusive-or.)

Constraints:All AND criteria must be true. If OR and AND criteria occur together, one criterion out of the OR-group must be true and all AND criteria must be true also. If XOR criteria occur together with OR and AND criteria, exactly one of the XOR criteria must be true, and at least one of the OR criteria and all AND criteria must be true. In other words, the sets of AND, OR, and XOR criteria are in turn combined by a logical AND operator (all AND criteria and at least one OR criterion and exactly one XOR criterion.) To overcome this ordering, Act criteria can be nested in any way necessary.

Assigment of spiritual faith affiliation

Description:Different types of research studies that may be conducted and reported on.Examples:

* Observational * Investigational

Specifies the administrative functionality within a formal experimental design for which the ResearchSubject role was established. Examples: screening - role is used for pre-enrollment evaluation portion of the design; enrolled - role is used for subjects admitted to the active treatment portion of the design.

Codes to characterize a Resource Group using categories that typify its membership and/or function

.

Example:PractitionerGroup

Specifies whether a response is expected from the addressee of this interaction and what level of detail that response should include

Defines the timing and grouping of the response instances.

Specifies the mode, immediate versus deferred or queued, by which a receiver should communicate its receiver responsibilities.

The role played by a party who has legal responsibility for another party.

**Description:**Codes that further characterize the association of a material playing the role of a retailed material to the scoper which retails the material. Used only with the RET (retailed material) role classCode.

Examples:Department store, Self-service and Online.

Type of material that provides access to another entity.

This table includes codes for the Role class hierarchy. The values in this hierarchy, represent a Role which is an association or relationship between two entities - the entity that plays the role and the entity that scopes the role. Roles names are derived from the name of the playing entity in that role.

The role hierarchy stems from three core concepts, or abstract domains:

* **RoleClassOntological** is an abstract domain that collects roles in which the playing entity is defined or specified by the scoping entity. * **RoleClassPartitive** collects roles in which the playing entity is in some sense a "part" of the scoping entity. * **RoleClassAssociative** collects all of the remaining forms of association between the playing entity and the scoping entity. This set of roles is further partitioned between: * **RoleClassPassive** which are roles in which the playing entity is used, known, treated, handled, built, or destroyed, etc. under the auspices of the scoping entity. The playing entity is passive in these roles in that the role exists without an agreement from the playing entity. * **RoleClassMutualRelationship** which are relationships based on mutual behavior of the two entities. The basis of these relationship may be formal agreements or they may be *de facto* behavior. Thus, this sub-domain is further divided into: * **RoleClassRelationshipFormal** in which the relationship is formally defined, frequently by a contract or agreement. * **Personal relationship** which inks two people in a personal relationship.

The hierarchy discussed above is represented In the current vocabulary tables as a set of abstract domains, with the exception of the "Personal relationship" which is a leaf concept.

Specific classification codes for further qualifying RoleClass codes.

**Description:**The status of an instance of the RIM RoleLink class.

Constraint:It is intended to be used based on usage of the ParticipationType concept domain.Examples:

* Active * No longer active * Nullified

A code specifying the kind of connection represented by this RoleLink, e.g., has-part, has-authority.

The status of an instance of the RIM Role class.

**Description:**This describes which path the administered medication takes to get into the body or into contact with the body and constitutes part of thewhere(the other part being site - see below). It is theway inor the course the medication must take to get to its destination.

Note that a path is in no sense a description of a *final destination*; it is a stylized description of the path taken. For example, an oral antibiotic may be used to treat a severe infection on a toe; the oral route is used to get the medicine to be able to reach and treat the infection in the toe. For some specific routes of administration there may be an incidental sense of *final destination*, for example an ocular administration usually occurs when treatment of an eye condition is required. However, this is in no sense definitional: rectal administration of a medicine may be for a local effect (a steroid foam for treatment of colitis) or for a systemic effect (metronidazole for treatment of infection). The route of administration of a medicine should only be a description of the path taken and not the form.

Examples:

* oral * rectal * intravenous (IV) * subcutaneous (SC) * intramuscular (IM)

Description:Possible reasons generating a report providing information developed during the investigation of an adverse event or a product problem.Examples:

* Correction * Additional information/Follow-up * Response to regulatory agency request

Type of security metadata observation made about the alteration integrity of an altered IT resource (data, information object, service, or system capability), which indicates the mechanism used for authorized transformation of the resource.

Examples:Types of security alteration integrity observation metadata, which may value the observation with a code used to indicate the mechanism used for authorized transformation of an IT resource, include:

* translation * syntactic transformation * semantic mapping * redaction * masking * pseudonymization * anonymization

Usage Note:SecurityAlterationIntegrityObservationType concept domain designates a code system used to name a security label field type that may be valued with a "security label tag" such as a code from the security label tag set "SecurityAlterationIntegrityObservationValue" value set, which convey the mechanism used for authorized transformation of an IT resource.

Security observation values used to indicate security alteration integrity metadata.

Examples:Codes conveying the mechanisms used to make authorized alteration of an IT resource, such as:

* translation * masking * anonymization

Usage Note:SecurityAlterationIntegrityObservationValue codes are members of a security label "tag set" used to populate or "tag" a security label field named by the associated SecurityAlterationIntegrityObservationType code. \[FIPS 188\]

Type of security metadata observation made about the category of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security category metadata is defined by ISO/IEC 2382-8:1998(E/F)/ T-REC-X.812-1995 as: "A nonhierarchical grouping of sensitive information used to control access to data more finely than with hierarchical security classification alone."

Rationale:A security category observation supports the requirement to specify the type of IT resource in order to facilitate application of appropriate levels of security according to a range of levels of impact or consequences that might result form the unauthorized disclosure, modification, or use of the information or information system. A resource is assigned to a specific category of information (e.g., privacy, medical, proprietary, financial, investigative, contractor sensitive, security management) defined by an organization or in some instances, by a specific law, Executive Order, directive, policy, or regulation. \[FIPS 188\]Examples:Types of security categories include:

* Compartment: A division of data into isolated blocks with separate security controls for the purpose of reducing risk. (ISO 2382-8). Security label metadata that "segments" an IT resource by indicating that access and use is restricted to members of a defined community or project. (HL7 Healthcare Classification System) * Sensitivity: The characteristic of a resource which implies its value or importance and may include its vulnerability. (ISO 7492-2) Privacy metadata for information perceived as undesirable to share. (HL7 Healthcare Classification System)

Usage Note:SecurityCategoryObservationType concept domain designates a code system used to name a security label field type that may be valued with a "security label tag" such as a code from the security label tage set "SecurityCategoryObservatonValue" value set.

Codes may be drawn from the union of the following value sets: V:PrivacyPolicyType, V:ActPrivacyLaw, V:ActConsentDirective, V:InformationSensitivityPolicy, V:ActInformationSensitivityPolicy, V:RoleInformationSensitivityPolicy, EntitySensitivityPolicy, and V:ActConsentType. Could be bound R1 to a V:ActUSPrivacyPolicy in a future US Realm.

Security observation values used to indicate security category metadata.

Examples:Codes conveying the category of an IT resource such as:

* applicable privacy policy * sensitivity * consent directive type

Usage Note:SecurityCategoryObservationValue codes are members of a security label "tag set" used to populate or "tag" a security label field named by the associated SecurityCategoryObservationType code. \[FIPS 188\]

Type of security metadata observation made about the classification of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security classification is defined by ISO/IEC 2382-8:1998(E/F)/ T-REC-X.812-1995 as: "The determination of which specific degree of protection against access the data or information requires, together with a designation of that degree of protection." Security classification metadata is based on an analysis of applicable policies and the risk of harm to an individual that could result from unauthorized disclosure.

Examples:Types of security classification include: HL7 Confidentiality Codes such as very restricted, unrestricted, and normal. Intelligence community examples include top secret, security, and confidential.Usage Note:SecurityClassificationObservationType concept domain designates a code system used to name a security label field type that may be valued with a "security label tag" such as a code from the security label tag set "SecurityClassificationObservationValue" value set.

Note that an Act or Role may be associated with an Observation coded as SecurityClassificationObservationType with a SecurityClassificationObservationValue coded with a confidentiality code from V:Confidentiality Code to indicate that the confidentiality level indicated by an Act or Role confidentiality attribute has been overridden by the entity responsible for assigning the SecurityClassificationObservationValue. This supports the business requirement for increasing or decreasing the level of confidentiality (classification or declassification) based on parameters beyond the original assignment of an Act or Role confidentiality.

Security observation values used to indicate security classification metadata.

Examples:Codes conveying the classification of an IT resource, such as confidentiality codes.Usage Note:SecurityClassificationObservationValue codes are members of a security label "tag set" used to populate or "tag" a security label field named by the associated SecurityClassificationObservationType code. \[FIPS 188\]

Type of security metadata observation made about the control of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security control metadata convey instructions to users and receivers for secure distribution, transmission,and storage; dictate obligations or mandated actions; specify any action prohibited by refrain policy such as dissemination controls; and stipulate the permissible purpose of use of an IT resource.

Examples:Types of security control metadata include handling:

* caveats * dissemination controls * obligations * refrain policies * purpose of use constraints

Usage Note:SecurityControlObservationType concept domain designates a code system used to name a security label field type that may be valued with a "security label tag" such as a code from the security label tag set "SecurityControlObservationValue" value set. Codes may be drawn from the union of the following value sets: V:SecurityPolicy, V:ObligationiPolicy, V:RefrainPolicy, V:PurposeOfUse, and V:GeneralPurposeOfUse.

Security observation values used to indicate security control metadata.

Examples:Codes conveying dissemination controls, handling caveats, purpose of use, and obligations to which an IT resource custodian or receiver must comply.Usage Note:SecurityControlObservationValue codes are members of a security label "tag set" used to populate or "tag" a security label field named by the associated SecurityControlObservationType code. \[FIPS 188\]

Type of security metadata observation made about the data integrity of an IT resource (data, information object, service, or system capability), which indicates the security mechanism used to preserve resource accuracy and consistency. Data integrity is defined by ISO 22600-23.3.21 as: "The property that data has not been altered or destroyed in an unauthorized manner", and by ISO/IEC 2382-8: "The property of data whose accuracy and consistency are preserved regardless of changes made."

Rationale:In accordance with the HL7 RM-ES EHR-FM Profile Standard: The validity of a patient record entry requires an indelible statement (e.g., attestation or electronic signature) by the author(s) of completeness, accuracy, and affirmation that the record cannot be repudiated, assigning each author to his/her actual contributed content.Examples:Types of security data integrity observation metadata, which may value the observation, include:

* cryptographic hash function * digital signature

Usage Note:SecurityDataIntegrityObservationType concept domain designates a code system used to name a security label field type that may be valued with a "security label tag" such as a code from the security label tag set "SecurityIntegrityConfidenceObservationValue" value set.

Security observation values used to indicate security data integrity metadata.

Examples:Codes conveying the mechanisms used to preserve the accuracy and consistency of an IT resource such as:

* a digital signature * a cryptographic hash function

Usage Note:SecurityDataIntegrityObservationValue codes are members of a security label "tag set" used to populate or "tag" a security label field named by the associated SecurityDataIntegrityObservationType code. \[FIPS 188\]

Type of security metadata observation made about the integrity confidence of an IT resource (data, information object,service, or system capability) that indicates the reliability or trustworthiness of a resource, which may be used to make access control decisions.

Examples:Types of security integrity confidence observation metadata, which may value the observation, include:

* highly reliable * uncertain reliability * not reliable

Usage Note:A security integrity confidence observation on an Act may indicated that a valued Act.uncertainty attribute has been overridden by the entity responsible for assigning the SecurityIntegrityConfidenceObservationValue. This supports the business requirements for increasing or decreasing the assessment of the reliability or trustworthiness of an IT resource based on parameters beyond the original assignment of an Act.uncertaintyCode.

Security observation values used to indicate security integrity confidence metadata.

Examples:Codes conveying the level of veracity, reliability, and trustworthiness of an IT resource.Usage Note:Codes conveying the level of veracity, reliability, and trustworthiness of an IT resource.

Type of security metadata observation made about the integrity of an IT resource (data, information object,service, or system capability), which may be used to make access control decisions.

Rationale:Integrity security label fields support integrity models such as the Biba Integrity Model, the Lipner Full Integrity Model, and the Clar-Wilson Model. The value in the integrity label field indicates the degree of confidence that may be placed in the data and also indicates which measures the data requires for protection from modification and destruction.Examples:Types of security integrity observation metadata, which may value the observation include:

* Integrity status, which indicates the completeness or workflow status of a resource (data, information object, service, or system capability); * Integrity confidence, which indicates the reliability and trustworthiness of the resource; * Integrity control, which indicates pertinent handling caveats, obligations, refrain policies, and purpose of use for the resource; * Data integrity, which indicate the security mechanisms used to ensure that the accuracy and consistency are preserved regardless of changes made (ISO/IEC DIS 2382-8); * Alteration integrity, which indicate the security mechanisms used for authorized transformations of the resource; * Integrity provenance, which indicates the second-hand origins of a reported or asserted resource.

Usage Note:SecurityIntegrityObservationType concept domain designates a code system used to name a security label field type that may be valued with a "security label tag" such as a code from the security label tag set "SecurityIntegrityObservationValue" value set.

Security observation values used to indicate security integrity metadata.

Examples:Codes conveying an IT resource:

* veracity * reliability * trustworthiness * provenance

Usage Note:SecurityIntegrityObservationValue codes are members of a security label "tag set" used to populate or "tag" a security label field named by the associated SecurityIntegrityObservationType code. \[FIPS 188\]

Type of security metadata observation made about the provenance integrity of an IT resource (data, information object, service, or system capability), which indicates the entity responsible for an assertion relayed "second-hand" about an IT resource.

Rationale:In accordance with HL7 RM-ES EHR-FM Profile at IN:1.8: If more than one author contributed to the EHR content, then the system shall provide the ability to associate and maintain all authors/contributors with their content.Examples:Types of security integrity provenance asserted by observation metadata, which may value the observation, include assertions about an IT resource by a patient, a clinician, or a device.Usage Note:SecurityIntegrityProvenanceAssertedByObservationType concept domain designates a code system used to name a security label field type that may be valued with a "security label tag" such as a code from the security label tag set "SecurityIntegrityProvenanceAssertedByObservationValue" value set.

Security observation values used to indicate security integrity provenance asserted by metadata.

Examples:Codes conveying the provenance metadata about the entity asserting an IT resource.Usage Note:SecurityIntegrityProvenanceAssertedByObservationValue codes are members of a security label "tag set" used to populate or "tag" a security label field named by the associated SecurityIntegrityProvenanceAssertedByObservationType code. \[FIPS 188\]

Type of security metadata observation made about the provenance integrity of an IT resource (data, information object, service, or system capability), which indicates the lifecycle completeness and workflow status of an IT resource, such as create, modify, append, amend, suspend, archive, and delete; locations in which the resource has been collected or archived, from which it may be retrieved, and the history of its distribution and disclosure. Integrity provenance metadata about an IT resource may be used to assess its veracity, reliability, and trustworthiness.

Examples:Types of security integrity provenance observation metadata, which may value the observation with a code used to indicate provenance, include the entity responsible for a report or assertion relayed "second-hand" about an IT resource.Usage Note:SecurityIntegrityProvenanceObservationType concept domain designates a code system used to name a security label field type that may be valued with a "security label tag" such as a code from the security label tag set "SecurityIntegrityProvenanceObservationValue" value set.

Security observation values used to indicate security alteration integrity metadata.

Examples:Codes conveying the provenance of an IT resource such as the entity responsible for a report or assertion relayed "second-hand" about an IT resource.Usage Note:SecurityIntegrityProvenanceObservationValue codes are members of a security label "tag set" used to populate or "tag" a security label field named by the associated SecurityIntegrityProvenanceObservationType code. \[FIPS 188\]

Type of security metadata observation made about the provenance integrity of an IT resource (data, information object, service, or system capability), which indicates the entity responsible for a report relayed "second-hand" about an IT resource.

Rationale:In accordance with HL7 RM-ES EHR-FM Profile at IN:1.8: If more than one author contributed to the EHR content, then the system shall provide the ability to associate and maintain all authors/contributors with their content.Examples:Types of security integrity provenance observation metadata, which may value the observation with a code used to indicate provenance, include reports about an IT resource by a patient, a clinician, or a device.Usage Note:SecurityIntegrityProvenanceReportedByObservationType concept domain designates a code system used to name a security label field type that may be valued with a "security label tag" such as a code from the security label tag set "SecurityIntegrityProvenanceReportedByObservationValue" value set.

Security observation values used to indicate security integrity provenance reported by metadata.

Examples:Codes conveying the provenance metadata about the entity reporting an IT resource.Usage Note:SecurityIntegrityProvenanceReportedByObservationValue codes are members of a security label "tag set" used to populate or "tag" a security label field named by the associated SecurityIntegrityProvenanceReportedByObservationType code. \[FIPS 188\]

Type of security metadata observation made about the integrity status of an IT resource (data, information object,service, or system capability), which may be used to make access control decisions. Indicates the completeness or workflow status of an IT resource, which may impact which users that are authorized to access and use the resource.

Rationale:In accordance with the HL7 RM-ES Profile Standard: The validity of a patient record entry requires an indelible statement (e.g., attestation or electronic signature) by the author(s) of completeness, accuracy, and affirmation that the record cannot be repudiated, assigning each author to his/her actual contributed content.Examples:Types of security integrity status observation metadata, which may value the observation, include codes from the HL7 DocumentCompletion value set such as:

* legally authenticated * in progress * incomplete

Usage Note:SecurityIntegrityStatusObservationType concept domain designates a code system used to name a security label field type that may be valued with a "security label tag" such as a code from the security label tag set "SecurityIntegrityStatusObservationValue" concept domain, which may be valued with coded concepts from the HL7 DocumentCompletion value set.

Security observation values used to indicate security integrity status metadata.

Examples:Codes conveying the completeness of an IT resource in terms of workflow status such as:

* authenticated * legally authenticated * in progress

Usage Note:SecurityIntegrityStatusObservationValue codes are members of a security label "tag set" used to populate or "tag" a security label field named by the associated SecurityIntegrityStatusObservationType code. \[FIPS 188\]

Type of security metadata observation made about an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security metadata are used in security labels.

Rationale:According to ISO/TS 22600-3:2009(E) A.9.1.7 SECURITY LABEL MATCHING, Security label matching compares the initiatorÃs clearance to the targetÃs security label. All of the following must be true for authorization to be granted:

* The security policy identifiers shall be identical, * The classification level of the initiator shall be greater than or equal to that of the target (that is, there shall be at least one value in the classification list of the clearance greater than or equal to the classification of the target), and * For each security category in the target label, there shall be a security category of the same type in the initiatorÃs clearance and the initiatorÃs classification level shall dominate that of the target.

Usage Note:SecurityObservationType concept domain designates a code system used to name a security label field type that may be valued with a "security label tag" such as a code from the securty label tag set "SecurityObservationValue" value set.

Observation values used to indicate security observation metadata.

Examples:

* Codes conveying the classification of an IT resource, such as confidentiality codes * Codes conveying privacy law, sensitivity, and consent directive types governing an IT resource * Codes conveying dissemination controls, handling caveats, purpose of use, refrain policies, and obligations to which an IT resource custodian or receiver must comply. * Codes conveying an IT resource completeness, veracity, reliability, trustworthiness, and provenance * Codes conveying the mechanism used to preserve the accuracy and consistency of an IT resource such as a digital signature and a cryptographic hash function * Codes conveying the mechanism used to make authorized alterations of an IT resource, such as translation, masking, and anonymization

Usage Note:SecurityObservationValue codes are members of a security label "tag set" used to populate or "tag" a security label field named by the associated SecurityObservationType code. \[FIPS 188\]

Type of security metadata observation made about the formal declaration by an authority or neutral third party that validates the technical, security, trust, and business practice conformance of Trust Agents to facilitate security, interoperability, and trust among participants within a security domain or trust framework.

Values for security metadata observation made about the formal declaration by an authority or neutral third party that validates the technical, security, trust, and business practice conformance of Trust Agents to facilitate security, interoperability, and trust among participants within a security domain or trust framework.

For example, DirectTrust, Kantara Initiative, Open Identity

Type of security metadata observation made about security requirements for a security domain. \[ISO IEC 10181-1\]

Values for security metadata observation made about security requirements with which a security domain must comply. \[ISO IEC 10181-1\] Conveys the agreement of an asserter to comply with jurisdictional, community, or contractual (security domains) codes of conduct which an information custodian requires as a condition of authorizing collection, access, use or disclosure.

For example, DURSA, DIRECT Applicability Statement, HIPAA Covered Entity and Business Associate Agreement, and FTC PHR Vendor, Related Entity, and third party agreements.

Type of security metadata observation made about the digital quality or reliability of a trust assertion, activity, capability, information exchange, mechanism, process, or protocol.

Values for security metadata observation made about the digital quality or reliability of a trust assertion, activity, capability, information exchange, mechanism, process, or protocol.

For example, authentication, identity proofing, and non-repudiation level of assurance.

Type of security metadata observation made about a set of security-relevant data issued by a security authority or trusted third party, together with security information which is used to provide the integrity and data origin authentication services for an IT resource (data, information object, service, or system capability). \[Based on ISO IEC 10181-1\]

Values for security metadata observation made about a set of security-relevant data issued by a security authority or trusted third party, together with security information which is used to provide the integrity and data origin authentication services for an IT resource (data, information object, service, or system capability). \[Based on ISO IEC 10181-1\]

For example, a single use certificate, dual use certificate, digital signature certificate.

Type of security metadata observation made about a complete set of contracts, regulations, or commitments that enable participating actors to rely on certain assertions by other actors to fulfill their information security requirements. \[Kantara Initiative\]

Values for security metadata observation made about a complete set of contracts, regulations or commitments that enable participating actors to rely on certain assertions by other actors to fulfill their information security requirements. \[Kantara Initiative\]

For example, FICAM, DirectTrust, and HITRUST.

Type of security metadata observation made about a security architecture system component that supports enforcement of security policies.

Values for security metadata observation made about a security architecture system component that supports enforcement of security policies.

For example, Digital signature, authorization scheme, and certificate token.

Type of security metadata observation made about aspects of trust applicable to an IT resource (data, information object, service, or system capability). Trust applicable to IT resources is established and maintained in and among security domains, and may be comprised of observations about the domain's trust authority, trust framework, trust policy, trust interaction rules, means for assessing and monitoring adherence to trust policies, mechanisms that enforce trust, and quality and reliability measures of assurance in those mechanisms. \[Based on ISO IEC 10181-1 and NIST SP 800-63-2\]

Usage Note:SecurityTrustObservationType may be used as a trust attribute in a computable trust policy, trust credential, trust assertion, or trust label field in a security label and populated with trust observation values. The valued trust attributes may be used for used for authentication, authorization, and access control decisions. These may also be used to negotiate trust relationships, adjudicate or bridge trust policies, and to specify requirements for participation in a Trust Domain or for asserting compliance with a Trust Framework.

Observation value used to indicate aspects of trust policy applicable to an IT resource (data, information object, service, or system capability).

For example, applicable trust framework, policy, or mechanisms.

Usage Note:Security trust metadata values may be used as the trust attribute value populating a computable trust policy, trust credential, trust assertion, or trust label field in a security label and principally used for authentication, authorization, and access control decisions.

SecurityTrustObservationValue may be used as a trust attribute value populating a computable trust policy, trust credential, trust assertion, or trust label field in a security label with trust observation values. The valued trust attributes may be used for used for authentication, authorization, and access control decisions. These may also be used to negotiate trust relationships, adjudicate or bridge trust policies, and to specify requirements for participation in a Trust Domain or for asserting compliance with a Trust Framework.

DESCRIPTION:

Specifies direction of sort.

Examples:

* Ascending * Descending * None

\*\*\*\* MISSING DEFINITIONS \*\*\*\*

Categorization of types of observation that capture the interpretation of the result of a laboratory test in terms of normality.

Description:An indication of the seriousness of the subject's condition or issue.Examples:

* Mild * Moderate * Severe

Description:Represents the components of a measured clinical observation.Examples:

* the systolic and diastolic components of a blood pressure * 24-hour urine output * ARAC gene

Types of measurement observations typically performed in a clinical (non-lab) setting. E.g. Height, Weight, Blood-pressure

OpenIssue:This concept domain should be reviewed to determine whether it needs a "ConceptualSpaceForClassCode" property to link to a RIM classCode.

Provides coded names for attribute Device.softwareName, which has data type SC.

A code indicating the type of special arrangements provided for a patient encounter (e.g., wheelchair, stretcher, interpreter, attendant, seeing eye dog). For encounters in intention moods, this information can be used to identify special arrangements that will need to be made for the incoming patient.

**Definition:**Materials introduced to a specimen. These additives may be introduced in order to preserve, maintain or enhance the particular nature or component of the specimen.

Examples:

* Ammonium heparin * Boric Acid * Phenol

Description:A specimen is defined as a physical entity that is an individual, a group, an item, or a part representative of a larger group, class or whole that is the target of an observation or analysis for the purpose of drawing conclusions about the group, class, or whole. This can be used to code a component of the specimen that the observation diagnosis relates to. Note that any physical entity in the universe has the potential to become a specimen.Examples:

* Blood * Water * Animal cadaver

Description:A role by which one can communicate additional identifiers for a specimen.Examples:

* specimen identifier * accession identifier * container identifier

Description:Trigger events associated with specimen process steps.Examples:

* Specimen process step activate * Specimen process step complete * Specimen process step abort

Description:Further classifies the types of specimen roles.Examples:Examples include Quality control specimens, grouped specimens and patient specimens. Definition:Set of codes indicating the manner in which sponsors participate in a policy or program. NOTE: use only when the Sponsor is not further specified with a SponsorRoleType as being either a fully insured sponsor or a self insured sponsor.

Indicates why the act revision (status update) is being refused.

Type of role attendance the covered party has at a recognized educational institution as defined by a particular insurance policy.

(abstract) Used within an instance to give the author some control over various aspects of rendering

Contains codes for defining the observed, physical position of a subject, such as during an observation, assessment, collection of a specimen, etc. ECG waveforms and vital signs, such as blood pressure, are two examples where a general, observed position typically needs to be noted.

The spatial relationship of a subject whether human, other animal, or plant, to a frame of reference such as gravity or a collection device.

A code to capture the kind of reaction that was suffered by the investigated subject, and that is being reported in the ICSR. At this point, SNOMED or MedDRA have been suggested as code systems to be used for providing this information.

Example concepts include hives, swelling, rash, anaphylactic shock.

Code that captures the emphasis that the reporter placed on this reaction.

Examples include: highlighted by the reporter, NOT serious, Not highlighted by the reporter, NOT serious, Highlighted by the reporter, SERIOUS, Not highlighted by the reporter, SERIOUS.

Code that captures the type of outcome from an individual outcome of a reaction to the suspect product reported in the ICSR.

Examples include: Recovered/resolved. Recovering/resolving, Not recovered/not resolved, Recovered/resolved with sequelae, Fatal.

Reasons why substitution of a substance administration request is not permitted.

Indicates the reason for substitution when substitution occurs, or reason for non-substitution when substitution is expected.

Indicates the reason for non-substitution when substitution was expected.

Examples:

* prescriber request * patient request * continuing therapy (where this latter means that the prescribed item was not substituted, even though "policy" implied it should be, so as not to change from the item that the patient had previously received)

Indicates the reason for substitution when substitution has occurred.

Examples:

* formulary policy * regulatory requirement * out of stock (where this latter means that the prescribed item was out of stock and an equivalent product was substituted)

**Definition:**Indicates why the requested authorization to prescribe or dispense a medication has been refused.

Distinguishing traits, qualities, or properties given about substances, including chemical structure (as encapsulated data in SMILES, MolFile, InChi), nucleic acid sequence, amino acid sequence, molecular sum formula; molecular mass; stereochemistry and optical activity properties; viscosity; pH, pKa, catalytic activity, etc.

Identifies what sort of change is permitted or has occurred between the item that was ordered/requested and the one that was/will be provided.

Indicates why the prescription should no longer be allowed to be dispensed (but can still administer what already has been dispensed).

UsageNote:This is typically used in the scenario where the prescription allows for repeats or refills.

**Description:**Ensures consistent coding of the susceptibility battery or panel.

Examples:

* Bacterial susceptibility panel * Fungal susceptibility panel * Mycobacterial susceptibility panel * Viral susceptibility panel

Description: Examples:

* Disk Diffusion (Kirby-Bauer) * Minimum Inhibitory Concentration * Viral Genotype Susceptibility * Gradient Strip (E-Strip)

**Description:**Ensures consistent coding of antimicrobial information in the Microbiology lab message.

Examples:

* Ciprofloxacin; Disk Diffusion (Kirby-Bauer) * Vancomycin * Tetracycline; Minimum Inhibitory Concentration

**Description:**Used to code and identify the Susceptibility Observation result value when a coded result is reported.

Examples:

* Susceptible * Resistant * Moderately susceptible

Indicates an observed abnormality in the patientaTMs condition, but does not assert causation. E.g. Runny nose, swelling, flaky skin, etc.

These values are defined within the XHTML 4.0 Table Model

These values are defined within the XHTML 4.0 Table Model

These values are defined within the XHTML 4.0 Table Model

These values are defined within the XHTML 4.0 Table Model

These values are defined within the XHTML 4.0 Table Model

A code specifying the extent to which the Entity playing the participating Role (usually as a target Participation) is aware of the associated Act.

Examples:For diagnostic observations, is the patient, family member or other participant aware of his terminal illness?Discussion:If the awareness, denial, unconsciousness, etc. is the subject of medical considerations (e.g., part of the problem list), one should use explicit observations in these matters as well, and should not solely rely on this simple attribute in the Participation.

\*\*\*\* MISSING DEFINITIONS \*\*\*\*

Description:Concepts that define the telecommunication capabilities of a particular device. Used to identify the expected capabilities to be found at a particular telecommunication address. Description:Concepts which further characterizing the type of territorial authority. Used only with the TERR (territorial authority) role classCode.Example:public health authority, judicial authority and national authority. Description:A territorial entity that may be cited as the body over which an agency exercises jurisdiction, or which defines a sphere in which a party has a particular responsibility.Examples:

* United States * New York * European Union

**Description:**Codes that further characterize the Theraputic Agent as a manufactured product. Used only with the THER (therapeutic agent) role classCode.

Examples:Generic and Brand name.

\*\*\*\* MISSING DEFINITIONS \*\*\*\*

A codes specifying the meaning and purpose of every TransmissionRelationship instance. Each of the values implies specific constraints to what kinds of Transmission objects can be related and in which way.

This element was deprecated as of the release indicated.

**Description:**A code specifying the meaning and purpose of every TransmissionRelationship instance. Each of its values implies specific constraints to what kinds of Transmission objects can be related and in which way.

Description:Trigger Event ID as published in the standard.Deprecation Comment:This Domain has been deprecated as the Domain HL7TriggerEventCode is being used instead, along with its subDomains. Please update designs that refer to this Domain and instead refer to the appropriate Domain in the HL7TriggerEventCode hierarchy.

This element was deprecated as of the release indicated.

A Universal Resource Locator (URL) is a type of telecommunications address specified as Internet standard RFC 1738 \[http://www.isi.edu/in-notes/rfc1738.txt\]. The URL specifies the protocol and the contact point defined by that protocol for the resource.

Definition:Set of codes indicating the manner in which underwriters participate in a policy or program.

\*\*\*\* MISSING DEFINITIONS \*\*\*\*

Description:Identifies why a request to update to a record is being refused. Examples include the receiving system not able to match the identifier and find that record in the receiving system, having no permission, or a detected issue exists which precludes the requested action.

The manufacturer of a vaccine.

Types of manufactured material that when administered are intended to confer protection against specific disease(s).

\*\*\*\* MISSING DEFINITIONS \*\*\*\*

Values for observations of verification act results

Examples:Verified, not verified, verified with warning.

**Description:**A role type that is used to further qualify an entity playing a role where the role is that of a vision product such as lenses, frames, etc.

**Description:**Codes that further characterize a warranted product role. Used only with the WRTE (warranted product) role classCode.

Example:Express warranty, Implied Warranty and Lifetime Warranty.

Five character alphabetic codes fit into current claims processing software or onto standard paper claim forms. ABC Codes give business parity to licensed CAM and nurse providers who file claims to insurance companies. .

UPDATE:

The codes identify the conditions under which accept acknowledgements are required to be returned in response to this message. Note that accept acknowledgement address two different issues at the same time: reliable transport as well as syntactical correctness

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired..

Always send an acknowledgement.

Send an acknowledgement for error/reject conditions only.

Never send an acknowledgement.

Send an acknowledgement for successful completions only.

UPDATE:

*OpenIssue:*Missing description.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired..

An internal software component (database, application, queue mechanism, etc.) has failed, leading to inability to process the message.

Rejection:The message can't be stored by the receiver due to an unspecified internal application issue. The message was neither processed nor stored by the receiving application.

The interaction (or: this version of the interaction) is not supported.

The Processing ID is not supported.

The Version ID is not supported.

The processing mode is not supported.

The Device.id of the sender is unknown.

The receiver requires information in the attentionLine classes for routing purposes.

Error:The destination of this message is known to the receiving application. Messages have been successfully routed to that destination in the past. The link to the destination application or an intermediate application is unavailable.

The destination of this message is unknown to the receiving application. The receiving application in the message does not match the application which received the message. The message was neither routed, processed nor stored by the receiving application.

Warning:The destination of this message is known to the receiving application. Messages have been successfully routed to that destination in the past. The link to the destination application or an intermediate application is (temporarily) unavailable. The receiving application will forward the message as soon as the destination can be reached again.

Reflects errors in the syntax or structure of the communication.

Required association missing in message; or the sequence of the classes is different than required by the standard or one of the conformance profiles identified in the message.

A required attribute is missing in a class.

The attribute contained data of the wrong data type, e.g. a numeric attribute contained "FOO".

An attribute value was compared against the corresponding code system, and no match was found.

An attribute value referenced a code system that is not valid for an attribute constrained to CNE.

Description:Required association or attribute missing in message; or the sequence of the classes is different than required by the standard or one of the conformance profiles identified in the message. Description:A coded attribute or datatype property violates one of the terminology constraints specified in the standard or one of the conformance profiles or templates declared by the instance. Description:A coded attribute is referencing a code that has been deprecated by the owning code system. Description:The number of repetitions of a (group of) association(s) or attribute(s) exceeds the limits of the standard or of one of the conformance profiles or templates identified in the message. Description:An attribute or association identified as mandatory in a specification or declared conformance profile or template has been specified with a null flavor.

The number of repetitions of a (group of) association(s) exceeds the limits of the standard or of one of the conformance profiles identified in the message.

Description:The value of an attribute or property differs from the fixed value asserted in the standard or one of the conformance profiles or templates declared in the message.

The number of repetitions of an attribute exceeds the limits of the standard or of one of the conformance profiles identified in the message.

Description:A formal constraint asserted in the standard or one of the conformance profiles or templates declared in the message has been violated. Description:The number of repetitions of a group of association or attributes is less than the required minimum for the standard or of one of the conformance profiles or templates identified in the message.

Refelects rejections because elements of the communication are not supported in the current context.

Reflects errors in the syntax or structure of the communication.

UPDATE:

A code identifying the specific message to be provided.

Discussion:A textual value may be specified as the print name, or for non-coded messages, as the original text.Examples:'Required attribute xxx is missing', 'System will be unavailable March 19 from 0100 to 0300'
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired..

**Definition:**An issue which has prevented, or will prevent (unless a management is provided for the issue by the sender), the successful processing of an interaction. Response interactions which include an issue which is an Error are a 'rejection', indicating that the request was not successfully processed.

**Example:**Unable to find specified patient.

Definition:The message relates to an issue which has no bearing on the successful processing of the request. Information issues cannot be overridden by specifying a management.Example:A Patient's coverage will expire in 5 days. Definition:The message relates to an issue which cannot prevent the successful processing of a request, but which could result in the processing not having the ideal or intended effect. Managing a warning issue is not required for successful processing, but will suppress the warning from being raised.Example:

Unexpected additional repetitions of phone number have been ignored.

UPDATE:

This attribute contains an acknowledgement code as described in the HL7 message processing rules.

OpenIssue:Description was copied from attribute and needs to be improved to be appropriate for a code system.
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Receiving application successfully processed message.

Receiving application found error in processing message. Sending error response with additional error detail information.

Receiving application failed to process message for reason unrelated to content or format. Original message sender must decide on whether to automatically send message again.

Receiving message handling service accepts responsibility for passing message onto receiving application.

Receiving message handling service cannot accept message for any other reason (e.g. message sequence number, etc.).

Receiving message handling service rejects message if interaction identifier, version or processing mode is incompatible with known receiving application role information.

American College of Radiology finding codes

UPDATE:

A code specifying the major type of Act that this Act-instance represents.

Constraints:The classCode domain is a tightly controlled vocabulary, not an external or user-defined vocabulary.

Every Act-instance must have a classCode. If the act class is not further specified, the most general Act.classCode (ACT) is used.

The Act.classCode must be a generalization of the specific Act concept (e.g., as expressed in Act.code), in other words, the Act concepts conveyed in an Act must be specializations of the Act.classCode. Especially, Act.code is not a "modifier" that can alter the meaning of a class code. (See Act.code for contrast.)

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. A property that indicates the status of the concept. One of active, experimental, deprecated, or retired. The formal name for the class clone under this code The formal name for relationship from Participation to Act An additional concept code that was also attributed to a concept

An accommodation is a service provided for a Person or other LivingSubject in which a place is provided for the subject to reside for a period of time. Commonly used to track the provision of ward, private and semi-private accommodations for a patient.

A financial account established to track the net result of financial acts.

A unit of work, a grouper of work items as defined by the system performing that work. Typically some laboratory order fulfillers communicate references to accessions in their communications regarding laboratory orders. Often one or more specimens are related to an accession such that in some environments the accession number is taken as an identifier for a specimen (group).

A record of something that is being done, has been done, can be done, or is intended or requested to be done.

*Examples:*The kinds of acts that are common in health care are (1) a clinical observation, (2) an assessment of health condition (such as problems and diagnoses), (3) healthcare goals, (4) treatment services (such as medication, surgery, physical and psychological therapy), (5) assisting, monitoring or attending, (6) training and education services to patients and their next of kin, (7) and notary services (such as advanced directives or living will), (8) editing and maintaining documents, and many others.

Discussion and Rationale:Acts are the pivot of the RIM; all domain information and processes are represented primarily in Acts. Any profession or business, including healthcare, is primarily constituted of intentional and occasionally non-intentional actions, performed and recorded by responsible actors. An Act-instance is a record of such an action.

Acts connect to Entities in their Roles through Participations and connect to other Acts through ActRelationships. Participations are the authors, performers and other responsible parties as well as subjects and beneficiaries (which includes tools and material used in the performance of the act, which are also subjects). The moodCode distinguishes between Acts that are meant as factual records, vs. records of intended or ordered services, and the other modalities in which act can appear.

One of the Participations that all acts have (at least implicitly) is a primary author, who is responsible of the Act and who "owns" the act. Responsibility for the act means responsibility for what is being stated in the Act and as what it is stated. Ownership of the act is assumed in the sense of who may operationally modify the same act. Ownership and responsibility of the Act is not the same as ownership or responsibility of what the Act-object refers to in the real world. The same real world activity can be described by two people, each being the author of their Act, describing the same real world activity. Yet one can be a witness while the other can be a principal performer. The performer has responsibilities for the physical actions; the witness only has responsibility for making a true statement to the best of his or her ability. The two Act-instances may even disagree, but because each is properly attributed to its author, such disagreements can exist side by side and left to arbitration by a recipient of these Act-instances.

In this sense, an Act-instance represents a "statement" according to Rector and Nowlan (1991) \[Foundations for an electronic medical record. Methods Inf Med. 30.\] Rector and Nowlan have emphasized the importance of understanding the medical record not as a collection of facts, but "a faithful record of what clinicians have heard, seen, thought, and done." Rector and Nowlan go on saying that "the other requirements for a medical record, e.g., that it be attributable and permanent, follow naturally from this view." Indeed the Act class is this attributable statement, and the rules of updating acts (discussed in the state-transition model, see Act.statusCode) versus generating new Act-instances are designed according to this principle of permanent attributable statements.

Rector and Nolan focus on the electronic medical record as a collection of statements, while attributed statements, these are still mostly factual statements. However, the Act class goes beyond this limitation to attributed factual statements, representing what is known as "speech-acts" in linguistics and philosophy. The notion of speech-act includes that there is pragmatic meaning in language utterances, aside from just factual statements; and that these utterances interact with the real world to change the state of affairs, even directly cause physical activities to happen. For example, an order is a speech act that (provided it is issued adequately) will cause the ordered action to be physically performed. The speech act theory has culminated in the seminal work by Austin (1962) \[How to do things with words. Oxford University Press\].

An activity in the real world may progress from defined, through planned and ordered to executed, which is represented as the mood of the Act. Even though one might think of a single activity as progressing from planned to executed, this progression is reflected by multiple Act-instances, each having one and only one mood that will not change along the Act-instance life cycle. This is because the attribution and content of speech acts along this progression of an activity may be different, and it is often critical that a permanent and faithful record be maintained of this progression. The specification of orders or promises or plans must not be overwritten by the specification of what was actually done, so as to allow comparing actions with their earlier specifications. Act-instances that describe this progression of the same real world activity are linked through the ActRelationships (of the relationship category "sequel").

Act as statements or speech-acts are the only representation of real world facts or processes in the HL7 RIM. The truth about the real world is constructed through a combination (and arbitration) of such attributed statements only, and there is no class in the RIM whose objects represent "objective state of affairs" or "real processes" independent from attributed statements. As such, there is no distinction between an activity and its documentation. Every Act includes both to varying degrees. For example, a factual statement made about recent (but past) activities, authored (and signed) by the performer of such activities, is commonly known as a procedure report or original documentation (e.g., surgical procedure report, clinic note etc.). Conversely, a status update on an activity that is presently in progress, authored by the performer (or a close observer) is considered to capture that activity (and is later superceded by a full procedure report). However, both status update and procedure report are acts of the same kind, only distinguished by mood and state (see statusCode) and completeness of the information.

Sender asks addressee to do something depending on the focal Act of the payload. An example is "fulfill this order". Addressee has responsibilities to either reject the message or to act on it in an appropriate way (specified by the specific receiver responsibilities for the interaction).

A transformation process where a requested invoice is transformed into an agreed invoice. Represents the adjudication processing of an invoice (claim). Adjudication results can be adjudicated as submitted, with adjustments or refused.

Adjudication results comprise 2 components: the adjudication processing results and a restated (or adjudicated) invoice or claim

Description:

An acquisition exposure act describes the proximity (location and time) through which the participating entity was potentially exposed to a physical (including energy), chemical or biological agent from another entity. The acquisition exposure act is used in conjunction with transmission exposure acts as part of an analysis technique for contact tracing. Although an exposure can be decomposed into transmission and acquisition exposures, there is no requirement that all exposures be treated in this fashion.

Constraints:The Acquisition Exposure inherits the participation constraints that apply to Exposure with the following exception. The EXPSRC (exposure source) participation must never be associated with the Transmission Exposure either directly or via context conduction.

An observation identifying a potential adverse outcome as a result of an Act or combination of Acts.

Examples:Detection of a drug-drug interaction; Identification of a late-submission for an invoice; Requesting discharge for a patient who does not meet hospital-defined discharge criteria.Discussion:This class is commonly used for identifying 'business rule' or 'process' problems that may result in a refusal to carry out a particular request. In some circumstances it may be possible to 'bypass' a problem by modifying the request to acknowledge the issue and/or by providing some form of mitigation.Constraints:the Act or Acts that may cause the the adverse outcome are the target of a subject ActRelationship. The subbtypes of this concept indicate the type of problem being detected (e.g. drug-drug interaction) while the Observation.value is used to repesent a specific problem code (e.g. specific drug-drug interaction id).
Definition:An observation that is composed of a set of observations. These observations typically have a logical or practical grouping for generally accepted clinical or functional purposes, such as observations that are run together because of automation. A battery can define required and optional component observations and, in some cases, will define complex rules that determine whether or not a particular observation is made. BATTERY is a constraint on the Observation class in that it is understood to always be composed of component observations.UsageNotes:The focus in a BATTERY is that it is composed of individual observations. In request (RQO) mood, a battery is a request to perform the component observations. In event (EVN) mood a battery is a reporting of associated set of observation events. In definition mood a battery is the definition of the associated set of observations.Examples:Vital signs, Full blood count, Chemistry panel. The focus in a BATTERY is that it is composed of individual observations. In request (RQO) mood, a battery is a request to perform the component observations. In event (EVN) mood a battery is a reporting of associated set of observation events. In definition mood a battery is the definition of the associated set of observations.

An act representing a system action such as the change of state of another act or the initiation of a query. All control acts represent trigger events in the HL7 context. ControlActs may occur in different moods.

A public health case is an Observation representing a condition or event that has a specific significance for public health. Typically it involves an instance or instances of a reportable infectious disease or other condition. The public health case can include a health-related event concerning a single individual or it may refer to multiple health-related events that are occurrences of the same disease or condition of interest to public health. An outbreak involving multiple individuals may be considered as a type of public health case. A public health case definition (Act.moodCode = "definition") includes the description of the clinical, laboratory, and epidemiologic indicators associated with a disease or condition of interest to public health. There are case definitions for conditions that are reportable, as well as for those that are not. There are also case definitions for outbreaks. A public health case definition is a construct used by public health for the purpose of counting cases, and should not be used as clinical indications for treatment. Examples include AIDS, toxic-shock syndrome, and salmonellosis and their associated indicators that are used to define a case.

A group of entries within a composition or topic that have a common characteristic - for example, Examination, Diagnosis, Management OR Subjective, Objective, Analysis, Plan.

The distinction from Topic relates to value sets. For Category there is a bounded list of things like "Examination", "Diagnosis" or SOAP categories. For Topic the list is wide open to any clinical condition or reason for a part of an encounter.

A CATEGORY MAY CONTAIN ENTRIES.

A clinical document that conforms to Level One of the HL7 Clinical Document Architecture (CDA)

The set of actions that define an experiment to assess the effectiveness and/or safety of a biopharmaceutical product (food, drug, device, etc.). In definition mood, this set of actions is often embodied in a clinical trial protocol; in event mood, this designates the aggregate act of applying the actions to one or more subjects.

**Description:**An ACT that organizes a set of component acts into a semantic grouping that have a shared subject. The subject may be either a subject participation (SBJ), subject act relationship (SUBJ), or child participation/act relationship types.

Discussion:The focus in a CLUSTER act is the grouping of the contained acts. For example "a request to cluster" (RQO), "a type of cluster that is allowed to occur" (DEF), etc.Examples:

* Radiologic investigations that might include administration of a dye, followed by radiographic observations; * "Isolate cluster" which includes all testing and specimen processing performed on a specific isolate; * a set of actions to perform at a particular stage in a clinical trial.

An instance of Observation of a Condition at a point in time that includes any Observations or Procedures associated with that Condition as well as links to previous instances of Condition Node for the same Condition

Deprecation Comment:This concept has been deprecated because an alternative structure for tracking the evolution of a problem has been presented and adopted by the Care Provision Work Group.

An agreement of obligation between two or more parties that is subject to contractual law and enforcement.

A context representing a grouped commitment of information to the EHR. It is considered the unit of modification of the record, the unit of transmission in record extracts, and the unit of attestation by authorizing clinicians.

A composition represents part of a patient record originating from a single interaction between an authenticator and the record.

Unless otherwise stated all statements within a composition have the same authenticator, apply to the same patient and were recorded in a single session of use of a single application.

A composition contains organizers and entries.

Definition:A worry that tends to persist over time and has as its subject a state or process. The subject of the worry has the potential to require intervention or management.Examples:an observation result, procedure, substance administration, equipment repair status, device recall status, a health risk, a financial risk, public health risk, pregnancy, health maintenance, allergy, and acute or chronic illness.

An observable finding or state that persists over time and tends to require intervention or management, and, therefore, distinguished from an Observation made at a point in time; may exist before an Observation of the Condition is made or after interventions to manage the Condition are undertaken. Examples: equipment repair status, device recall status, a health risk, a financial risk, public health risk, pregnancy, health maintenance, chronic illness

The Consent class represents informed consents and all similar medico-legal transactions between the patient (or his legal guardian) and the provider. Examples are informed consent for surgical procedures, informed consent for clinical trials, advanced beneficiary notice, against medical advice decline from service, release of information agreement, etc.

The details of consents vary. Often an institution has a number of different consent forms for various purposes, including reminding the physician about the topics to mention. Such forms also include patient education material. In electronic medical record communication, consents thus are information-generating acts on their own and need to be managed similar to medical activities. Thus, Consent is modeled as a special class of Act.

The "signatures" to the consent document are represented electronically through Participation instances to the consent object. Typically an informed consent has Participation.typeCode of "performer", the healthcare provider informing the patient, and "consenter", the patient or legal guardian. Some consent may associate a witness or a notary public (e.g., living wills, advanced directives). In consents where a healthcare provider is not required (e.g. living will), the performer may be the patient himself or a notary public.

Some consent has a minimum required delay between the consent and the service, so as to allow the patient to rethink his decisions. This minimum delay can be expressed in the act definition by the ActRelationship.pauseQuantity attribute that delays the service until the pause time has elapsed after the consent has been completed.

Description:Container of clinical statements. Navigational. No semantic content. Knowledge of the section code is not required to interpret contained observations. Represents a heading in a heading structure, or "container tree".

The record entries relating to a single clinical session are usually grouped under headings that represent phases of the encounter, or assist with layout and navigation. Clinical headings usually reflect the clinical workflow during a care session, and might also reflect the main author's reasoning processes. Much research has demonstrated that headings are used differently by different professional groups and specialties, and that headings are not used consistently enough to support safe automatic processing of the E H R.

An Act where a container is registered either via an automated sensor, such as a barcode reader, or by manual receipt

When used in the EVN mood, this concept means with respect to a covered party:

  • A health care insurance policy or plan that is contractually binding between two or more parties; or

  • A health care program, usually administered by government entities, that provides coverage to persons determined eligible under the terms of the program.

* When used in the definition (DEF) mood, COV means potential coverage for a patient who may or may not be a covered party. * The concept's meaning is fully specified by the choice of ActCoverageTypeCode (abstract) ActProgramCode or ActInsurancePolicyCode.

An identified point during a clinical trial at which one or more actions are scheduled to be performed (definition mood), or are actually performed (event mood). The actions may or may not involve an encounter between the subject and a healthcare professional.

**Description:**A determinant peptide in a polypeptide as described by polypeptide.

Class for holding attributes unique to diagnostic images.

Diet services are supply services, with some aspects resembling Medication services: the detail of the diet is given as a description of the Material associated via Participation.typeCode="product". Medically relevant diet types may be communicated in the Diet.code attribute using domain ActDietCode, however, the detail of the food supplied and the various combinations of dishes should be communicated as Material instances.

Deprecation Note Class:Use either the Supply class (if dealing with what should be given to the patient) or SubstanceAdministration class (if dealing with what the patient should consume)energyQuantity:This quantity can be conveyed by using a Content relationship with a quantity attribute expressing the calories

**carbohydrateQuantity:**This quantity can be conveyed using a Content relationship to an Entity with a code of carbohydrate and a quantity attribute on the content relationship.

An action taken with respect to a subject Entity by a regulatory or authoritative body with supervisory capacity over that entity. The action is taken in response to behavior by the subject Entity that body finds to be undesirable.

Suspension, license restrictions, monetary fine, letter of reprimand, mandated training, mandated supervision, etc.*Examples:*

The notion of a document comes particularly from the paper world, where it corresponds to the contents recorded on discrete pieces of paper. In the electronic world, a document is a kind of composition that bears resemblance to their paper world counter-parts. Documents typically are meant to be human-readable.

HL7's notion of document differs from that described in the W3C XML Recommendation, in which a document refers specifically to the contents that fall between the root element's start-tag and end-tag. Not all XML documents are HL7 documents.

A context that distinguishes the body of a document from the document header. This is seen, for instance, in HTML documents, which have discrete <head> and <body> elements.

A clinical document is a documentation of clinical observations and services, with the following characteristics:

  • Persistence - A clinical document continues to exist in an unaltered state, for a time period defined by local and regulatory requirements;

  • Stewardship - A clinical document is maintained by a person or organization entrusted with its care;

  • Potential for authentication - A clinical document is an assemblage of information that is intended to be legally authenticated;

  • Wholeness - Authentication of a clinical document applies to the whole and does not apply to portions of the document without the full context of the document;

  • Human readability - A clinical document is human readable.

A context that subdivides the body of a document. Document sections are typically used for human navigation, to give a reader a clue as to the expected content. Document sections are used to organize and provide consistency to the contents of a document body. Document sections can contain document sections and can contain entries.

A context that comprises all compositions. The EHR is an extract that includes the entire chart.

NOTE:In an exchange scenario, an EHR is a specialization of an extract.

An interaction between a patient and healthcare participant(s) for the purpose of providing patient service(s) or assessing the health status of a patient. For example, outpatient visit to multiple departments, home health support (including physical therapy), inpatient hospital stay, emergency room visit, field visit (e.g., traffic accident), office visit, occupational therapy, telephone call.

This context represents the information acquired and recorded for an observation, a clinical statement such as a portion of the patient's history or an inference or assertion, or an action that might be intended or has actually been performed. This class may represent both the actual data describing the observation, inference, or action, and optionally the details supporting the clinical reasoning process such as a reference to an electronic guideline, decision support system, or other knowledge reference.

**Description:**An expression level of genes/proteins or other expressed genomic entities.

An interaction between entities that provides opportunity for transmission of a physical, chemical, or biological agent from an exposure source entity to an exposure target entity.

Examples:The following examples are provided to indicate what interactions are considered exposures rather than other types of Acts:

* A patient accidentally receives three times the recommended dose of their medication due to a dosing error. * This is a substance administration. Public health and/or safety authorities may also be interested in documenting this with an associated exposure. * A patient accidentally is dispensed an incorrect medicine (e.g., clomiphene instead of clomipramine). They have taken several doses before the mistake is detected. They are therefore "exposed" to a medicine that there was no therapeutic indication for them to receive. * There are several substance administrations in this example. Public health and/or safety authorities may also be interested in documenting this with associated exposures. * In a busy medical ward, a patient is receiving chemotherapy for a lymphoma. Unfortunately, the IV infusion bag containing the medicine splits, spraying cytotoxic medication over the patient being treated and the patient in the adjacent bed. * There are three substance administrations in this example. The first is the intended one (IV infusion) with its associated (implicit) exposure. There is an incident with an associated substance administration to the same patient involving the medication sprayed over the patient as well as an associated exposure. Additionally, the incident includes a substance administration involving the spraying of medication on the adjacent patient, also with an associated exposure. * A patient who is a refugee from a war-torn African nation arrives in a busy inner city A&E department suffering from a cough with bloody sputum. Not understanding the registration and triage process, they sit in the waiting room for several hours before it is noticed that they have not booked in. As soon as they are being processed, it is suspected that they are suffering from TB. Vulnerable (immunosuppressed) patients who were sharing the waiting room with this patient may have been exposed to the tubercule bacillus, and must be traced for investigation. * This is an exposure (or possibly multiple exposures) in the waiting room involving the refugee and everyone else in the waiting room during the period. There might also be a number of known or presumed substance administrations (coughing) via several possible routes. The substance administrations are only hypotheses until confirmed by further testing. * A patient who has received an elective total hip replacement procedure suffers a prolonged stay in hospital, due to contracting an MRSA infection in the surgical wound site after the surgery. * This is an exposure to MRSA. Although there was some sort of substance administration, it's possible the exact mechanism for introduction of the MRSA into the wound will not be identified. * Routine maintenance of the X-ray machines at a local hospital reveals a serious breach of the shielding on one of the machines. Patients who have undergone investigations using that machine in the last month are likely to have been exposed to significantly higher doses of X-rays than was intended, and must be tracked for possible adverse effects. * There has been an exposure of each patient who used the machine in the past 30 days. Some patients may have had substance administrations. * A new member of staff is employed in the laundry processing room of a small cottage hospital, and a misreading of the instructions for adding detergents results in fifty times the usual concentration of cleaning materials being added to a batch of hospital bedding. As a result, several patients have been exposed to very high levels of detergents still present in the "clean" bedding, and have experienced dermatological reactions to this. * There has been an incident with multiple exposures to several patients. Although there are substance administrations involving the application of the detergent to the skin of the patients, it is expected that the substance administrations would not be directly documented. * Seven patients who are residents in a health care facility for the elderly mentally ill have developed respiratory problems. After several months of various tests having been performed and various medications prescribed to these patients, the problem is traced to their being "sensitive" to a new fungicide used in the wall plaster of the ward where these patients reside. * The patients have been continuously exposed to the fungicide. Although there have been continuous substance administrations (via breathing) this would not normally be documented as a substance administration. * A patient with osteoarthritis of the knees is treated symptomatically using analgesia, paracetamol (acetaminophen) 1g up to four times a day for pain relief. His GP does not realize that the patient has, 20 years previously (while at college) had severe alcohol addiction problems, and now, although this is completely under control, his liver has suffered significantly, leaving him more sensitive to hepatic toxicity from paracetamol use. Later that year, the patient returns with a noticeable level of jaundice. Paracetamol is immediately withdrawn and alternative solutions for the knee pain are sought. The jaundice gradually subsides with conservative management, but referral to the gastroenterologist is required for advice and monitoring. * There is a substance administration with an associated exposure. The exposure component is based on the relative toxic level of the substance to a patient with a compromised liver function. * A patient goes to their GP complaining of abdominal pain, having been discharged from the local hospital ten days' previously after an emergency appendectomy. The GP can find nothing particularly amiss, and presumes it is post operative surgical pain that will resolve. The patient returns a fortnight later, when the GP prescribes further analgesia, but does decide to request an outpatient surgical follow-up appointment. At this post-surgical outpatient review, the registrar decides to order an ultrasound, which, when performed three weeks later, shows a small faint inexplicable mass. A laparoscopy is then performed, as a day case procedure, and a piece of a surgical swab is removed from the patient's abdominal cavity. Thankfully, a full recovery then takes place. * This is a procedural sequelae. There may be an Incident recorded for this also. * A patient is slightly late for a regular pacemaker battery check in the Cardiology department of the local hospital. They are hurrying down the second floor corridor. A sudden summer squall has recently passed over the area, and rain has come in through an open corridor window leaving a small puddle on the corridor floor. In their haste, the patient slips in the puddle and falls so badly that they have to be taken to the A&E department, where it is discovered on investigation they have slightly torn the cruciate ligament in their left knee. * This is not an exposure. There has been an incident.

Usage Notes:This class deals only with opportunity and not the outcome of the exposure; i.e. not all exposed parties will necessarily experience actual harm or benefit.

Exposure differs from Substance Administration by the absence of the participation of a performer in the act.

The following participations SHOULD be used with the following participations to distinguish the specific entities:

* The exposed entity participates via the "exposure target" (EXPTRGT) participation. * An entity that has carried the agent transmitted in the exposure participates via the "exposure source" (EXSRC) participation. For example: * a person or animal who carried an infectious disease and interacts (EXSRC) with another person or animal (EXPTRGT) transmitting the disease agent; * a place or other environment (EXSRC) and a person or animal (EXPTRGT) who is exposed in the presence of this environment. * When it is unknown whether a participating entity is the source of the agent (EXSRC) or the target of the transmission (EXPTRGT), the "exposure participant" (EXPART) is used. * The physical (including energy), chemical or biological substance which is participating in the exposure uses the "exposure agent" (EXPAGNT) participation. There are at least three scenarios: 1. the player of the Role that participates as EXPAGNT is the chemical or biological substance mixed or carried by the scoper-entity of the Role (e.g., ingredient role); or 2. the player of the Role that participates as EXPAGNT is a mixture known to contain the chemical, radiological or biological substance of interest; or 3. the player of the Role that participates as a EXPAGNT is known to carry the agent (i.e., the player is a fomite, vector, etc.).

The Exposure.statusCode attribute should be interpreted as the state of the Exposure business object (e.g., active, aborted, completed) and not the clinical status of the exposure (e.g., probable, confirmed). The clinical status of the exposure should be associated with the exposure via a subject observation.

Design Comment:The usage notes require a clear criterion for determining whether an act is an exposure or substance administration-deleterious potential, uncertainty of actual transmission, or otherwise. SBADM states that the criterion is the presence of a performer-but there are examples above that call this criterion into question (e.g., the first one, concerning a dosing error).
This class deals only with opportunity and not the outcome of the exposure; i.e. not all exposed parties will necessarily experience actual harm or benefit. Exposure differs from Substance Administration by the absence of the participation of a performer in the act. The following participations SHOULD be used with the following participations to distinguish the specific entities: The exposed entity participates via the "exposure target" (EXPTRGT) participation. An entity that has carried the agent transmitted in the exposure participates via the "exposure source" (EXSRC) participation. For example: a person or animal who carried an infectious disease and interacts (EXSRC) with another person or animal (EXPTRGT) transmitting the disease agent; a place or other environment (EXSRC) and a person or animal (EXPTRGT) who is exposed in the presence of this environment. When it is unknown whether a participating entity is the source of the agent (EXSRC) or the target of the transmission (EXPTRGT), the "exposure participant" (EXPART) is used. The physical (including energy), chemical or biological substance which is participating in the exposure uses the "exposure agent" (EXPAGNT) participation. There are at least three scenarios: the player of the Role that participates as EXPAGNT is the chemical or biological substance mixed or carried by the scoper-entity of the Role (e.g., ingredient role); or the player of the Role that participates as EXPAGNT is a mixture known to contain the chemical, radiological or biological substance of interest; or the player of the Role that participates as a EXPAGNT is known to carry the agent (i.e., the player is a fomite, vector, etc.). The Exposure.statusCode attribute should be interpreted as the state of the Exposure business object (e.g., active, aborted, completed) and not the clinical status of the exposure (e.g., probable, confirmed). The clinical status of the exposure should be associated with the exposure via a subject observation.

This context represents the part of a patient record conveyed in a single communication. It is drawn from a providing system for the purposes of communication to a requesting process (which might be another repository, a client application or a middleware service such as an electronic guideline engine), and supporting the faithful inclusion of the communicated data in the receiving system.

An extract may be the entirety of the patient record as held by the sender or it may be a part of that record (e.g. changes since a specified date).

An extract contains folders or compositions.

An extract cannot contain another extract.

A contract whose value is measured in monetary terms.

A context representing the high-level organization of an extract e.g. to group parts of the record by episode, care team, clinical specialty, clinical condition, or source application. Internationally, this kind of organizing structure is used variably: in some centers and systems the folder is treated as an informal compartmentalization of the overall health record; in others it might represent a significant legal portion of the EHR relating to the originating enterprise or team.

A folder contains compositions.

Folders may be nested within folders.

**Description:**An observation of genomic phenomena.

Definition:An ACT that organizes a set of component acts into a semantic grouping that share a particular context such as timeframe, patient, etc.UsageNotes:The focus in a GROUPER act is the grouping of the contained acts. For example "a request to group" (RQO), "a type of grouping that is allowed to occur" (DEF), etc.

Unlike WorkingList, which represents a dynamic, shared, continuously updated collection to provide a "view" of a set of objects, GROUPER collections tend to be static and simply indicate a shared set of semantics. Note that sharing of semantics can be achieved using ACT as well. However, with GROUPER, the sole semantic is of grouping.

The focus in a GROUPER act is the grouping of the contained acts. For example "a request to group" (RQO), "a type of grouping that is allowed to occur" (DEF), etc. Unlike WorkingList, which represents a dynamic, shared, continuously updated collection to provide a "view" of a set of objects, GROUPER collections tend to be static and simply indicate a shared set of semantics. Note that sharing of semantics can be achieved using ACT as well. However, with GROUPER, the sole semantic is of grouping.

A public health case is a Concern about an observation or event that has a specific significance for public health. The creation of a PublicHealthCase initiates the tracking of the object of concern. The decision to track is related to but somewhat independent of the underlying event or observation.

UsageNotes:Typically a Public Health Case involves an instance or instances of a reportable infectious disease or other condition. The public health case can include a health-related event concerning a single individual or it may refer to multiple health-related events that are occurrences of the same disease or condition of interest to public health.

A public health case definition (Act.moodCode = "definition") includes the description of the clinical, laboratory, and epidemiologic indicators associated with a disease or condition of interest to public health. There are case definitions for conditions that are reportable, as well as for those that are not. A public health case definition is a construct used by public health for the purpose of counting cases, and should not be used as clinical indications for treatment. Examples include AIDS, toxic-shock syndrome, and salmonellosis and their associated indicators that are used to define a case.

Typically a Public Health Case involves an instance or instances of a reportable infectious disease or other condition. The public health case can include a health-related event concerning a single individual or it may refer to multiple health-related events that are occurrences of the same disease or condition of interest to public health. A public health case definition (Act.moodCode = "definition") includes the description of the clinical, laboratory, and epidemiologic indicators associated with a disease or condition of interest to public health. There are case definitions for conditions that are reportable, as well as for those that are not. A public health case definition is a construct used by public health for the purpose of counting cases, and should not be used as clinical indications for treatment. Examples include AIDS, toxic-shock syndrome, and salmonellosis and their associated indicators that are used to define a case.

An event that occurred outside of the control of one or more of the parties involved. Includes the concept of an accident.

Sender sends payload to addressee as information. Addressee does not have responsibilities beyond serving addressee's own interest (i.e., read and memorize if you see fit). This is equivalent to an FYI on a memo.

The act of transmitting information and understanding about a topic to a subject where the participation association must be SBJ.

Discussion:This act may be used to request that a patient or provider be informed about an Act, or to indicate that a person was informed about a particular act.

Represents concepts related to invoice processing in health care

An formalized inquiry into the circumstances surrounding a particular unplanned event or potential event for the purposes of identifying possible causes and contributing factors for the event. This investigation could be conducted at a local institutional level or at the level of a local or national government.

**Description:**A mandate, regulation, obligation, requirement, rule, or expectation unilaterally imposed by a jurisdiction on:

* The activity of another party * The behavior of another party * The manner in which an act is executed

**Examples:**A jurisdictional mandate regarding the prescribing and dispensing of a particular medication. A jurisdictional privacy or security regulation dictating the manner in which personal health information is disclosed. A jurisdictional requirement that certain services or health conditions are reported to a monitoring program, e.g., immunizations, methadone treatment, or cancer registries.

Working list collects a dynamic list of individual instances of Act via ActRelationship which reflects the need of an individual worker, team of workers, or an organization to manage lists of acts for many different clinical and administrative reasons. Examples of working lists include problem lists, goal lists, allergy lists, and to-do lists.

Lying on the left side.

Deprecation Comment:This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system.

**Description:**The position of a gene (or other significant sequence) on the genome.

An officially or unofficially instituted program to track acts of a particular type or categorization.

**Description:**An act that is intended to result in new information about a subject. The main difference between Observations and other Acts is that Observations have a value attribute. Thecodeattribute of Observation and thevalueattribute of Observation must be considered in combination to determine the semantics of the observation.Discussion:

Structurally, many observations are name-value-pairs, where the Observation.code (inherited from Act) is the name and the Observation.value is the value of the property. Such a construct is also known as a variable (a named feature that can assume a value) hence, the Observation class is always used to hold generic name-value-pairs or variables, even though the variable valuation may not be the result of an elaborate observation method. It may be a simple answer to a question or it may be an assertion or setting of a parameter.

As with all Act statements, Observation statements describe what was done, and in the case of Observations, this includes a description of what was actually observed (results or answers); and those results or answers are part of the observation and not split off into other objects.

The method of action is asserted by the Observation classCode or its subclasses at the least granular level, by the Observation.code attribute value at the medium level of granularity, and by the attribute value of observation.methodCode when a finer level of granularity is required. The method in whole or in part may also appear in the attribute value of Observation.value when using coded data types to express the value of the attribute. Relevant aspects of methodology may also be restated in value when the results themselves imply or state a methodology.

An observation may consist of component observations each having their own Observation.code and Observation.value. In this case, the composite observation may not have an Observation.value for itself. For instance, a white blood cell count consists of the sub-observations for the counts of the various granulocytes, lymphocytes and other normal or abnormal blood cells (e.g., blasts). The overall white blood cell count Observation itself may therefore not have a value by itself (even though it could have one, e.g., the sum total of white blood cells). Thus, as long as an Act is essentially an Act of recognizing and noting information about a subject, it is an Observation, regardless of whether it has a simple value by itself or whether it has sub-observations.

Even though observations are professional acts (see Act) and as such are intentional actions, this does not require that every possible outcome of an observation be pondered in advance of it being actually made. For instance, differential white blood cell counts (WBC) rarely show blasts, but if they do, this is part of the WBC observation even though blasts might not be predefined in the structure of a normal WBC.

Clinical documents commonly have Subjective and Objective findings, both of which are kinds of Observations. In addition, clinical documents commonly contain Assessments, which are also kinds of Observations. Thus, the establishment of a diagnosis is an Observation.

Examples:

* Recording the results of a Family History Assessment * Laboratory test and associated result * Physical exam test and associated result * Device temperature * Soil lead level

Container for Observation Sequences (Observations whose values are contained in LIST<>'s) having values correlated with each other. Each contained Observation Sequence LIST<> must be the same length. Values in the LIST<>'s are correlated based on index. E.g. the values in position 2 in all the LIST<>'s are correlated. This is analogous to a table where each column is an Observation Sequence with a LIST<> of values, and each row in the table is a correlation between the columns. For example, a 12-lead ECG would contain 13 sequences: one sequence for time, and a sequence for each of the 12 leads.

Container for Correlated Observation Sequences sharing a common frame of reference. All Observations of the same cd must be comparable and relative to the common frame of reference. For example, a 3-channel ECG device records a 12-lead ECG in 4 steps (3 leads at a time). Each of the separate 3-channel recordings would be in their own "OBSCOR". And, all 4 OBSCOR would be contained in one OBSSER because all the times are relative to the same origin (beginning of the recording) and all the ECG signals were from a fixed set of electrodes.

Organizer of entries. Navigational. No semantic content. Knowledge of the section code is not required to interpret contained observations. Represents a heading in a heading structure, or "organizer tree".

The record entries relating to a single clinical session are usually grouped under headings that represent phases of the encounter, or assist with layout and navigation. Clinical headings usually reflect the clinical workflow during a care session, and might also reflect the main author's reasoning processes. Much research has demonstrated that headings are used differently by different professional groups and specialties, and that headings are not used consistently enough to support safe automatic processing of the E H R.

**Description:**A mandate, obligation, requirement, rule, or expectation unilaterally imposed by an organization on:

* The activity of another party * The behavior of another party * The manner in which an act is executed

**Examples:**A clinical or research protocols imposed by a payer, a malpractice insurer, or an institution to which a provider must adhere. A mandate imposed by a denominational institution for a provider to provide or withhold certain information from the patient about treatment options.

An outbreak represents a series of public health cases. The date on which an outbreak starts is the earliest date of onset among the cases assigned to the outbreak, and its ending date is the last date of onset among the cases assigned to the outbreak.

An Outbreak is a concern resulting from a series of public health cases.

UsageNotes:The date on which an outbreak starts is the earliest date of onset among the cases assigned to the outbreak and its ending date is the last date of onset among the cases assigned to the outbreak. The effectiveTime attribute is used to convey the relevant dates for the case. An outbreak definition (Act.moodCode = "definition" includes the criteria for the number, types and occurrence pattern of cases necessary to declare an outbreak and to judge the severity of an outbreak.
The date on which an outbreak starts is the earliest date of onset among the cases assigned to the outbreak and its ending date is the last date of onset among the cases assigned to the outbreak. The effectiveTime attribute is used to convey the relevant dates for the case. An outbreak definition (Act.moodCode = "definition" includes the criteria for the number, types and occurrence pattern of cases necessary to declare an outbreak and to judge the severity of an outbreak.
AnActthat of taking on whole or partial responsibility for, or attention to, safety and well-being of a subject of care.Discussion:Acare provisionevent may exist without any other care actions taking place. For example, when a patient is assigned to the care of a particular health professional.Inrequest(RQO) moodcare provisioncommunicates a referral, which is a request:

* from one party (linked as a **participant** of type **author** (AUT)), * to another party (linked as a **participant** of type **performer** (PRF), * to take responsibility for a scope specified by the code attribute, * for an entity (linked as a **participant** of type **subject** (SBJ)).

The scope of the care for which responsibility is taken is identified bycodeattribute.Inevent(EVN) moodcare provisionindicates the effective time interval of a specified scope of responsibility by aperformer(PRF) or set ofperformers(PRF) for asubject(SBJ).Examples:
  • Referral from GP to a specialist.

  • Assignment of a patient or group of patients to the case list of a health professional.

  • Assignment of inpatients to the care of particular nurses for a working shift.

**Description:**A genomic phenomenon that is expressed externally in the organism.

**Description:**A polypeptide resulting from the translation of a gene.

**Description:**A mandate, regulation, obligation, requirement, rule, or expectation unilaterally imposed by one party on:

* The activity of another party * The behavior of another party * The manner in which an act is executed

An observation denoting the physical location of a person or thing based on a reference coordinate system.

**Description:**An observation representing the degree to which the assignment of the spatial coordinates, based on a matching algorithm by a geocoding engine against a reference spatial database, matches true or accepted values.

**Description:**An observation representing one of a set of numerical values used to determine the position of a place. The name of the coordinate value is determined by the reference coordinate system.

Lying with the front or ventral surface downward; lying face down.

Deprecation Comment:This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system.

An Act whose immediate and primary outcome (post-condition) is the alteration of the physical condition of the subject.

Examples:: Procedures may involve the disruption of some body surface (e.g. an incision in a surgical procedure), but they also include conservative procedures such as reduction of a luxated join, chiropractic treatment, massage, balneotherapy, acupuncture, shiatsu, etc. Outside of clinical medicine, procedures may be such things as alteration of environments (e.g. straightening rivers, draining swamps, building dams) or the repair or change of machinery etc.

Represents the act of maintaining information about the registration of its associated registered subject. The subject can be either an Act or a Role, and includes subjects such as lab exam definitions, drug protocol definitions, prescriptions, persons, patients, practitioners, and equipment.

The registration may have a unique identifier - separate from the unique identification of the subject - as well as a core set of related participations and act relationships that characterize the registration event and aid in the disposition of the subject information by a receiving system.

The act of examining and evaluating the subject, usually another act. For example, "This prescription needs to be reviewed in 2 months."

Lying on the right side.

Deprecation Comment:This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system.

A Region of Interest (ROI) specified for a multidimensional observation, such as an Observation Series (OBSSER). The ROI is specified using a set of observation criteria, each delineating the boundary of the region in one of the dimensions in the multidimensional observation. The relationship between a ROI and its referenced Act is specified through an ActRelationship of type subject (SUBJ), which must always be present. Each of the boundary criteria observations is connected with the ROI using ActRelationships of type "has component" (COMP). In each boundary criterion, the Act.code names the dimension and the Observation.value specifies the range of values inside the region. Typically the bounded dimension is continuous, and so the Observation.value will be an interval (IVL) data type. The Observation.value need not be specified if the respective dimension is only named but not constrained. For example, an ROI for the QT interval of a certain beat in ECG Lead II would contain 2 boundary criteria, one naming the interval in time (constrained), and the other naming the interval in ECG Lead II (only named, but not constrained).

A Region of Interest (ROI) specified for an image using an overlay shape. Typically used to make reference to specific regions in images, e.g., to specify the location of a radiologic finding in an image or to specify the site of a physical finding by "circling" a region in a schematic picture of a human body. The units of the coordinate values are in pixels. The origin is in the upper left hand corner, with positive X values going to the right and positive Y values going down. The relationship between a ROI and its referenced Act is specified through an ActRelationship of type "subject" (SUBJ), which must always be present.

Lying on the back, on an inclined plane, typically about 30-45 degrees with head raised and feet lowered.

Deprecation Comment:This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system.

The act of introducing or otherwise applying a substance to the subject.

Discussion:The effect of the substance is typically established on a biochemical basis, however, that is not a requirement. For example, radiotherapy can largely be described in the same way, especially if it is a systemic therapy such as radio-iodine. This class also includes the application of chemical treatments to an area.Examples:Chemotherapy protocol; Drug prescription; Vaccination record
Description:The act of removing a substance from the subject.

**Description:**An ethical or clinical obligation, requirement, rule, or expectation imposed or strongly encouraged by organizations that oversee particular clinical domains or provider certification which define the boundaries within which a provider may practice and which may have legal basis or ramifications on:

* The activity of another party * The behavior of another party * The manner in which an act is executed

**Examples:**An ethical obligation for a provider to fully inform a patient about all treatment options. An ethical obligation for a provider not to disclose personal health information that meets certain criteria, e.g., where disclosure might result in harm to the patient or another person. The set of health care services which a provider is credentialed or privileged to provide.

**Description:**A sequence of biomolecule like the DNA, RNA, protein and the like.

**Description:**A variation in a sequence as described by BioSequence.

A semi-sitting position in bed with the head of the bed elevated approximately 45 degrees.

Deprecation Comment:This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system.

Resting the body on the buttocks, typically with upper torso erect or semi erect.

Deprecation Comment:This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system.

An observation on a specimen in a laboratory environment that may affect processing, analysis or result interpretation

A procedure or treatment performed on a specimen to prepare it for analysis

A procedure for obtaining a specimen from a source entity.

Supply orders and deliveries are simple Acts that focus on the delivered product. The product is associated with the Supply Act via Participation.typeCode="product". With general Supply Acts, the precise identification of the Material (manufacturer, serial numbers, etc.) is important. Most of the detailed information about the Supply should be represented using the Material class. If delivery needs to be scheduled, tracked, and billed separately, one can associate a Transportation Act with the Supply Act. Pharmacy dispense services are represented as Supply Acts, associated with a SubstanceAdministration Act. The SubstanceAdministration class represents the administration of medication, while dispensing is supply.

Description:Sender transmits a status change pertaining to the focal act of the payload. This status of the focal act is the final state of the state transition. This can be either a request or an event, according to the mood of the control act.

**Description:**A requirement, rule, or expectation typically documented as guidelines, protocols, or formularies imposed or strongly encouraged by an organization that oversees or has authority over the practices within a domain, and which may have legal basis or ramifications on:

* The activity of another party * The behavior of another party * The manner in which an act is executed

**Examples:**A payer may require a prescribing provider to adhere to formulary guidelines. An institution may adopt clinical guidelines and protocols and implement these within its electronic health record and decision support systems.

To be stationary, upright, vertical, on one's legs.

Deprecation Comment:This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system.

The act of putting something away for safe keeping. The "something" may be physical object such as a specimen, or information, such as observations regarding a specimen.

Definition: Indicates that the subject Act has undergone or should undergo substitution of a type indicated by Act.code.

Rationale: Used to specify "allowed" substitution when creating orders, "actual" susbstitution when sending events, as well as the reason for the substitution and who was responsible for it.

Deprecation Comment:This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system. Description:

A transmission exposure act describes the proximity (time and location) over which the participating source entity was capable of transmitting a physical (including energy), chemical or biological substance agent to another entity. The transmission exposure act is used in conjunction with acquisition exposure acts as part of an analysis technique for contact tracing. Although an exposure can be decomposed into transmission and acquisition exposures, there is no requirement that all exposures be treated in this fashion.

Constraints:The Transmission Exposure inherits the participation constraints that apply to Exposure with the following exception. The EXPTRGT (exposure target) participation must never be associated with the Transmission Exposure either directly or via context conduction.

A group of entries within a composition that are related to a common clinical theme - such as a specific disorder or problem, prevention, screening and provision of contraceptive services.

A topic may contain categories and entries.

Lying on the back, on an inclined plane, typically about 30-45 degrees, with head lowered and feet raised.

Deprecation Comment:This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system.
Definition:The act of transferring information without the intent of imparting understanding about a topic to the subject that is the recipient or holder of the transferred information where the participation association must be RCV or HLD.

Transportation is the moving of a payload (people or material) from a location of origin to a destination location. Thus, any transport service has the three target instances of type payload, origin, and destination, besides the targets that are generally used for any service (i.e., performer, device, etc.)

An act which describes the process whereby a 'verifying party' validates either the existence of the Role attested to by some Credential or the actual Vetting act and its details.

A sub-class of Act representing any transaction between two accounts whose value is measured in monetary terms.

In the "intent" mood, communicates a request for a transaction to be initiated, or communicates a transfer of value between two accounts.

In the "event" mood, communicates the posting of a transaction to an account.

Regions of Interest (ROI) within a subject Act. Primarily used for making secondary observations on a subset of a subject observation. The relationship between a ROI and its referenced Act is specified through an ActRelationship of type "subject" (SUBJ), which must always be present.

Used to group a set of acts sharing a common context. Organizer structures can nest within other context structures - such as where a document is contained within a folder, or a folder is contained within an EHR extract.

A code specifying qualitatively the spatial relation between imaged object and imaging film or detector.

Contains codes for defining the observed, physical position of a subject, such as during an observation, assessment, collection of a specimen, etc. ECG waveforms and vital signs, such as blood pressure, are two examples where a general, observed position typically needs to be noted.

Deprecation Comment:This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation. The same code has been added to the ObservationValue code system.

The spatial relationship of a subject whether human, other animal, or plant, to a frame of reference such as gravity or a collection device.

UPDATE:

A code specifying the particular kind of Act that the Act-instance represents within its class.

Constraints:The kind of Act (e.g. physical examination, serum potassium, inpatient encounter, charge financial transaction, etc.) is specified with a code from one of several, typically external, coding systems. The coding system will depend on the class of Act, such as LOINC for observations, etc.

Conceptually, the Act.code must be a specialization of the Act.classCode. This is why the structure of ActClass domain should be reflected in the superstructure of the ActCode domain and then individual codes or externally referenced vocabularies subordinated under these domains that reflect the ActClass structure.

Act.classCode and Act.code are not modifiers of each other but the Act.code concept should really imply the Act.classCode concept. For a negative example, it is not appropriate to use an Act.code "potassium" together with and Act.classCode for "laboratory observation" to somehow mean "potassium laboratory observation" and then use the same Act.code for "potassium" together with Act.classCode for "medication" to mean "substitution of potassium". This mutually modifying use of Act.code and Act.classCode is not permitted.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The child code is a classification of the particular class group identified by the 'classCode' in a RIM class as the parent code. Used only in RIM backbone classes to link the code and classCode values. The internal identifier for the concept in the HL7 Access database repository. A property that indicates the status of the concept. One of active, experimental, deprecated, or retired. An additional concept code that was also attributed to a concept

Confirmed drug therapy appropriate

Provided education or training to the patient on appropriate therapy use

Instituted an additional therapy to mitigate potential negative effects

Suspended existing therapy that triggered interaction for the duration of this therapy

Aborted existing therapy that triggered interaction.

Confirmed supply action appropriate

Patient's existing supply was lost/wasted

Supply date is due to patient vacation

Supply date is intended to carry patient over weekend

Supply is intended for use during a leave of absence from an institution.

Consulted other supplier/pharmacy, therapy confirmed

Assessed patient, therapy is appropriate

Description:Supply is different than expected as an additional quantity has been supplied in a separate dispense. Description:Indicates that the permissions have been externally verified and the request should be processed.

**Definition:**Estimated age.

**Definition:**Reported age.

Description:The patient has the appropriate indication or diagnosis for the action to be taken. Description:It has been confirmed that the appropriate pre-requisite therapy has been tried.

**Definition:**Calculated age.

Patient gave adequate explanation

**Definition:**General specification of age with no implied method of determination.

**Definition:**Age at onset of associated adverse event; no implied method of determination.

Consulted other supply source, therapy still appropriate

A code representing 42 CFR Part 2 Confidentiality of Substance Use Disorder Patient Records. 42 CFR Part 2 stipulates the privacy rights of an individual who has applied for or been given diagnosis or treatment for alcohol or drug abuse at a federally assisted program, which includes non-disclosure of health information relating to health care paid for by a federally assisted substance use disorder program without patient consent. https://www.gpo.gov/fdsys/pkg/CFR-2010-title42-vol1/pdf/CFR-2010-title42-vol1-part2.pdf

Usage Note:Used to indicate the legal authority for assigning security labels to governed information. In this case, the collection, access, use, and disclosure of healthcare information is governed by 42 CFR Part 2 Confidentiality of Substance Use Disorder Patient Records https://www.gpo.gov/fdsys/pkg/CFR-2010-title42-vol1/pdf/CFR-2010-title42-vol1-part2.pdf use "42CFRPart2" as the security label policy code.

Since information governed by a 42 CFR Part 2 has a level of confidentiality protection that is more stringent than the normal level of protection under HIPAA 45 CFR Section 164.506 Uses and disclosures to carry out treatment, payment, or health care operations https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-506.pdf assign the HL7 Confidentiality code "R" (restricted).

A code representing an individual's privacy consent directive that complies with 42 CFR Part 2.31 Consent requirements https://www.gpo.gov/fdsys/pkg/CFR-2017-title42-vol1/pdf/CFR-2017-title42-vol1-sec2-31.pdf, which is a US Federal law stipulating the policy elements of a written consent to a disclosure under the regulations in Part 2.

(1) The name of the patient. (2) The specific name(s) or general designation(s) of the part 2 program(s), entity(ies), or individual(s) permitted to make the disclosure. (3) How much and what kind of information is to be disclosed, including an explicit description of the substance use disorder information that may be disclosed. (4) (i) The name(s) of the individual(s) to whom a disclosure is to be made; or (ii)Entities with a treating provider relationship with the patient. If the recipient entity has a treating provider relationship with the patient whose information is being disclosed, such as a hospital, a health care clinic, or a private practice, the name of that entity; or (iii)Entities without a treating provider relationship with the patient. (A) If the recipient entity does not have a treating provider relationship with the patient whose information is being disclosed and is a third-party payer, the name of the entity; or (B) If the recipient entity does not have a treating provider relationship with the patient whose information is being disclosed and is not covered by paragraph (a)(4)(iii)(A) of this section, such as an entity that facilitates the exchange of health information or a research institution, the name(s) of the entity(-ies); and (1) The name(s) of an individual participant(s); or (2) The name(s) of an entity participant(s) that has a treating provider relationship with the patient whose information is being disclosed; or (3) A general designation of an individual or entity participant(s) or class of participants that must be limited to a participant(s) who has a treating provider relationship with the patient whose information is being disclosed. (i) When using a general designation, a statement must be included on the consent form that the patient (or other individual authorized to sign in lieu of the patient), confirms their understanding that, upon their request and consistent with this part, they must be provided a list of entities to which their information has been disclosed pursuant to the general designation (see Section 2.13(d)). (ii) \[Reserved\] (5) The purpose of the disclosure. In accordance with Section 2.13(a), the disclosure must be limited to that information which is necessary to carry out the stated purpose. (6) A statement that the consent is subject to revocation at any time except to the extent that the part 2 program or other lawful holder of patient identifying information that is permitted to make the disclosure has already acted in reliance on it. Acting in reliance includes the provision of treatment services in reliance on a valid consent to disclose information to a third-party payer (7) The date, event, or condition upon which the consent will expire if not revoked before. This date, event, or condition must ensure that the consent will last no longer than reasonably necessary to serve the purpose for which it is provided. (8) The signature of the patient and, when required for a patient who is a minor, the signature of an individual authorized to give consent under Section 2.14; or, when required for a patient who is incompetent or deceased, the signature of an individual authorized to sign under Section 2.15. Electronic signatures are permitted to the extent that they are not prohibited by any applicable law. (9) The date on which the consent is signed.

Usage Note:Used to indicate the legal authority for assigning security labels to governed information. In this case, where collection, access, use, or disclosure of healthcare information is governed by an individual's 42 CFR Part 2.31 consent directive, "42CFRPart2CD" as the security label policy code.

Since information governed by an individual's 42 CFR Part 2.31 consent directive has a level of confidentiality protection that is more stringent than the normal level of protection under HIPAA 45 CFR § 164.506 Uses and disclosures to carry out treatment, payment, or health care operations https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-506.pdf, assign the HL7 Confidentiality code "R" (restricted).

Consulted prescriber, therapy confirmed

Consulted prescriber and recommended change, prescriber declined

Concurrent therapy triggering alert is no longer on-going or planned

Order is performed as issued, but other action taken to mitigate potential adverse effects

Arranged to monitor patient for adverse effects

The invoice element has been accepted for payment but one or more adjustment(s) have been made to one or more invoice element line items (component charges).

Also includes the concept 'Adjudicate as zero' and items not covered under a particular Policy.

Invoice element can be reversed (nullified).

Recommend that the invoice element is saved for DUR (Drug Utilization Reporting).

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency.

**Description:**The proposed therapy is frequently misused or abused and therefore should be used with caution and/or monitoring.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency.

Description:Provide consent to collect, use, disclose, or access adverse drug reaction information for a patient. Description:Provide consent to collect, use, disclose, or access all information for a patient. Description:Provide consent to collect, use, disclose, or access allergy information for a patient.

An access control policy specific to the type of access control scheme, which is used to enforce one or more authorization policies.

Usage Note:Access control schemes are the type of access control policy, which is comprised of access control policy rules concerning the provision of the access control service.

There are two categories of access control policies, rule-based and identity-based, which are identified in CCITT Rec. X.800 aka ISO 7498-2. Rule-based access control policies are intended to apply to all access requests by any initiator on any target in a security domain. Identity-based access control policies are based on rules specific to an individual initiator, a group of initiators, entities acting on behalf of initiators, or originators acting in a specific role. Context can modify rule-based or identity-based access control policies. Context rules may define the entire policy in effect. Real systems will usually employ a combination of these policy types; if a rule-based policy is used, then an identity-based policy is usually in effect also.

An access control scheme may be based on access control lists, capabilities, labels, and context or a combination of these. An access control scheme is a component of an access control mechanism or "service") along with the supporting mechanisms required by that scheme to provide access control decision information (ADI) supplied by the scheme to the access decision facility (ADF also known as a PDP). (Based on ISO/IEC 10181-3:1996)

Examples:

* Attribute Based Access Control (ABAC) * Discretionary Access Control (DAC) * History Based Access Control (HBAC) * Identity Based Access Control (IBAC) * Mandatory Access Control (MAC) * Organization Based Access Control (OrBAC) * Relationship Based Access Control (RelBac) * Responsibility Based Access Control (RespBAC) * Risk Adaptable Access Control (RAdAC)

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Description:Provide consent to collect, use, disclose, or access informational consent information for a patient.

An account for collecting charges, reversals, adjustments and payments, including deductibles, copayments, coinsurance (financial transactions) credited or debited to the account receivable account for a patient's encounter.

Description:Provide consent to collect, use, disclose, or access demographics information for a patient. Description:Provide consent to collect, use, disclose, or access diagnostic imaging information for a patient.

Automated Clearing House (ACH).

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency.

The lowering of specimen pH through the addition of an acid

Description:Provide consent to collect, use, disclose, or access immunization information for a patient. Description:Provide consent to collect, use, disclose, or access lab test result information for a patient. Description:Provide consent to collect, use, disclose, or access medical condition information for a patient. Definition:Provide consent to view or access medical condition information for a patient.

**Description:**Provide consent to collect, use, disclose, or access mental health information for a patient.

Description:Provide consent to collect, use, disclose, or access common observation information for a patient.

A group of health care entities, which may include health care providers, care givers, hospitals, facilities, health plans, and other health care constituents who coordinate care for reimbursement based on quality metrics for improving outcomes and lowering costs, and may be authorized to access the consumer's health information because of membership in that group.

Security Compartment Labels assigned to a consumer's information use in accountable care workflows should be met or exceeded by the Security Compartment attribute claimed by a participant in a an accountable care workflow who is requesting access to that information

Description:Provide consent to collect, use, disclose, or access coverage policy or program for a patient. Description:Provide consent to collect, use, disclose, or access provider information for a patient. Description:Provide consent to collect, use, disclose, or access professional service information for a patient.

**Description:**Provide consent to collect, use, disclose, or access substance abuse information for a patient.

**Definition:**A list of medications which the patient is only expected to consume for the duration of the current order or limited set of orders and which is not expected to be renewed.

An acute inpatient encounter.

Proposed therapy is outside of the standard practice for an adult patient.

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically.

Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.

Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently nullified in the specified period and submitted electronically.

Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently nullified in the specified period and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.

Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.

Admitting diagnosis are the diagnoses documented for administrative purposes as the basis for a hospital admission.

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.

Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.

Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.

Policy for handling information related to an adolescent, which will be afforded heightened confidentiality per applicable organizational or jurisdictional policy. An enterprise may have a policy that requires that adolescent patient information be provided heightened confidentiality. Information deemed sensitive typically includes health information and patient role information including patient status, demographics, next of kin, and location.

Usage Note:For use within an enterprise in which an adolescent is the information subject. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.

Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.

Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.

Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.

Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.

Identifies the total net amount of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted electronically.

Identifies the total number of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted manually.

Identifies the total number of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted manually.

Identifies the total net amount of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted electronically.

Identifies the total number of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted manually.

Identifies the total number of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted manually.

Indicates that the observation is of an unexpected negative occurrence in the subject suspected to result from the subject's exposure to one or more agents. Observation values would be the symptom resulting from the reaction.

Premium paid on service fees in compensation for practicing outside of normal working hours.

Proposed therapy may be inappropriate or contraindicated due to patient age

Indicates that the observation is carrying out an aggregation calculation, contained in the value element.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency.

Communication of an agent from a living subject or environmental source to a living subject through indirect contact via oral or nasal inhalation.

Provision of Alternate Level of Care to a patient in an acute bed. Patient is waiting for placement in a long-term care facility and is unable to return home.

Payment initiated by the payor as the result of adjudicating a submitted invoice that arrived to the payor from an electronic source that did not provide a conformant set of HL7 messages (e.g. web claim submission).

Hypersensitivity to an agent caused by an immunologic response to an initial exposure

Proposed therapy may be inappropriate or contraindicated because of a recorded patient allergy to the proposed product. (Allergies are immune based reactions.)

The act rendering alkaline by impregnating with an alkali; a conferring of alkaline qualities.

Description:All patient information.

**Definition:**The requested action has already been performed and so this request has no effect

Description:A person enters a known allergy for a given patient. Description:A person reviews a list of known allergies of a given patient.

**Definition:**All information pertaining to a patient's allergy and intolerance records.

**Definition:**Proposed therapy may be inappropriate or ineffective because the end of administration is too close to another planned therapy.

**Definition:**Proposed therapy may be inappropriate or ineffective because the start of administration is too late after the onset of the condition.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency.

A comprehensive term for health care provided in a healthcare facility (e.g. a practitioneraTMs office, clinic setting, or hospital) on a nonresident basis. The term ambulatory usually implies that the patient has come to the location and is not assigned to a bed. Sometimes referred to as an outpatient encounter.

Communication of an agent from one animal to another proximate animal.

The invoice element has been accepted for payment but one or more adjustment(s) have been made to one or more invoice element line items (component charges) without changing the amount.

Invoice element can be reversed (nullified).

Recommend that the invoice element is saved for DUR (Drug Utilization Reporting).

Communication of an agent from an animal to a proximate person.

**Description:**A note that is specific to a patient's diagnostic images, either historical, current or planned.

**Description:**A general or uncategorized note.

A note that is specific to a patient's immunizations, either historical, current or planned.

**Description:**A note that is specific to a patient's laboratory results, either historical, current or planned.

**Description:**A note that is specific to a patient's medications, either historical, current or planned.

Definition:A policy that, after an initial premium or premiums, pays out a sum at pre-determined intervals.

For example, a policy holder may pay $10,000, and in return receive $150 each month until he dies; or $1,000 for each of 14 years or death benefits if he dies before the full term of the annuity has elapsed.

Custodian system must remove any information that could result in identifying the information subject.

Custodian system must make available to an information subject upon request an accounting of certain disclosures of the individual's protected health information over a period of time. Policy may dictate that the accounting include information about the information disclosed, the date of disclosure, the identification of the receiver, the purpose of the disclosure, the time in which the disclosing entity must provide a response and the time period for which accountings of disclosure can be requested.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency.

The invoice element has passed through the adjudication process but payment is refused due to one or more reasons.

Includes items such as patient not covered, or invoice element is not constructed according to payer rules (e.g. 'invoice submitted too late').

If one invoice element line item in the invoice element structure is rejected, the remaining line items may not be adjudicated and the complete group is treated as rejected.

A refused invoice element can be forwarded to the next payer (for Coordination of Benefits) or modified and resubmitted to refusing payer.

Invoice element cannot be reversed (nullified) as there is nothing to reverse.

Recommend that the invoice element is not saved for DUR (Drug Utilization Reporting).

Description:All information pertaining to a patient's adverse drug reactions.

Describes the artificial blood identifier that is associated with the specimen.

The invoice element was/will be paid exactly as submitted, without financial adjustment(s).

If the dollar amount stays the same, but the billing codes have been amended or financial adjustments have been applied through the adjudication process, the invoice element is treated as "Adjudicated with Adjustment".

If information items are included in the adjudication results that do not affect the monetary amounts paid, then this is still Adjudicated as Submitted (e.g. 'reached Plan Maximum on this Claim').

Invoice element can be reversed (nullified).

Recommend that the invoice element is saved for DUR (Drug Utilization Reporting).

**Description:**Refines classCode OBS to indicate an observation in which observation.value contains a finding or other nominalized statement, where the encoded information in Observation.value is not altered by Observation.code. For instance, observation.code="ASSERTION" and observation.value="fracture of femur present" is an assertion of a clinical finding of femur fracture.

Custodian system must monitor systems to ensure that all users are authorized to operate on information objects.

Custodian system must monitor and maintain retrievable log for each user and operation on information.

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.

Authorisation policies are essentially security policies related to access-control and specify what activities a subject is permitted or forbidden to do, to a set of target objects. They are designed to protect target objects so are interpreted by access control agents or the run-time systems at the target system.

A positive authorisation policy defines the actions that a subject is permitted to perform on a target. A negative authorisation policy specifies the actions that a subject is forbidden to perform on a target. Positive authorisation policies may also include filters to transform the parameters associated with their actions. (Based on PONDERS)

Specifies whether or not automatic repeat testing is to be initiated on specimens.

The dilution of a sample performed by automated equipment. The value is specified by the equipment

The dilution of a sample performed by automated equipment. The value is specified by the equipment

Description:Automobile Information Attachment

Insurance policy for injuries sustained in an automobile accident. Will also typically covered non-named parties to the policy, such as pedestrians and passengers.

The available quantity of specimen. This is the current quantity minus any planned consumption (e.g., tests that are planned)

A mandate, obligation, requirement, rule, or expectation conveyed as security metadata between senders and receivers required to establish the reliability, authenticity, and trustworthiness of their transactions.

Trust security metadata are observation made about aspects of trust applicable to an IT resource (data, information object, service, or system capability).

Trust applicable to IT resources is established and maintained in and among security domains, and may be comprised of observations about the domain's trust authority, trust framework, trust policy, trust interaction rules, means for assessing and monitoring adherence to trust policies, mechanisms that enforce trust, and quality and reliability measures of assurance in those mechanisms. \[Based on ISO IEC 10181-1 and NIST SP 800-63-2\]

For example, identity proofing , level of assurance, and Trust Framework.

Policy for handling trade secrets such as financial information or intellectual property, which will be afforded heightened confidentiality. Description: Since the service class can represent knowledge structures that may be considered a trade or business secret, there is sometimes (though rarely) the need to flag those items as of business level confidentiality.

Usage Notes:No patient related information may ever be of this confidentiality level. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
No patient related information may ever be of this confidentiality level. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.

Communication of an agent from one living subject to another living subject through direct contact with any body fluid.

Policy for handling information related to behavioral and emotional disturbances affecting social adjustment and physical health, which is afforded heightened confidentiality.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code.

Communication of an agent to a living subject through direct contact with blood or blood products whether the contact with blood is part of a therapeutic procedure or not.

A billing arrangement where a Provider charges a lump sum to provide a prescribed group (volume) of services to a single patient which occur over a period of time. Services included in the block may vary.

This billing arrangement is also known as Program of Care for some specific Payors and Program Fees for other Payors.

Bonus payments based on performance, volume, etc. as agreed to by the payor.

An additional immunization administration within a series intended to bolster or enhance immunity.

A diet exclusively composed of oatmeal, semolina, or rice, to be extremely easy to eat and digest.

**Description:**A local business rule relating multiple elements has been violated.

**Description:**Indicates that result data has been corrected.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

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.

Definition:A program that provides low-income, uninsured, and underserved women access to timely, high-quality screening and diagnostic services, to detect breast and cervical cancer at the earliest stages.Example:To improve women's access to screening for breast and cervical cancers, Congress passed the Breast and Cervical Cancer Mortality Prevention Act of 1990, which guided CDC in creating the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), which provides access to critical breast and cervical cancer screening services for underserved women in the United States. An estimated 7 to 10% of U.S. women of screening age are eligible to receive NBCCEDP services. Federal guidelines establish an eligibility baseline to direct services to uninsured and underinsured women at or below 250% of federal poverty level; ages 18 to 64 for cervical screening; ages 40 to 64 for breast screening.

A billing arrangement where the payment made to a Provider is determined by analyzing one or more demographic attributes about the persons/patients who are enrolled with the Provider (in their practice).

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

Provision of diagnosis and treatment of diseases and disorders affecting the heart

Identifies the type of detected issue is a care gap

List of acts representing a care plan. The acts can be in a varierty of moods including event (EVN) to record acts that have been carried out as part of the care plan.

**Definition:**An observation that provides a characterization of the level of harm to an investigation subject as a result of a reaction or event.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

Description:Types of advance payment to be made on a plastic card usually issued by a financial institution used of purchasing services and/or products.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

An observation that states whether the disease was likely acquired outside the jurisdiction of observation, and if so, the nature of the inter-jurisdictional relationship.

OpenIssue:This code could be moved to LOINC if it can be done before there are significant implemenations using it.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

A person reviews a recommendation/assessment provided automatically by a clinical decision support application for a given patient.

This compartment code may be used as a field value in an initiator's clearance to indicate permission for its Clinical Decision Support system (CDSS) to access and use an IT Resource with a security label having the same compartment value in the security category label field.

This code permits a CDS system to algorithmically process information with this compartment tag for the purpose of alerting an unauthorized end user that masked information is needed to address an emergency or a patient safety issue, such as a contraindicated medication. The alert would advise the end user to "break the glass", to access the masked information in an accountable manner, or to ask the patient about possibly masked information.

For example, releasing a list of sensitive medications with this compartment tag means that while the CDS system is permitted to use this list in its contraindication analysis, this sensitive information should not be shared directly with unauthorized end-users or end-user-facing Apps. Based on the results of the CDS system analysis (e.g., warnings about prescriptions) the end-user (e.g., a clinician) may still have the ability to access to the sensitive information by invoking "break-the-glass protocol".

Usage Note:A security label with the CDS system compartment may be used in conjunction with other security labels, e.g., a label authorizing an end user with adequate clearance to access the same CDS system compartment tagged information. For example, a patient may restrict sharing sensitive information with most care team members except in an emergency or to prevent an adverse event, and may consent to sharing with their sensitive service care team providers, e.g., for mental health or substance abuse.

Policy for handling information related to a celebrity (people of public interest (VIP), which will be afforded heightened confidentiality. Celebrities are people of public interest (VIP) about whose information an enterprise may have a policy that requires heightened confidentiality. Information deemed sensitive may include health information and patient role information including patient status, demographics, next of kin, and location.

Usage Note:For use within an enterprise in which the information subject is deemed a celebrity or very important person. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

An amount still owing to the payor but the payment is 0$ and this cannot be settled until a future payment is made.

Definition:A program that covers the cost of services provided directly to a beneficiary who typically has no other source of coverage without charge.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

A written order to a bank to pay the amount specified from funds on deposit.

Description:Exposure participants' interaction occurred in a child care setting

Provision of recurring care for chronic illness.

A type of transaction that represents a charge for a service or product. Expressed in monetary terms.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

**Definition:**A list of medications which are expected to be continued beyond the present order and which the patient should be assumed to be taking unless explicitly stopped.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

A circle defined by two (column,row) pairs. The first point is the center of the circle and the second point is a point on the perimeter of the circle.

A clinician enters a clinical note about a given patient

A person reviews a clinical note of a given patient.

Description:The class room associated with the patient during the immunization event.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

**Description:**.

Indicates what method is used in a quality measure to combine the component measure results included in an composite measure.

An attribute of a quality measure describing the weight this component measure score is to carry in determining the overall composite measure final score. The value is real value greater than 0 and less than 1.0. Each component measure score will be multiplied by its CMPMSRSCRWGHT and then summed with the other component measures to determine the final overall composite measure score. The sum across all CMPMSRSCRWGHT values within a single composite measure SHALL be 1.0. The value assigned is scoped to the composite measure referencing this component measure only.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

**Definition:**All information pertaining to a patient's common observation records (height, weight, blood pressure, temperature, etc.).

**Description:**The specified code has been deprecated and should no longer be used. Select another code from the code system.

**Description:**The specified code is not valid against the list of codes allowed for the element.

Identifies the type of detected issue is a risk adjustment coding gap

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

Policy for handling information related to cognitive disability disorders and conditions caused by these disorders, which are afforded heightened confidentiality.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code.

Examples may include dementia, traumatic brain injury, attention deficit, hearing and visual disability such as dyslexia and other disorders and related conditions which impair learning and self-sufficiency. However, the cognitive disabilities to which this term may apply versus other behavioral health categories varies by jurisdiction and organizational policy in part due to overlap with other behavioral health conditions. Implementers should constrain to those diagnoses applicable in the domain in which this code is used.

That portion of the eligible charges which a covered party must pay for each service and/or product. It is a percentage of the eligible amount for the service/product that is typically charged after the covered party has met the policy deductible. This amount represents the covered party's coinsurance that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results.

The covered party pays a percentage of the cost of covered services.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

Definition:An automobile insurance policy under which the insurance company will cover the cost of damages to an automobile owned by the named insured that are caused by accident or intentionally by another party.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

There may be an issue with the patient complying with the intentions of the proposed therapy

This is the healthcare analog to the US Intelligence Community's concept of a Special Access Program. Compartment codes may be used in as a field value in an initiator's clearance to indicate permission to access and use an IT Resource with a security label having the same compartment value in security category label field.

Map: Aligns with ISO 2382-8 definition of Compartment - "A division of data into isolated blocks with separate security controls for the purpose of reducing risk."

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

Proposed therapy may be inappropriate or contraindicated due to an existing/recent patient condition or diagnosis

List of condition observations.

The quantity of specimen that is used each time the equipment uses this substance

Transaction counts and value totals by Contract Identifier.

A billing arrangement where a Provider charges a lump sum to provide a particular volume of one or more interventions/procedures or groups of interventions/procedures.

A displayed mark, required to be rendered as "CONTROLLED", indicating that the electronic or hardcopy information is protected at the level of the subset of CUI for which the authorizing law, regulation, or Government-wide policy does not set out specific handling or dissemination controls. Agencies handle CUI Basic according to the uniform set of controls set forth in this part and the CUI Registry. CUI Basic differs from CUI Specified (see definition for CUI Specified), and CUI Basic controls apply whenever CUI Specified ones do not cover the involved CUI. From CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html.

Usage Note:Mandatory control marking, which must be displayed on the top portion of each rendered or printed page containing controlled information. Should be displayed at the bottom of each rendered or printed page containing controlled information. Must be displayed on each portion of controlled information at the portion level if portions are uncontrolled unclassified information. Based on CUI Marking Handbook https://www.archives.gov/files/cui/20161206-cui-marking-handbook-v1-1.pdf.
Description:An interaction where the exposure participants traveled in/on the same vehicle (not necessarily concurrently, e.g. both are passengers of the same plane, but on different flights of that plane).

That portion of the eligible charges which a covered party must pay for each service and/or product. It is a defined amount per service/product of the eligible amount for the service/product. This amount represents the covered party's copayment that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

Identifies the organization(s) who own the intellectual property represented by the eMeasure.

A displayed mark indicating that the electronic or hardcopy information is a copy of an authoritative source for the information. The copy is not considered authoritative but is a duplicate of the authoritative content.

Usage Note:Applicable policy will dictate how the COPY mark will be displayed. Typical renderings include the marking appearing at the top or "banner" of electronic or hardcopy pages, or as watermarks set diagonally across each page.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

Insurance coverage problems have been encountered. Additional explanation information to be supplied.

Definition:Codes representing the maximum coverate or financial participation requirements.

**Description:**A mandate, obligation, requirement, rule, or expectation unilaterally imposed on benefit coverage under a policy or program by a sponsor, underwriter or payor on:

* The activity of another party * The behavior of another party * The manner in which an act is executed

**Examples:**A clinical protocol imposed by a payer to which a provider must adhere in order to be paid for providing the service. A formulary from which a provider must select prescribed drugs in order for the patient to incur a lower copay.

Codes representing the time period during which coverage is available; or financial participation requirements are in effect.

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.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

Custodian security system must retrieve, evaluate, and comply with the information handling directions of the Confidentiality Code associated with an information target.

Usage Note:CPLYCC may be used as a security label code to inform senders and receivers of information tagged with a Confidentiality Code to comply with applicable level of protection required by the assigned confidentiality code.

Custodian security system must retrieve, evaluate, and comply with applicable information subject consent directives.

Usage Note:CPLYCD may be used as a security label code to inform senders and receivers of information tagged with an ActCode\_ActPolicyType\_ActConsent code or an ActCode\_ActPolicyType\_ActPrivacyPolicy\_ActConsentDirective code to comply with applicable consent directives.

Custodian security system must retrieve, evaluate, and comply with applicable Controlled Unclassified Information (CUI) policies associated with the target information.

Usage Note:In the US, CPLYCUI may be used as a security label code to inform recipients of information designated by a US Federal Agency as Controlled Unclassified Information (CUI) to comply with the applicable laws, regulations, executive orders, and other guidances, such as included in DURSAs, to persist, mark, and enforce required CUI controls

Background:

In accordance with US 32 CFR Part 2002 and US Executive Order 13556 Controlled Unclassified Information, US Federal Agencies and their contractors are charged with classifying and marking certain information they create as Controlled Unclassified Information (CUI).

The following definitions, which are provided for context, are based on terms defined by the CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html

* CUI is defined as "information in any form that the Government creates or possesses, or that an entity creates or possesses for or on behalf of the Government, that a law, regulation, or Government-wide policy requires or permits an agency to handle using safeguarding or dissemination controls." * Designating CUI occurs when an authorized holder, consistent with 32 CFR Part 2002 and the CUI Registry, determines that a specific item of information falls into a CUI category or subcategory. * The designating agency is the executive branch agency that designates or approves the designation of a specific item of information as CUI. * The authorized holder who designates the CUI must make recipients aware of the information's CUI status when disseminating that information. * • Disseminating occurs when authorized holders provide access, transmit, or transfer CUI to other authorized holders through any means, whether internal or external to the agency.

Once designated as CUI, US Federal Agencies and their contractors must assign CUI marks as prescribed by the National Archives and Records Administration (NARA) CUI Registry, and display marks as prescribed by the CUI Marking Handbook.

CUI markings must be displayed on hard copy, on containers, electronic media, and to end users for IT systems.

When HL7 content is designated as CUI, these computable markings can be interoperably conveyed using HL7 security label CUI tags, and may be included in HL7 text and narrative elements as human readable markings.

Impact of CUI markings:

CUI Custodians must enforce CUI security controls per applicable CUI policies. Federal agencies and their contractors must adhere to FISMA and NIST SP 800-53 security controls. Custodians, who are not Federal agencies or agency contractors, and are receivers of CUI, must adhere to NIST SP 800-171 security controls and those dictated by the Authorities indicated by the assigned CUI markings.

For most participants in US healthcare information exchange, including Federal Agencies and their contractors, additional controls are required by HIPAA Security standards for health information US 42 USC 1320d-2(d)(2) https://www.govinfo.gov/content/pkg/USCODE-2016-title42/pdf/USCODE-2016-title42-chap7-subchapXI-partC-sec1320d-2.pdf

Federal Agencies and their contractors may be the CUI classifier of original CUI content; or a CUI derivative classifier, which reclassifies CUI content that has been aggregated with other CUI or Unclassified Uncontrolled Information (U) or dissembled from a larger CUI content; or declassifiers, depending on the designating agency's policies.

Applicable CUI policies include the following and any future applicable updates to policies or laws related to CUI:

* Executive Order 13556 https://www.federalregister.gov/articles/2010/11/09/2010-28360/controlled-unclassified-information * US 32 CFR Part 2002 https://www.govinfo.gov/content/pkg/CFR-2017-title32-vol6/pdf/CFR-2017-title32-vol6-part2002.pdf * NIST SP 800-171 https://nvlpubs.nist.gov/nistpubs/SpecialPublications/NIST.SP.800-171r1.pdf * NIST SP 800-171A https://doi.org/10.6028/NIST.SP.800-171A * CUI Marking Handbook https://www.archives.gov/files/cui/20161206-cui-marking-handbook-v1-1.pdf * CUI Registry - Health Information Category https://www.archives.gov/cui/registry/category-detail/health-info * CUI Registry: Limited Dissemination Controls https://www.archives.gov/cui/registry/limited-dissemination * CUI Policy and Guidance https://www.archives.gov/cui/registry/policy-guidance

Custodian security system must retrieve, evaluate, and comply with applicable jurisdictional privacy policies associated with the target information.

Usage Note:CPLYJPP may be used as a security label code to inform senders and receivers of information tagged with an ActCode\_ActPolicyType\_ActPrivacyPolicy\_ActPrivacyLaw code or an ActCode\_ActPolicyType\_ActInformationPolicy.JurisIP code to comply with applicable jurisdictional privacy policy.

Custodian security system must retrieve, evaluate, and comply with applicable jurisdictional security policies associated with the target information.

Usage Note:CPLYJSP may be used as a security label code to inform senders and receivers of information tagged with an ActCode\_ActPolicyType.SecurityPolicy code to comply with applicable jurisdictional security policy.

Custodian security system must retrieve, evaluate, and comply with applicable organizational privacy policies associated with the target information.

Usage Note:CPLYOPP may be used as a security label code to inform senders and receivers of information tagged with an ActCode\_ActPolicyType\_ActInformationPolicy.OrgIP code to comply with applicable organizational privacy policy.

Custodian security system must retrieve, evaluate, and comply with the organizational security policies associated with the target information.

Usage Note:CPLYOSP may be used as a security label code to inform senders and receivers of information tagged with an ActCode\_ActPolicyType.SecurityPolicy code to comply with applicable organizational security policy.

Custodian security system must retrieve, evaluate, and comply with applicable policies associated with the target information.

Usage Note:CPLYPOL may be used as a security label code to inform senders and receivers of the tagged information to comply with applicable policy without specifying the specific policy type(s).

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

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.

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.

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.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

**Description:**CPT modifier codes are found in Appendix A of CPT 2000 Standard Edition.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

**Description:**Proposed therapy may be inappropriate or contraindicated because of a common but non-patient specific reaction to the product.

**Example:**There is no record of a specific sensitivity for the patient, but the presence of the sensitivity is common and therefore caution is warranted.

Definition:A program that covers the cost of services provided to crime victims for injuries or losses related to the occurrence of a crime.

A clinical judgment as to the worst case result of a future exposure (including substance administration). When the worst case result is assessed to have a life-threatening or organ system threatening potential, it is considered to be of high criticality.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

Summary of relevant clinical guidelines or other clinical recommendations supporting this eMeasure.

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).

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

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).

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

Care coordination across participants in a care plan requires sharing of a healthcare consumer's information specific to that workflow. A care team member should only have access to that information while participating in that workflow or for other authorized uses.

Security Compartment Labels assigned to a consumer's information use in care coordination workflows should be met or exceeded by the Security Compartment attribute claimed by a participant in a care team member workflow who is requesting access to that information

A monitoring program that focuses on narcotics and/or commonly abused substances that are subject to legal restriction.

An observation that states the mechanism by which disease was acquired by the living subject involved in the public health case.

OpenIssue:This code could be moved to LOINC if it can be done before there are significant implemenations using it.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

A displayed mark, required to be rendered as "CUI", indicating that the electronic or hardcopy information is protected at the level of the subset of CUI for which the authorizing law, regulation, or Government-wide policy does not set out specific handling or dissemination controls. Agencies handle CUI Basic according to the uniform set of controls set forth in this part and the CUI Registry. CUI Basic differs from CUI Specified (see definition for CUI Specified), and CUI Basic controls apply whenever CUI Specified ones do not cover the involved CUI. From CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html.

Usage Note:Mandatory control marking, which must be displayed on the top portion of each rendered or printed page containing controlled information. Should be displayed at the bottom of each rendered or printed page containing controlled information. Must be displayed on each portion of controlled information at the portion level if portions are uncontrolled unclassified information. Based on CUI Marking Handbook https://www.archives.gov/files/cui/20161206-cui-marking-handbook-v1-1.pdf.

A displayed mark, required to be rendered as "CUI//HLTH", indicating that the electronic or hardcopy information is protected at the level of the subset of CUI for which the authorizing law, regulation, or Government-wide policy does not set out specific handling or dissemination controls. Agencies handle CUI Basic according to the uniform set of controls set forth in this part and the CUI Registry. CUI Basic differs from CUI Specified (see definition for CUI Specified), and CUI Basic controls apply whenever CUI Specified ones do not cover the involved CUI. From CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html.

Usage Note:Examples of healthcare regulation governing CUI Basic marking include HIPAA Unique Identifier provisions 42 USC 1320d-2 note(b) https://www.govinfo.gov/content/pkg/USCODE-2016-title42/pdf/USCODE-2016-title42-chap7-subchapXI-partC-sec1320d-2.pdf; Title 38 Section 7332 https://www.govinfo.gov/content/pkg/USCODE-2016-title38/pdf/USCODE-2016-title38-partV-chap73-subchapIII-sec7332.pdf; and several sections of 42 CFR Part 2.related to consent and confidentiality, e.g., https://www.govinfo.gov/content/pkg/CFR-2017-title42-vol1/pdf/CFR-2017-title42-vol1-sec2-12.pdf

A displayed mark, required to be rendered as "(CUI//HLTH)", indicating that a portion of an electronic or hardcopy information is protected at the level of the subset of CUI for which the authorizing law, regulation, or Government-wide policy does not set out specific handling or dissemination controls. Agencies handle CUI Basic according to the uniform set of controls set forth in this part and the CUI Registry. CUI Basic differs from CUI Specified (see definition for CUI Specified), and CUI Basic controls apply whenever CUI Specified ones do not cover the involved CUI. From CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html.

Usage Note:Examples of healthcare regulation governing CUI Basic marking include HIPAA Unique Identifier provisions 42 USC 1320d-2 note(b) https://www.govinfo.gov/content/pkg/USCODE-2016-title42/pdf/USCODE-2016-title42-chap7-subchapXI-partC-sec1320d-2.pdf; Title 38 Section 7332 https://www.govinfo.gov/content/pkg/USCODE-2016-title38/pdf/USCODE-2016-title38-partV-chap73-subchapIII-sec7332.pdf; and several sections of 42 CFR Part 2.related to consent and confidentiality, e.g., https://www.govinfo.gov/content/pkg/CFR-2017-title42-vol1/pdf/CFR-2017-title42-vol1-sec2-12.pdf

An originator must mark, persist, display, and convey computable and renderable Controlled Unclassified Information (CUI) marks as required by policy. A recipient must consume, persist, display, and reconvey CUI marks on information received based on agreements with the originator..

Examples:

* As CUI custodians, Federal Agencies and their contractors must mark, persist, display, and convey these marks. * All CUI receivers must consume, persist, display, and reconvey CUI markings on information further disclosed

Usage Note:

In accordance with US 32 CFR Part 2002 and US Executive Order 13556 Controlled Unclassified Information, US Federal Agencies and their contractors are charged with classifying and marking certain information they create as Controlled Unclassified Information (CUI).

The following definitions, which are provided for context, are based on terms defined by the CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html

* CUI is defined as "information in any form that the Government creates or possesses, or that an entity creates or possesses for or on behalf of the Government, that a law, regulation, or Government-wide policy requires or permits an agency to handle using safeguarding or dissemination controls" * Designating CUI occurs when an authorized holder, consistent with US 32 CFR Part 2002 and the CUI Registry, determines that a specific item of information falls into a CUI category or subcategory. * The designating agency is the executive branch agency that designates or approves the designation of a specific item of information as CUI. * The authorized holder who designates the CUI must make recipients aware of the information's CUI status when disseminating that information. * Disseminating occurs when authorized holders provide access, transmit, or transfer CUI to other authorized holders through any means, whether internal or external to the agency.

Once designated as CUI, US Federal Agencies and their contractors must assign CUI marks as prescribed by the National Archives and Records Administration (NARA) CUI Registry, and display marks as prescribed by the CUI Marking Handbook.

CUI markings must be displayed on hard copy, on containers, electronic media, and to end users for IT systems.

When HL7 content is designated as CUI, these computable markings can be interoperably conveyed using HL7 security label CUI tags, and may be included in HL7 text and narrative elements as human readable markings.

Impact of CUI markings:

CUI Custodians must enforce CUI security controls per applicable CUI policies. Federal agencies and their contractors must adhere to FISMA and NIST SP 800-53 security controls. Custodians, who are not Federal agencies or agency contractors, and are receivers of CUI, must adhere to NIST SP 800-171 security controls and those dictated by the Authorities indicated by the assigned CUI markings.

For most participants in US healthcare information exchange, including Federal Agencies and their contractors, additional controls are required by HIPAA Security standards for health information US 42 USC 1320d-2(d)(2) https://www.govinfo.gov/content/pkg/USCODE-2016-title42/pdf/USCODE-2016-title42-chap7-subchapXI-partC-sec1320d-2.pdf

Federal Agencies and their contractors may be the CUI classifier of original CUI content; or a CUI derivative classifier, which reclassifies CUI content that has been aggregated with other CUI or Unclassified Uncontrolled Information (U) or dissembled from a larger CUI content; or declassifiers, depending on the designating agency's policies.

Applicable CUI policies include the following and any future applicable updates to policies or laws related to CUI:

* Executive Order 13556 https://www.federalregister.gov/articles/2010/11/09/2010-28360/controlled-unclassified-information * US 32 CFR Part 2002 https://www.govinfo.gov/content/pkg/CFR-2017-title32-vol6/pdf/CFR-2017-title32-vol6-part2002.pdf * NIST SP 800-171 https://nvlpubs.nist.gov/nistpubs/SpecialPublications/NIST.SP.800-171r1.pdf * NIST SP 800-171A https://doi.org/10.6028/NIST.SP.800-171A * CUI Marking Handbook https://www.archives.gov/files/cui/20161206-cui-marking-handbook-v1-1.pdf * CUI Registry - Health Information Category https://www.archives.gov/cui/registry/category-detail/health-info * CUI Registry: Limited Dissemination Controls https://www.archives.gov/cui/registry/limited-dissemination * CUI Policy and Guidance https://www.archives.gov/cui/registry/policy-guidance

A displayed mark, required to be rendered as "(CUI)", indicating that a portion of an electronic or hardcopy information is protected at the level of the subset of CUI for which the authorizing law, regulation, or Government-wide policy does not set out specific handling or dissemination controls. Agencies handle CUI Basic according to the uniform set of controls set forth in this part and the CUI Registry. CUI Basic differs from CUI Specified (see definition for CUI Specified), and CUI Basic controls apply whenever CUI Specified ones do not cover the involved CUI. From CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html.

Usage Note:Examples of healthcare regulation governing CUI Basic marking include HIPAA Unique Identifier provisions 42 USC 1320d-2 note(b) https://www.govinfo.gov/content/pkg/USCODE-2016-title42/pdf/USCODE-2016-title42-chap7-subchapXI-partC-sec1320d-2.pdf; Title 38 Section 7332 https://www.govinfo.gov/content/pkg/USCODE-2016-title38/pdf/USCODE-2016-title38-partV-chap73-subchapIII-sec7332.pdf; and several sections of 42 CFR Part 2.related to consent and confidentiality, e.g., https://www.govinfo.gov/content/pkg/CFR-2017-title42-vol1/pdf/CFR-2017-title42-vol1-sec2-12.pdf

A displayed mark, required to be rendered as "CUI//PRVCY", indicating that the electronic or hardcopy controlled unclassified basic privacy information is private and must be protected at the level of the subset of CUI for which the authorizing law, regulation, or Government-wide policy does not set out specific handling or dissemination controls. Agencies handle CUI Basic according to the uniform set of controls set forth in this part and the CUI Registry. CUI Basic differs from CUI Specified (see definition for CUI Specified), and CUI Basic controls apply whenever CUI Specified ones do not cover the involved CUI. From CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html.

Usage Note:Examples of privacy regulation governing CUI Basic marking include 20 CFR 401.100 related to SSA disclosure of personal, program, and non-program information. https://www.govinfo.gov/content/pkg/CFR-2017-title20-vol2/pdf/CFR-2017-title20-vol2-sec401-100.pdf.

A displayed mark, required to be rendered as "(CUI//PRVCY)", indicating that a portion of an electronic or hardcopy information is protected at the level of the subset of CUI for which the authorizing law, regulation, or Government-wide policy does not set out specific handling or dissemination controls. Agencies handle CUI Basic according to the uniform set of controls set forth in this part and the CUI Registry. CUI Basic differs from CUI Specified (see definition for CUI Specified), and CUI Basic controls apply whenever CUI Specified ones do not cover the involved CUI. From CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html.

Usage Note:Examples of privacy regulation governing CUI Basic marking include 20 CFR 401.100 related to SSA disclosure of personal, program, and non-program information. https://www.govinfo.gov/content/pkg/CFR-2017-title20-vol2/pdf/CFR-2017-title20-vol2-sec401-100.pdf.

A displayed mark, required to be rendered as "CUI//SP-HLTH", indicating that the electronic or hardcopy information is protected at the level of the subset of CUI in which the authorizing law, regulation, or Government-wide policy contains specific handling controls that it requires or permits agencies to use that differ from those for CUI Basic. The CUI Registry indicates which laws, regulations, and Government-wide policies include such specific requirements. CUI Specified controls may be more stringent than, or may simply differ from, those required by CUI Basic; the distinction is that the underlying authority spells out the controls for CUI Specified information and does not for CUI Basic information. CUI Basic controls apply to those aspects of CUI Specified where the authorizing laws, regulations, and Government-wide policies do not provide specific guidance. From CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html.

Usage Note:Examples of healthcare regulation governing CUI Specified marking include HIPAA Transaction and Code Sets and references the Congressional requirement that HHS promulgate Privacy, and Security rules https://www.govinfo.gov/content/pkg/USCODE-2016-title42/pdf/USCODE-2016-title42-chap7-subchapXI-partC-sec1320d-2.pdf.

A displayed mark, required to be rendered as "(CUI//SP-HLTH)", indicating that a portion of an electronic or hardcopy information is protected at the level of the subset of CUI for which the authorizing law, regulation, or Government-wide policy does not set out specific handling or dissemination controls. Agencies handle CUI Basic according to the uniform set of controls set forth in this part and the CUI Registry. CUI Basic differs from CUI Specified (see definition for CUI Specified), and CUI Basic controls apply whenever CUI Specified ones do not cover the involved CUI. From CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html.

Usage Note:Examples of healthcare regulation governing CUI Specified marking include HIPAA Transaction and Code Sets and references the Congressional requirement that HHS promulgate Privacy, and Security rules https://www.govinfo.gov/content/pkg/USCODE-2016-title42/pdf/USCODE-2016-title42-chap7-subchapXI-partC-sec1320d-2.pdf

A displayed mark, required to be rendered as "CUI//SP-PRVCY", indicating that the electronic or hardcopy information is protected at the level of the subset of CUI for which the authorizing law, regulation, or Government-wide policy does not set out specific handling or dissemination controls. Agencies handle CUI Basic according to the uniform set of controls set forth in this part and the CUI Registry. CUI Basic differs from CUI Specified (see definition for CUI Specified), and CUI Basic controls apply whenever CUI Specified ones do not cover the involved CUI. From CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html.

Usage Note:Examples of privacy regulation governing CUI Specified marking is OMB M-17-12� This Memorandum sets forth the policy for Federal agencies to prepare for and respond to a breach of personally identifiable information (PII). It includes a framework for assessing and mitigating the risk of harm to individuals potentially affected by a breach, as well as guidance on whether and how to provide notification and services to those individuals. https://www.whitehouse.gov/sites/whitehouse.gov/files/omb/memoranda/2017/m-17-12\_0.pdf.

A displayed mark, required to be rendered as "(CUI//SP-PRVCY)", indicating that a portion of an electronic or hardcopy information is protected at the level of the subset of CUI for which the authorizing law, regulation, or Government-wide policy does not set out specific handling or dissemination controls. Agencies handle CUI Basic according to the uniform set of controls set forth in this part and the CUI Registry. CUI Basic differs from CUI Specified (see definition for CUI Specified), and CUI Basic controls apply whenever CUI Specified ones do not cover the involved CUI. From CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html.

Usage Note:Examples of privacy regulation governing CUI Specified marking is OMB M-17-12� This Memorandum sets forth the policy for Federal agencies to prepare for and respond to a breach of personally identifiable information (PII). It includes a framework for assessing and mitigating the risk of harm to individuals potentially affected by a breach, as well as guidance on whether and how to provide notification and services to those individuals. https://www.whitehouse.gov/sites/whitehouse.gov/files/omb/memoranda/2017/m-17-12\_0.pdf.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

List of current medications.

The current quantity of the specimen, i.e., initial quantity minus what has been actually used.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

**Description:**Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

**Description:**Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.

A code representing U.S. Federal laws governing research-related privacy policies known as the "Common Rule". The Common Rule is the U.S. Federal regulations governing the protection of human subjects in research (codified at Subpart A of 45 CFR part 46), which has been adopted by 15 U.S. Federal departments and agencies in an effort to promote uniformity, understanding, and compliance with human subject protections. Existing regulations governing the protection of human subjects in Food and Drug Administration (FDA)-regulated research (21 CFR parts 50, 56, 312, and 812) are separate from the Common Rule but include similar requirements.

Usage Note:Used to indicate the legal authority for assigning security labels to governed information. In this case, where collection, access, use, or disclosure of healthcare information or biospecimen is governed by the Common Rule use "COMMONRULE" as the security label policy code. Information or biospecimen disclosed under the Common Rule are not protected by the HIPAA Privacy Rule. If protected under other laws such as confidentiality provisions under the Common Rule, assign the HL7 Confidentiality code "M" (moderate).

A code representing an individual's consent directive that complies with HIPAA Privacy rule 45 CFR Section 164.508 Uses and disclosures for which an authorization is required https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-508.pdf, which is a US Federal law stipulating the policy elements of a valid authorization under this Section specific to disclosures for purposes of research when combined with a Common Rule or Federal Drug Administration consent to participate in research also known as a compound authorization.

Usage Note:The Agency for Healthcare Research and Quality (AHRQ) has developed the Informed Consent and Authorization Toolkit for Minimal Risk Research to facilitate the process of obtaining informed consent and Health Insurance Portability and Accountability Act (HIPAA) authorization from potential research subjects. This toolkit contains information for people responsible for ensuring that potential research subjects are informed in a manner that is consistent with medical ethics and regulatory guidelines. From https://www.ahrq.gov/sites/default/files/publications/files/ictoolkit.pdf.

Used to indicate the legal authority for assigning security labels to governed information. In this case, where collection, access, use, or disclosure of healthcare information is governed by an individual's right of access directive under 45 CFR Section 164.508 use "CompoundResearchCD" as the security label policy code.

Information or biospecimen disclosed under the Common Rule are not protected by the HIPAA Privacy Rule. If protected under other laws such as confidentiality provisions under the Common Rule, assign the HL7 Confidentiality code "M" (moderate).

See ActCode.\_ActPolicyType.\_ActPrivacyPolicy.\_ActPrivacyLaw.\_ActUSPrivacyLaw.HIPAAAuth (HIPAA Authorization for Disclosure). See: HIPAAAuth and NIH Sample Authorization Language for Research Uses and Disclosures of Individually Identifiable Health Information by a Covered Health Care Provider https://privacyruleandresearch.nih.gov/authorization.asp

A displayed mark rendered as "Confidential", which indicates to end users that the electronic or hardcopy information they are viewing must be protected at a level of protection as dictated by applicable policy.

May be used to indicate proprietary or classified information that is, for example, business, intelligence, or project related, e.g., secret ingredients in a therapeutic substance; location of disaster health facilities and providers, or the name of a manufacturer or project contractor. Example use cases include a display to alert authorized business system users that they are viewing additionally protected proprietary and business confidential information deemed proprietary under an applicable jurisdictional or organizational policy.

Usage Note:

The ConfidentialMark (confidential mark) description is based on the HL7 Confidentiality Concept Domain: Types of privacy metadata classifying an IT resource (data, information object, service, or system capability) according to its level of sensitivity, which is based on an analysis of applicable privacy policies and the risk of financial, reputational, or other harm to an individual or entity that could result if made available or disclosed to unauthorized individuals, entities, or processes.

Usage Note:Confidentiality codes may be used in security labels and privacy markings to classify IT resources based on sensitivity to indicate the obligation of a custodian or receiver to ensure that the protected resource is not made available or disclosed to individuals, entities, or processes (security principals) unless authorized per applicable policies. Confidentiality codes may also be used in the clearances of initiators requesting access to protected resources.

Map: Definition aligns with ISO 7498-2:1989 - Confidentiality is the property that information is not made available or disclosed to unauthorized individuals, entities, or processes.

Information the US Government creates or possesses, or that an entity creates or possesses for or on behalf of the Government, that a law, regulation, or Government-wide policy requires or permits an agency to handle using safeguarding or dissemination controls. However, CUI does not include classified information (see definition above) or information a non-executive branch entity possesses and maintains in its own systems that did not come from, or was not created or possessed by or for, an executive branch agency or an entity acting for an agency. Law, regulation, or Government-wide policy may require or permit safeguarding or dissemination controls in three ways: Requiring or permitting agencies to control or protect the information but providing no specific controls, which makes the information CUI Basic; requiring or permitting agencies to control or protect the information and providing specific controls for doing so, which makes the information CUI Specified; or requiring or permitting agencies to control the information and specifying only some of those controls, which makes the information CUI Specified, but with CUI Basic controls where the authority does not specify. Based on CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html .

Usage Note:Mandatory control marking, which must be displayed on the top portion of each rendered or printed page containing controlled information. Should be displayed at the bottom of each rendered or printed page containing controlled information. Must be displayed on each portion of controlled information at the portion level if portions are uncontrolled unclassified information. Based on CUI Marking Handbook https://www.archives.gov/files/cui/20161206-cui-marking-handbook-v1-1.pdf. For definitions of key terms see CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html.

**Description:**Proposed therapy may be contraindicated or ineffective based on an existing or recent drug therapy.

An allergy to a pharmaceutical product.

Transaction counts and value totals for each calendar day within the date range specified.

Electronic Funds Transfer (EFT) deposit into the payee's bank account

Custodian security system must declassify information assigned security labels by instantiating a new version of the classified information so as to break the binding of the classifying security label when assigning a new security label that marks the information as unclassified in accordance with applicable jurisdictional privacy policies associated with the target information. The system must retain an immutable record of the previous assignment and binding.

That portion of the eligible charges which a covered party must pay in a particular period (e.g. annual) before the benefits are payable by the adjudicator. This amount represents the covered party's deductible that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results.

Description of individual terms, provided as needed.

The removal of fibrin from whole blood or plasma through physical or chemical means

Custodian system must strip information of data that would allow the identification of the source of the information or the information subject.

Custodian system must remove target information from access after use.

Delegation policies specify which actions subjects are allowed to delegate to others. A delegation policy thus specifies an authorisation to delegate. Subjects must already possess the access rights to be delegated.

Delegation policies are aimed at subjects delegating rights to servers or third parties to perform actions on their behalf and are not meant to be the means by which security administrators would assign rights to subjects. A negative delegation policy identifies what delegations are forbidden.

A Delegation policy specifies the authorisation policy from which delegated rights are derived, the grantors, which are the entities which can delegate these access rights, and the grantees, which are the entities to which the access rights can be delegated. There are two types of delegation policy, positive and negative. (Based on PONDERS)

Policy for handling all demographic information about an information subject, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to all demographic about an information subject, the disclosure of which could impact the privacy, well-being, or safety of that subject.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.

**Definition:**All information pertaining to a patient's demographics (such as name, date of birth, gender, address, etc).

Criteria which specify subjects who should be removed from the eMeasure population and denominator before determining if numerator criteria are met. Denominator exclusions are used in proportion and ratio measures to help narrow the denominator.

Criteria which specify the removal of a subject, procedure or unit of measurement from the denominator, only if the numerator criteria are not met. Denominator exceptions allow for adjustment of the calculated score for those providers with higher risk populations. Denominator exceptions are used only in proportion eMeasures. They are not appropriate for ratio or continuous variable eMeasures. Denominator exceptions allow for the exercise of clinical judgment and should be specifically defined where capturing the information in a structured manner fits the clinical workflow. Generic denominator exception reasons used in proportion eMeasures fall into three general categories:

* Medical reasons * Patient (or subject) reasons * System reasons

Criteria for specifying the entities to be evaluated by a specific quality measure, based on a shared common set of characteristics (within a specific measurement set to which a given measure belongs). The denominator can be the same as the initial population, or it may be a subset of the initial population to further constrain it for the purpose of the eMeasure. Different measures within an eMeasure set may have different denominators. Continuous Variable eMeasures do not have a denominator, but instead define a measure population.

Definition:A health insurance policy that that covers benefits for dental services. Definition:A public or government health program that administers and funds coverage for dental care to assist program eligible who meet financial and health status criteria.

Communication of an agent from a living subject or environmental source to a living subject via agent migration through intact skin.

A fill providing sufficient supply for one day

Policy for handling information related to a diagnosis, health condition or health problem, which will be afforded heightened confidentiality. Diagnostic, health condition or health problem related information may be deemed sensitive by organizational policy, and require heightened confidentiality.

Usage Note:For use within an enterprise that provides heightened confidentiality to diagnostic, health condition or health problem related information deemed sensitive. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.

A clinician enters a diagnosis for a given patient.

A person reviews a list of diagnoses of a given patient.

**Definition:**All information pertaining to a patient's diagnostic image records (orders & results).

Code set to define specialized/allowed diets

An observation that reports the dilution of a sample.

Hypersensitivity resulting in an adverse reaction upon exposure to a drug.

Definition:An insurance policy that provides a regular payment to compensate for income lost due to the covered party's inability to work because of illness or injury.

Disclaimer information for the eMeasure.

A person provides a discharge instruction to a patient.

A clinician enters a discharge summary for a given patient.

A person reviews a discharge summary of a given patient.

List of discharge medications.

Discharge diagnosis are the diagnoses documented for administrative purposes as the time of hospital discharge.

Definition:A health insurance policy that covers benefits for healthcare services provided for named conditions under the policy, e.g., cancer, diabetes, or HIV-AIDS. Definition:A public or government health program that administers and funds coverage for health and social services to assist program eligible who meet financial and health status criteria related to a particular disease.Example:Reproductive health, sexually transmitted disease, and end renal disease programs.

The adjudication result associated is to be displayed to the receiver of the adjudication result.

A diet that uses carbohydrates sparingly. Typically with a restriction in daily energy content (e.g. 1600-2000 kcal).

Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure

Provision of treatment for oral health and/or dental surgery.

Policy for handling information related to an information subject's date of birth, which will be afforded heightened confidentiality.Policies may govern sensitivity of information related to an information subject's date of birth, the disclosure of which could impact the privacy, well-being, or safety of that subject.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Description:Document Attachment

Proposed dosage instructions for therapy differ from standard practice.

**Description:**Proposed dosage is inappropriate due to patient's medical condition.

Proposed length of therapy differs from standard practice.

Proposed length of therapy is longer than standard practice

Proposed length of therapy is longer than standard practice for the identified indication or diagnosis

Proposed length of therapy is shorter than that necessary for therapeutic effect

Proposed length of therapy is shorter than standard practice for the identified indication or diagnosis

Proposed dosage exceeds standard practice

Proposed dosage exceeds standard practice for the patient's age

Proposed dosage exceeds standard practice for the patient's height or body surface area

Proposed dosage exceeds standard practice for the patient's weight

Proposed dosage interval/timing differs from standard practice

Proposed dosage interval/timing differs from standard practice for the identified indication or diagnosis

Proposed dosage is below suggested therapeutic levels

Proposed dosage is below suggested therapeutic levels for the patient's age

Proposed dosage is below suggested therapeutic levels for the patient's height or body surface area

Proposed dosage is below suggested therapeutic levels for the patient's weight

Custodian security system must downgrade information assigned security labels by instantiating a new version of the classified information so as to break the binding of the classifying security label when assigning a new security label that marks the information as classified at a less protected level in accordance with applicable jurisdictional privacy policies associated with the target information. The system must retain an immutable record of the previous assignment and binding.

A displayed mark indicating that the electronic or hard-copy information is still under development and is not yet considered to be ready for normal use.

Proposed therapy may interact with an existing or recent drug therapy

Policy for handling information related to a drug, which will be afforded heightened confidentiality. Drug information may be deemed sensitive by organizational policy, and require heightened confidentiality.

Usage Note:For use within an enterprise that provides heightened confidentiality to drug information deemed sensitive. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.

Provision of treatment for drug abuse.

Custodian security system must assign and bind security labels derived from compilations of information by aggregation or disaggregation in order to classify information compiled in the information systems under its control for collection, access, use and disclosure in accordance with applicable jurisdictional privacy policies associated with the target information. The system must retain an immutable record of the previous assignment and binding.

The introduction of a drug into a subject with the intention of altering its biologic state with the intent of improving its health status.

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

Definition:A health insurance policy that covers benefits for prescription drugs, pharmaceuticals, and supplies. Definition:A public or government health program that administers and funds coverage for prescription drugs to assist program eligible who meet financial and health status criteria.

A reduction in the amount charged as a percentage of the amount. For example a 5% discount for volume purchase.

**Description:**The proposed therapy appears to have the same intended therapeutic benefit as an existing therapy, though the specific mechanisms of action vary.

**Description:**The proposed therapy appears to have the same intended therapeutic benefit as an existing therapy and uses the same mechanisms of action as the existing therapy.

The proposed therapy appears to duplicate an existing therapy

Policy for handling information related to developmental disability disorders and conditions caused by these disorders, which is afforded heightened confidentiality.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code.

A diverse group of chronic conditions that are due to mental or physical impairments impacting activities of daily living, self-care, language acuity, learning, mobility, independent living and economic self-sufficiency. Examples may include Down syndrome and Autism spectrum. However, the developmental disabilities to which this term applies versus other behavioral health categories varies by jurisdiction and organizational policy in part due to overlap with other behavioral health conditions. Implementers should constrain to those diagnoses applicable in the domain in which this code is used.

Includes all codes defining types of indications such as diagnosis, symptom and other indications such as contrast agents for lab tests.

A displayed mark on an electronic transmission or physical container such as an electronic transmittal wrapper, batch file, message header, or a physical envelop or package indicating that the contents, whether electronic or hardcopy information, must only be delivered to the authorized recipient(s) named in the address.

Usage Note:Required by US 32 CRF Part 2002 for container storing or transmitting CUI.

An allergy to a substance other than a drug or a food. E.g. Latex, pollen, etc.

Definition:An employee assistance program is run by an employer or employee organization for the purpose of providing benefits and covering all or part of the cost for employees to receive counseling, referrals, and advice in dealing with stressful issues in their lives. These may include substance abuse, bereavement, marital problems, weight issues, or general wellness issues. The services are usually provided by a third-party, rather than the company itself, and the company receives only summary statistical data from the service provider. Employee's names and services received are kept confidential.

Fees deducted on behalf of a payee for tuition and continuing education.

Electronic form with supporting or additional information to follow.

Private insurance policy that provides coverage in addition to other policies (e.g. in addition to a Public Healthcare insurance policy).

Hypersensitivity resulting in an adverse reaction upon exposure to environmental conditions.

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

An ellipse defined by four (column,row) pairs, the first two points specifying the endpoints of the major axis and the second two points specifying the endpoints of the minor axis.

A supply action where there is no 'valid' order for the supplied medication. E.g. Emergency vacation supply, weekend supply (when prescriber is unavailable to provide a renewal prescription)

Used to temporarily override normal authorization rules to gain access to data in a case of emergency. Use of this override code will typically be monitored, and a procedure to verify its proper use may be triggered when used.

A patient encounter that takes place at a dedicated healthcare service delivery location where the patient receives immediate evaluation and treatment, provided until the patient can be discharged or responsibility for the patient's care is transferred elsewhere (for example, the patient could be admitted as an inpatient or transferred to another facility.)

Policy for handling information related to emotional disturbance disorders and conditions caused by these disorders, which is afforded heightened confidentiality.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code.

Typical used to characterize behavioral and mental health issues of adolescents where the disorder may be temporarily diagnosed in order to avoid the potential and unnecessary stigmatizing diagnoses of disorder long term.

Policy for handling information related to an employee, which will be afforded heightened confidentiality. When a patient is an employee, an enterprise may have a policy that requires heightened confidentiality. Information deemed sensitive typically includes health information and patient role information including patient status, demographics, next of kin, and location.

Usage Note:Policy for handling information related to an employee, which will be afforded heightened confidentiality. Description: When a patient is an employee, an enterprise may have a policy that requires heightened confidentiality. Information deemed sensitive typically includes health information and patient role information including patient status, demographics, next of kin, and location.

Policy for handling information related to an employer which is deemed classified to protect an employee who is the information subject, and which will be afforded heightened confidentiality. Description: Policies may govern sensitivity of information related to an employer, such as law enforcement or national security, the identity of which could impact the privacy, well-being, or safety of an information subject who is an employee.

Usage Notes:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.

Privacy consent directive restricting or prohibiting access, use, or disclosure of personal information, including de-identified information, and personal effects, such as biometrics, biospecimen or genetic material, which may be used to identify an individual in a registry or repository for all purposes except for emergency treatment generally, which may include treatment during a disaster, a threat, in an emergency department and for break the glass purposes of use as specified by applicable domain policy.

Usage Note:To specify the scope of an "EMRGONLY" consent directive within a policy domain, use one or more of the following Purpose of Use codes in the ActReason code system OID: 2.16.840.1.113883.5.8.

* ETREAT (Emergency Treatment): To perform one or more operations on information for provision of immediately needed health care for an emergent condition. * BTG (break the glass): To perform policy override operations on information for provision of immediately needed health care for an emergent condition affecting potential harm, death or patient safety by end users who are not provisioned for this purpose of use. Includes override of organizational provisioning policies and may include override of subject of care consent directive restricting access. * ERTREAT (emergency room treatment): To perform one or more operations on information for provision of immediately needed health care for an emergent condition in an emergency room or similar emergent care context by end users provisioned for this purpose, which does not constitute as policy override such as in a "Break the Glass" purpose of use. * THREAT (threat): To perform one or more operations on information used to prevent injury or disease to living subjects who may be the target of violence. * DISASTER (disaster): To perform one or more operations on information used for provision of immediately needed health care to a population of living subjects located in a disaster zone.

Map: An "emergency only" consent directive maps to ISO/TS 17975:2015(E) 5.13 Exceptional access

Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure

Custodian system must render information unreadable by algorithmically transforming plaintext into ciphertext.

Usage Notes:A mathematical transposition of a file or data stream so that it cannot be deciphered at the receiving end without the proper key. Encryption is a security feature that assures that only the parties who are supposed to be participating in a videoconference or data transfer are able to do so. It can include a password, public and private keys, or a complex combination of all. (Per Infoway.)
A mathematical transposition of a file or data stream so that it cannot be deciphered at the receiving end without the proper key. Encryption is a security feature that assures that only the parties who are supposed to be participating in a videoconference or data transfer are able to do so. It can include a password, public and private keys, or a complex combination of all. (Per Infoway.)

Custodian system must render information unreadable and unusable by algorithmically transforming plaintext into ciphertext when "at rest" or in storage.

Custodian system must render information unreadable and unusable by algorithmically transforming plaintext into ciphertext while "in transit" or being transported by any means.

Custodian system must render information unreadable and unusable by algorithmically transforming plaintext into ciphertext while in use such that operations permitted on the target information are limited by the license granted to the end user.

A baseline value for the measured test that is inherently contained in the diluent. In the calculation of the actual result for the measured test, this baseline value is normally considered.

Proposed therapy may be inappropriate or ineffective because the end of administration is too close to another planned therapy

Definition:A public or government program that administers publicly funded coverage of kidney dialysis and kidney transplant services.

Example: In the U.S., the Medicare End-stage Renal Disease program (ESRD), the National Kidney Foundation (NKF) American Kidney Fund (AKF) The Organ Transplant Fund.

Communication of an agent from an environmental surface or source to a living subject by direct contact.

Fees deducted on behalf of a payee for charges based on a shorter payment frequency (i.e. next day versus biweekly payments.

A premium on a service fee is requested because, due to extenuating circumstances, the service took an extraordinary amount of time or supplies.

Policy for handling alcohol or drug-abuse information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to alcohol or drug-abuse information that is deemed sensitive.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.

Policy for handling information related to alcohol use disorders and conditions caused by these disorders, which is afforded heightened confidentiality.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code.

Domain provides codes that qualify the ActLabObsEnvfctsCode domain. (Environmental Factors)

Definition:An insurance policy under a benefit plan run by an employer or employee organization for the purpose of providing benefits other than pension-related to employees and their families. Typically provides health-related benefits, benefits for disability, disease or unemployment, or day care and scholarship benefits, among others. An employer sponsored health policy includes coverage of health care expenses arising from sickness or accidental injury, coverage for on-site medical clinics or for dental or vision benefits, which are typically provided under a separate policy. Coverage excludes health care expenses covered by accident or disability, workers' compensation, liability or automobile insurance.

**Description:**Indicates that a result is complete. No further results are to come. This maps to the 'complete' state in the observation result status code.

An allergy to a substance generally consumed for nutritional purposes.

A person reviews a Falls Risk Assessment Instrument report of a given patient.

No enteral intake of foot or liquids whatsoever, no smoking. Typically 6 to 8 hours before anesthesia.

Fax with supporting or additional information to follow.

Description:The introduction of material into a subject with the intent of providing nutrition or other dietary supplements (e.g. minerals or vitamins).

FDA label coating

FDA label color

FDA label imprint code

FDA label logo

FDA label scoring

FDA label shape

FDA label size

Communication of an agent from a living subject or environmental source to a living subject through oral contact with material contaminated by person or animal fecal material.

The initial fill against an order. (This includes initial fills against refill orders.)

A first fill where the quantity supplied is equal to one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets).

A first fill where the quantity supplied is equal to one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets) and also where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).

A first fill where the quantity supplied is less than one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.)

A first fill where the quantity supplied is less than one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.) and also where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets)

A billing arrangement where a Provider charges a separate fee for each intervention/procedure/event or product.

Fee for Service is used when an individual intervention/procedure/event is used for billing purposes. In other words, fees are associated with the intervention/procedure/event. For example, a specific CCI (Canadian Classification of Interventions) code has an associated fee and is used for billing purposes.

A first fill where the strength supplied is less than the ordered strength. (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).

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.

The Fibrin Index of the specimen. In the case of only differentiating between Absent and Present, recommend using 0 and 1

The passage of a liquid through a filter, accomplished by gravity, pressure or vacuum (suction).

The timestamp when the eMeasure was last packaged in the Measure Authoring Tool.

A billing arrangement where a Provider charges for non-clinical items. This includes interest in arrears, mileage, etc. Clinical content is not included in Invoices submitted with this type of billing arrangement.

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.

Hypersensitivity resulting in an adverse reaction upon exposure to food.

A patient encounter that takes place both outside a dedicated service delivery location and outside a patient's residence. Example locations might include an accident site and at a supermarket.

Definition:An insurance policy that covers qualified benefits under a Flexible Benefit plan such as group medical insurance, long and short term disability income insurance, group term life insurance for employees only up to $50,000 face amount, specified disease coverage such as a cancer policy, dental and/or vision insurance, hospital indemnity insurance, accidental death and dismemberment insurance, a medical expense reimbursement plan and a dependent care reimbursement plan.Discussion:See UnderwriterRoleTypeCode flexible benefit plan which is defined as a benefit plan that allows employees to choose from several life, health, disability, dental, and other insurance plans according to their individual needs. Also known as cafeteria plans. Authorized under Section 125 of the Revenue Act of 1978.

Financial management department members who have access to healthcare consumer information as part of a patient account, billing and claims workflows.

Security Compartment Labels assigned to consumer information used in these workflows should be met or exceeded by the Security Compartment attribute claimed by a participant in a financial management workflow who is requesting access to that information.

Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure

Anticipated or actual final fee associated with treating a patient.

Communication of an agent from an non-living material to a living subject through direct contact.

Proposed therapy may interact with certain foods

Communication of an agent from a food source to a living subject via oral consumption.

The adjudication result associated is to be printed on the specified form, which is then provided to the covered party.

**Description:**The element does not follow the formatting or type rules defined for the field.

A diet consisting of a formula feeding, either for an infant or an adult, to provide nutrition either orally or through the gastrointestinal tract via tube, catheter or stoma.

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

**Description:**The request is suspected to have a fraudulent basis.

Anticipated or actual initial fee associated with treating a patient.

A supply action to restock a smaller more local dispensary.

Federal tax on transactions such as the Goods and Services Tax (GST)

**Definition:**The therapy being performed is in some way out of alignment with the requested therapy.

Fees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee.

Policy for handling genetic disease information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to genetic disease information that is deemed sensitive.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.

A consent directive compliant with the European Union General Data Protection Regulation (GDPR) definition: Consent of the data subject means any freely given, specific, informed and unambiguous indication of the data subject's wishes by which he or she, by a statement or by a clear affirmative action, signifies agreement to the processing of personal data relating to him or her.

Where processing is based on consent, the controller shall be able to demonstrate that the data subject has consented to processing of his or her personal data. If the data subject's consent is given in the context of a written declaration which also concerns other matters, the request for consent shall be presented in a manner which is clearly distinguishable from the other matters, in an intelligible and easily accessible form, using clear and plain language. Any part of such a declaration which constitutes an infringement of this Regulation shall not be binding. The data subject shall have the right to withdraw his or her consent at any time. The withdrawal of consent shall not affect the lawfulness of processing based on consent before its withdrawal. Prior to giving consent, the data subject shall be informed thereof. It shall be as easy to withdraw as to give consent. When assessing whether consent is freely given, utmost account shall be taken of whether, inter alia, the performance of a contract, including the provision of a service, is conditional on consent to the processing of personal data that is not necessary for the performance of that contract. Consent should be given by a clear affirmative act establishing a freely given, specific, informed and unambiguous indication of the data subject's agreement to the processing of personal data relating to him or her, such as by a written statement, including by electronic means, or an oral statement. This could include ticking a box when visiting an internet website, choosing technical settings for information society services or another statement or conduct which clearly indicates in this context the data subject's acceptance of the proposed processing of his or her personal data. Silence, pre-ticked boxes or inactivity should not therefore constitute consent. Consent should cover all processing activities carried out for the same purpose or purposes. When the processing has multiple purposes, consent should be given for all of them. If the data subject's consent is to be given following a request by electronic means, the request must be clear, concise and not unnecessarily disruptive to the use of the service for which it is provided.

Usage Note:* Article 4.11 GDPR Definitions https://gdpr-info.eu/art-4-gdpr/ 11) 'Consent' of the data subject means any freely given, specific, informed and unambiguous indication of the data subject's wishes by which he or she, by a statement or by a clear affirmative action, signifies agreement to the processing of personal data relating to him or her. Article 7 GDPR Conditions for consent https://gdpr-info.eu/art-7-gdpr Recital 32 Conditions for consent\* https://gdpr-info.eu/recitals/no-32 Recital 42 Burden of proof and requirements for consent\* https://gdpr-info.eu/recitals/no-42/> Recital 43 Freely given consent\https://gdpr-info.eu/recitals/no-43 GDPR Consent Brief https://gdpr-info.eu/issues/consent/ Art. 4 GDPR Definitions Art. 6 GDPR Lawfulness of processing Art. 7 GDPR Conditions for consent Art. 8 GDPR Conditions applicable to child's consent in relation to information society services Art. 9 GDPR Processing of special categories of personal data Art. 22 GDPR Automated individual decision-making, including profiling Art. 49 GDPR Derogations for specific situations

Relevant GDPR Recitals: (32) Conditions for consent (33) Consent to certain areas of scientific research (38) Special protection of children's personal data (40) Lawfulness of data processing (42) Burden of proof and requirements for consent (43) Freely given consent (50) Further processing of personal data (51) Protecting sensitive personal data (54) Processing of sensitive data in public health sector (71) Profiling (111) Exceptions for certain cases of international transfers (155) Processing in the employment context (161) Consenting to the participation in clinical trials (171) Repeal of Directive 95/46/EC and transitional provisions

Processing of personal data, inclusive of the special categories of data, is lawful only if the data subject has given explicit consent to the processing of his or her personal data, inclusive of the special categories of data, for one or more specific purposes, except where Union or Member State law provide that the prohibition to use the data may not be lifted by the data subject; and for personal data which are manifestly made public by the data subject.

Usage Note:The description is based on the following GDPR provisions: Article 6.1.a https://gdpr-info.eu/art-6-gdpr/ 1Processing shall be lawful only if and to the extent that at least one of the following applies: (a) the data subject has given consent to the processing of his or her personal data for one or more specific purposes. Article 9.1, 9.2a., 9.2.e https://gdpr-info.eu/art-9-gdpr/ 1. Processing of personal data revealing racial or ethnic origin, political opinions, religious or philosophical beliefs, or trade union membership, and the processing of genetic data, biometric data for the purpose of uniquely identifying a natural person, data concerning health or data concerning a natural person's sex life or sexual orientation shall be prohibited. 2. Paragraph 1 shall not apply if one of the following applies: (a) the data subject has given explicit consent to the processing of those personal data for one or more specified purposes, except where Union or Member State law provide that the prohibition referred to in paragraph 1 may not be lifted by the data subject; and (e) processing relates to personal data which are manifestly made public by the data subject.

A consent directive that complies with regulatory requirements for a consent directive compliant with the European Union General Data Protection Regulation (GDPR) definition: Consent of the data subject means any freely given, specific, informed and unambiguous indication of the data subject's wishes by which he or she, by a statement or by a clear affirmative action, signifies agreement to the processing of personal data relating to him or her.

GDPR research consent directive has the additional caveat that it is often not possible to fully identify the purpose of personal data processing for scientific research purposes at the time of data collection. Therefore, data subjects should be allowed to give their consent to certain areas of scientific research when in keeping with recognized ethical standards for scientific research. Data subjects should have the opportunity to give their consent only to certain areas of research or parts of research projects to the extent allowed by the intended purpose.

Usage Note:* HL7 Purpose of Use codes include specialize research purposes of use, which could be used to convey a data subject's purpose of use restrictions related to areas of research or parts of research projects. See citations for GDPRResearchCD and below: Recital 33 Consent to certain areas of scientific research https://gdpr-info.eu/recitals/no-33/> Recital 157 Information from registries and scientific research https://gdpr-info.eu/recitals/no-157 Recital 159 Processing for scientific research purposes\https://gdpr-info.eu/recitals/no-159/

Proposed therapy is outside of standard practice for a geriatric patient.

Proposed therapy may be inappropriate or contraindicated due to patient genetic indicators.

Proposed therapy may be inappropriate or contraindicated due to patient gender.

Policy for handling information related to an information subject's gender and sexual orientation, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's gender and sexual orientation, the disclosure of which could impact the privacy, well-being, or safety of that subject.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Description:A DNA segment that contributes to phenotype/function. In the absence of demonstrated function a gene may be characterized by sequence, transcription or homology

General care performed by a general practitioner or family doctor as a responsible provider for a patient.

Gluten free diet for celiac disease.

The medical service was provided to a patient in good faith that they had medical coverage, although no evidence of coverage was available before service was rendered.

Description:Accuracy determined as per the GIS tier code system.

List of observations in goal mood.

Definition:A set of codes used to indicate a government program that is an organized structure for administering and funding coverage of a benefit package for covered parties meeting eligibility criteria, typically related to employment, health and financial status. Government programs are established or permitted by legislation with provisions for ongoing government oversight. Regulation mandates the structure of the program, the manner in which it is funded and administered, covered benefits, provider types, eligibility criteria and financial participation. A government agency is charged with implementing the program in accordance to the regulationExample:Federal employee health benefit program in the U.S. Description:The school grade or level the patient was in when immunized.

A grantor's terms of agreement to which a grantee may assent or dissent, and which may include an opportunity for a grantee to request restrictions or extensions.

Comment:A grantor typically is able to stipulate preferred terms of agreement when the grantor has control over the topic of the agreement, which a grantee must accept in full or may be offered an opportunity to extend or restrict certain terms.Usage Note:If the grantor's term of agreement must be accepted in full, then this is considered "basic consent". If a grantee is offered an opportunity to extend or restrict certain terms, then the agreement is considered "granular consent".Examples:

* Healthcare: A PHR account holder \[grantor\] may require any PHR user \[grantee\] to accept the terms of agreement in full, or may permit a PHR user to extend or restrict terms selected by the account holder or requested by the PHR user. * Non-healthcare: The owner of a resource server \[grantor\] may require any authorization server \[grantee\] to meet authorization requirements stipulated in the grantor's terms of agreement.

**Description:**Global Trade Item Number is an identifier for trade items developed by GS1 (comprising the former EAN International and Uniform Code Council).

Used to allow measure developers to provide additional guidance for implementers to understand greater specificity than could be provided in the logic for data criteria.

**Description:**HCPCS Level II (HCFA-assigned) and Carrier-assigned (Level III) modifiers are reported in Appendix A of CPT 2000 Standard Edition and in the Medicare Bulletin.

Description:Health Record Attachment

**Definition:**There should be no actions taken in fulfillment of a request that has been held or suspended.

An observation of the hemolysis index of the specimen in g/L

Healthcare encounter that takes place in the residence of the patient or a designee

Indicates that the observation is of a person’s living situation in a household including the household composition and circumstances.

Definition:A health insurance policy that covers healthcare benefits by protecting covered parties from medical expenses arising from health conditions, sickness, or accidental injury as well as preventive care. Health insurance policies explicitly exclude coverage for losses insured under a disability policy, workers' compensation program, liability insurance (including automobile insurance); or for medical expenses, coverage for on-site medical clinics or for limited dental or vision benefits when these are provided under a separate policy.Discussion:Health insurance policies are offered by health insurance plans that typically reimburse providers for covered services on a fee-for-service basis, that is, a fee that is the allowable amount that a provider may charge. This is in contrast to managed care plans, which typically prepay providers a per-member/per-month amount or capitation as reimbursement for all covered services rendered. Health insurance plans include indemnity and healthcare services plans.

A code representing U.S. Public Law 104-191 Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule (45 CFR Section 164.508) Uses and disclosures for which an authorization is required https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-508.pdf, which stipulates the process by which a covered entity seeks agreement from an individual to use or disclose protected health information for other purposes, or to authorize another covered entity to disclose protected health information to the requesting covered entity, are termed "authorizations".

An "authorization" is required by the Privacy Rule for uses and disclosures of protected health information not otherwise allowed by the Rule. Where the Privacy Rule requires patient authorization, voluntary consent is not sufficient to permit a use or disclosure of protected health information unless it also satisfies the requirements of a valid authorization. An authorization is a detailed document that gives covered entities permission to use protected health information for specified purposes, which are generally other than treatment, payment, or health care operations, or to disclose protected health information to a third party specified by the individual.

An authorization must specify a number of elements, including a description of the protected health information to be used and disclosed, the person authorized to make the use or disclosure, the person to whom the covered entity may make the disclosure, an expiration date, and, in some cases, the purpose for which the information may be used or disclosed. With limited exceptions, covered entities may not condition treatment or coverage on the individual providing an authorization. https://www.hhs.gov/hipaa/for-professionals/faq/264/what-is-the-difference-between-consent-and-authorization/index.html

Usage Note:Used to indicate the legal authority for assigning security labels to HIPAA governed information. In this case, where use or disclosure of healthcare information is governed by a covered entity's HIPAA Authorization for Disclosure, use "HIPAAAuth" as the security label policy code.

Information disclosed under a HIPAA Authorization for Disclosure no longer has the level of confidentiality protection afforded under the 45 CFR Section 164.506 - Uses and disclosures to carry out treatment, payment, or health care operations https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-508.pdf, which is considered the "norm", assign the HL7 Confidentiality code "M" (moderate), which may be protected under other laws such as the Federal Trade Commission privacy and security regulations.

A code representing an individual's consent directive that complies with HIPAA Privacy rule 45 CFR Section 164.508 Uses and disclosures for which an authorization is required https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-508.pdf, which is a US Federal law stipulating the policy elements of a valid authorization under this Section.

An "authorization" is required by the Privacy Rule for uses and disclosures of protected health information not otherwise allowed by the Rule. Where the Privacy Rule requires patient authorization, voluntary consent is not sufficient to permit a use or disclosure of protected health information unless it also satisfies the requirements of a valid authorization. An authorization is a detailed document that gives covered entities permission to use protected health information for specified purposes, which are generally other than treatment, payment, or health care operations, or to disclose protected health information to a third party specified by the individual.

An authorization must specify a number of elements, including a description of the protected health information to be used and disclosed, the person authorized to make the use or disclosure, the person to whom the covered entity may make the disclosure, an expiration date, and, in some cases, the purpose for which the information may be used or disclosed. With limited exceptions, covered entities may not condition treatment or coverage on the individual providing an authorization. https://www.hhs.gov/hipaa/for-professionals/faq/264/what-is-the-difference-between-consent-and-authorization/index.html

A HIPAA Authorization must comply with 45 CFR Section164.508(c) Implementation specifications: Core elements and requirements - (1) Core elements. A valid authorization under this Section must contain at least the following elements: (i) A description of the information to be used or disclosed that identifies the information in a specific and meaningful fashion. (ii) The name or other specific identification of the person(s), or class of persons, authorized to make the requested use or disclosure. (iii) The name or other specific identification of the person(s), or class of persons, to whom the covered entity may make the requested use or disclosure. (iv) A description of each purpose of the requested use or disclosure. The statement "at the request of the individual" is a sufficient description of the purpose when an individual initiates the authorization and does not, or elects not to, provide a statement of the purpose. (v) An expiration date or an expiration event that relates to the individual or the purpose of the use or disclosure. The statement "end of the research study," "none," or similar language is sufficient if the authorization is for a use or disclosure of protected health information for research, including for the creation and maintenance of a research database or research repository. (vi) Signature of the individual and date. If the authorization is signed by a personal representative of the individual, a description of such representative's authority to act for the individual must also be provided. (2)Required statements. In addition to the core elements, the authorization must contain statements adequate to place the individual on notice of all of the following: (i) The individual's right to revoke the authorization in writing, and either: (A) The exceptions to the right to revoke and a description of how the individual may revoke the authorization; or (B) To the extent that the information in paragraph (c)(2)(i)(A) of this section is included in the notice required by Section 164.520, a reference to the covered entity's notice. https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-508.pdf

Usage Note:Used to indicate the legal authority for assigning security labels to HIPAA governed information. In this case, where collection, access, use, or disclosure of healthcare information is governed by a an individual's HIPAA Authorization for Disclosure, use "HIPAAAuthCD" as the security label policy code.

Information governed under a HIPAA Authorization for Disclosure has the level of confidentiality protection afforded under the 45 CFR Section 164.506 - Uses and disclosures to carry out treatment, payment, or health care operations https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-506.pdf, which is considered the "norm", assign the HL7 Confidentiality code "N" (normal).

A code representing U.S. Public Law 104-191 Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule (45 CFR Section 164.522), which stipulates the process by which a covered entity seeks agreement from an individual regarding how it will use and disclose the individual's protected health information for treatment, payment, and health care operations is termed a "consent".

The Privacy Rule permits, but does not require, a covered entity to voluntarily obtain patient consent for uses and disclosures of protected health information for treatment, payment, and health care operations. Covered entities that do so have complete discretion to design a process that best suits their needs. From https://www.hhs.gov/hipaa/for-professionals/faq/264/what-is-the-difference-between-consent-and-authorization/index.html. The provisions relating to consent are largely contained in Section 164.522 Rights to request privacy protection for protected health information https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-522.pdf.

Usage Note:Used to indicate the legal authority for assigning security labels to governed information. In this case, where collection, access, use, or disclosure of healthcare information is governed by 45 CFR Section 164.522 use 'HIPAAConsent' as the security label policy code.

Since information governed by a 45 CFR Section 164.522 has a level of confidentiality protection that is more stringent than the normal level of protection under HIPAA 45 CFR Section 164.506 Uses and disclosures to carry out treatment, payment, or health care operations https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-506.pdf, assign the HL7 Confidentiality code 'R' (restricted).

A code representing U.S. Public Law 104-191 Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule 45 CFR Section 164.522 Rights to request privacy protection for protected health information https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-522.pdf, which stipulates the process by which a covered entity seeks agreement from an individual regarding how it will use and disclose the individual's protected health information for treatment, payment, and health care operations is termed a "consent."

Usage Note:Used to indicate the legal authority for assigning security labels to governed information. In this case, where collection, access, use, or disclosure of healthcare information is governed by an individual's consent directive under 45 CFR Section 164.522 use "HIPAAConsentCD" as the security label policy code.

Since information governed by a 45 CFR Section 164.522 has a level of confidentiality protection that is more stringent than the normal level of protection under HIPAA 45 CFR Section 164.506 Uses and disclosures to carry out treatment, payment, or health care operations https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-506.pdf, assign the HL7 Confidentiality code "R" (restricted).

A code representing U.S. Public Law 104-191 Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule (45 CFR Section 164.520), which stipulates an individual's right to adequate notice of the uses and disclosures of protected health information that may be made by the covered entity, and of the individual's rights and the covered entity's legal duties with respect to protected health information. Relevant HIPAA Privacy Rule provisions are at Section 164.520 (a) Standard: Notice of privacy practices. https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-520.pdf

Usage Note:Used to indicate the legal authority for assigning security labels to HIPAA governed information. In this case, if collection, access, use, or disclosure of healthcare information is governed by a covered entity's HIPAA Notice of Privacy Practices, use "HIPAANOPP" as the security label policy code.

Information governed under a HIPAA Notice of Privacy Practices has the level of confidentiality protection afforded under the 45 CFR Section 164.506 - Uses and disclosures to carry out treatment, payment, or health care operations https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-506.pdf , which is considered the "norm", assign the HL7 Confidentiality code "N" (normal).

A code representing U.S. Public Law 104-191 Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule (45 CFR Section 164.508), which stipulates the privacy rights of an individual who is the subject of psychotherapy notes, and requires authorization for certain uses and disclosure of that information.

Definition of Psychotherapy notes 45 CFR Section 164.501 https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-501.pdf: Psychotherapy notes means notes recorded (in any medium) by a health care provider who is a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint, or family counseling session and that are separated from the rest of the individual's medical record. Psychotherapy notes excludes medication prescription and monitoring, counseling session start and stop times, the modalities and frequencies of treatment furnished, results of clinical tests, and any summary of the following items: Diagnosis, functional status, the treatment plan, symptoms, prognosis, and progress to date.

See Section 164.508 Uses and disclosures for which an authorization is required. (2)Authorization required: Psychotherapy notes https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-508.pdf: Notwithstanding any provision of this subpart, other than the transition provisions in Section 164.532, a covered entity must obtain an authorization for any use or disclosure of psychotherapy notes, except: (i) To carry out the following treatment, payment, or health care operations: (A) Use by the originator of the psychotherapy notes for treatment; (B) Use or disclosure by the covered entity for its own training programs in which students, trainees, or practitioners in mental health learn under supervision to practice or improve their skills in group, joint, family, or individual counseling; or (C) Use or disclosure by the covered entity to defend itself in a legal action or other proceeding brought by the individual; and (ii) A use or disclosure that is required by Section 164.502(a)(2)(ii) or permitted by Section 164.512(a); Section 164.512(d) with respect to the oversight of the originator of the psychotherapy notes; Section 164.512(g)(1); Section 164.512(j)(1)(i).

Usage Note:Used to indicate the legal authority for assigning security labels to HIPAA governed information. In this case, the collection, access, use, or disclosure of healthcare information is governed by HIPAA 45 CFR 164.508 (2) Authorization required: Psychotherapy notes https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-506.pdf , use "HIPAAPsyNotes" as the security label policy code.

Since information governed by a HIPAA 45 CFR 164.508 (2) has a level of confidentiality protection that is more stringent than the normal level of protection under 45 CFR Section 164.506 Uses and disclosures to carry out treatment, payment, or health care operations https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-506.pdf, assign the HL7 Confidentiality code "R" (restricted).

A code representing U.S. Public Law 104-191 Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule 45 CFR Section 164.524 Access of individuals to protected health information https://www.govinfo.gov/app/details/CFR-2017-title45-vol1/CFR-2017-title45-vol1-sec164-524, which stipulates that an individual has a right of access to inspect and obtain a copy of protected health information about the individual in a designated record set, for as long as the protected health information is maintained in the designated record set with exceptions stipulated in HIPAA Privacy Rule Section 164.524. Exceptions include psychotherapy notes and information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding.

If an individual's request for access directs the covered entity to transmit the copy of protected health information directly to another person designated by the individual, the covered entity must provide the copy to the person designated by the individual. The individual's request must be in writing, signed by the individual, and clearly identify the designated person and where to send the copy of protected health information.

For discussion on extent of right, grounds for denial, and documentation requirements see: HHS Individuals' Right under HIPAA to Access their Health Information 45 CFR Section 164.524 https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/access/index.html and HHS FAQ on Right of Access vs. HIPAA Authorization https://www.hhs.gov/hipaa/for-professionals/faq/2041/why-depend-on-the-individuals-right/index.html

Usage Note:Used to indicate the legal authority for assigning security labels to governed information. In this case, where collection, access, use, or disclosure of healthcare information is governed under 45 CFR Section 164.5224 use "HIPAAROA" as the security label policy code.

Information disclosed under a HIPAA 42 CFR Section 164.524 no longer has the level of confidentiality protection afforded under the 45 CFR Section 164.506 - Uses and disclosures to carry out treatment, payment, or health care operations https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-508.pdf, which is considered the "norm", assign the HL7 Confidentiality code "M" (moderate), which may be protected under other laws such as the Federal Trade Commission privacy and security regulations.

A code representing U.S. Public Law 104-191 Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule 45 CFR Section 164.524 Access of individuals to protected health information https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-524.pdf, stipulating the policy elements of an individual's written and signed right of access directive requesting that a covered entity send the individual's protected health information (PHI) to a third party.

See 45 CFR 164.524(c)(3)(ii) If an individual's request for access directs the covered entity to transmit the copy of protected health information directly to another person designated by the individual, the covered entity must provide the copy to the person designated by the individual. The individual's request must be in writing, signed by the individual, and clearly identify the designated person and where to send the copy of protected health information. https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-524.pdf

This right applies to PHI in a designated record set, which is defined as "Designated record set means: (1) A group of records maintained by or for a covered entity that is: (i) The medical records and billing records about individuals maintained by or for a covered health care provider; (ii) The enrollment, payment, claims adjudication, and case or medical management record systems maintained by or for a health plan; or (iii) Used, in whole or in part, by or for the covered entity to make decisions about individuals. \[https://www.law.cornell.edu/cfr/text/45/164.501\]. Also see HHS Individuals' Right under HIPAA to Access their Health Information 45 CFR Section 164.524 \[https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/access/index.html\#maximumflatfee\].

Usage Note:Used to indicate the legal authority for assigning security labels to governed information. In this case, where collection, access, use, or disclosure of healthcare information is governed by an individual's right of access directive under 45 CFR Section 164.524 use "HIPAAROAD" as the security label policy code.

Information disclosed under a HIPAA 42 CFR Section 164.524 no longer has the level of confidentiality protection afforded under the 45 CFR Section 164.506 - Uses and disclosures to carry out treatment, payment, or health care operations https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-508.pdf, which is considered the "norm", assign the HL7 Confidentiality code "M" (moderate), which may be protected under other laws such as the Federal Trade Commission privacy and security regulations.

A code representing an individual's consent directive that complies with HIPAA Privacy rule 45 CFR Section 164.508 Uses and disclosures for which an authorization is required https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-508.pdf, which is a US Federal law stipulating the policy elements of a valid authorization under this Section specific to disclosures for purposes of research.

Usage Note:Used to indicate the legal authority for assigning security labels to governed information. In this case, where collection, access, use, or disclosure of healthcare information is governed by an individual's HIPAA Authorization for Disclosure for Research under 45 CFR Section 164.508 use "HIPAAResearchAuthCD" as the security label policy code.

Information disclosed under an individual's HIPAA Authorization for Disclosure for Research are not protected by the HIPAA Privacy Rule. If protected under other laws such as confidentiality provisions under the Common Rule, assign the HL7 Confidentiality code "M" (moderate).

See ActCode.\_ActPolicyType.\_ActPrivacyPolicy.\_ActPrivacyLaw.\_ActUSPrivacyLaw.HIPAAAuth (HIPAA Authorization for Disclosure). See: HIPAAAuth and NIH Sample Authorization Language for Research Uses and Disclosures of Individually Identifiable Health Information by a Covered Health Care Provider https://privacyruleandresearch.nih.gov/authorization.asp

A code representing 45 CFR 164.522 Rights to request privacy protection for protected health information, which is a US Federal law stipulating the privacy rights of an individual to restrict disclosure of information related to health care items or services for which the individual pays out of pocket in full to a health plan or payer.

See 45 CFR 164.522 https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-522.pdf. (vi) A covered entity must agree to the request of an individual to restrict disclosure of protected health information about the individual to a health plan if: (A) The disclosure is for the purpose of carrying out payment or health care operations and is not otherwise required by law; and (B) The protected health information pertains solely to a health care item or service for which the individual, or person other than the health plan on behalf of the individual, has paid the covered entity in full.

Usage Note:Used to indicate the legal authority for assigning security labels to HIPAA governed information. In this case, the collection, access, use, or disclosure of healthcare information is governed by HIPAA 45 CFR 164.522 https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-522.pdf use "HIPAASelfPay" as the security label policy code.

Since information governed by a HIPAA 45 CFR 164.522 has a level of confidentiality protection that is more stringent than the normal level of protection under 45 CFR Section 164.506 Uses and disclosures to carry out treatment, payment, or health care operations https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-506.pdf, assign the HL7 Confidentiality code "R" (restricted).

Definition:A government program that provides health coverage to individuals who are considered medically uninsurable or high risk, and who have been denied health insurance due to a serious health condition. In certain cases, it also applies to those who have been quoted very high premiums a" again, due to a serious health condition. The pool charges premiums for coverage. Because the pool covers high-risk people, it incurs a higher level of claims than premiums can cover. The insurance industry pays into the pool to make up the difference and help it remain viable.

Historical list of medications.

Description:While the record was accepted in the repository, there is a more recent version of a record of this type.

Policy for handling HIV or AIDS information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to HIV or AIDS information that is deemed sensitive.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Definition:Government administered and funded HIV-AIDS program for beneficiaries meeting financial and health status criteria. Administration, funding levels, eligibility criteria, covered benefits, provider types, and financial participation are typically set by a regulatory process. Payer responsibilities for administering the program may be delegated to contractors.Example:In the U.S., the Ryan White program, which is administered by the Health Resources and Services Administration. Description:Exposure participants' interaction occurred during the course of health care delivery or in a health care delivery setting, but did not involve the direct provision of care (e.g. a janitor cleaning a patient's hospital room). Definition:A policy for a health plan that provides coverage for health care only through contracted or employed physicians and hospitals located in particular geographic or service areas. HMOs emphasize prevention and early detection of illness. Eligibility to enroll in an HMO is determined by where a covered party lives or works. Description:Exposure interaction occurred in context of one providing care for the other, i.e. a babysitter providing care for a child, a home-care aide providing assistance to a paraplegic. Description:Exposure participants' interaction occurred when both were patients being treated in the same (acute) health care delivery facility. Description:Exposure participants' interaction occurred when one visited the other who was a patient being treated in a health care delivery facility. Description:Exposure interaction occurred in context of domestic interaction, i.e. both participants reside in the same household.

A security category label field value, which indicates that access and use of an IT resource is restricted to members of human resources department or workflow.

Insurance policy that provides for an allotment of funds replenished on a periodic (e.g. annual) basis. The use of the funds under this policy is at the discretion of the covered party.

Joint Federal/Provincial Sales Tax

Custodian system must require human review and approval for permission requested.

Communication of an agent from a person to a proximate person.

Accommodations used in the care of diseases that are transmitted through casual contact or respiratory transmission.

Definition:Consent to have healthcare information collected in an electronic health record. This entails that the information may be used in analysis, modified, updated.

An observation that describes the icterus index of the specimen. It is recommended to use mMol/L of bilirubin

Used by one system to inform another that it has received a container.

Policy for handling information related to an identifier of an information subject, which will be afforded heightened confidentiality. Usage Note: Such policies may govern the sensitivity of information related to an identifier of an act, such as the identifier of a contract; a role, such as a citizen, a patient, a practitioner, or an organization; or an entity such as a medical device due to potential impact on the privacy, well-being, safety or integrity of an information subject. For example, protection against identity fraud or counterfeit.

Definition:Consent to have collected healthcare information disclosed.

Information on whether an increase or decrease in score is the preferred result (e.g., a higher score indicates better quality OR a lower score indicates better quality OR quality is within a range).

**Description:**The request is missing elements or contains elements which cause it to not meet the legal standards for actioning.

Description:Image Attachment Description:A person enters an immunization due or received for a given patient. Description:A person reviews a list of immunizations due or received for a given patient.

**Definition:**All information pertaining to a patient's vaccination records.

The introduction of an immunogen with the intent of stimulating an immune response, aimed at preventing subsequent infections by more viable agents.

A patient encounter where a patient is admitted by a hospital or equivalent facility, assigned to a location where patients generally stay at least overnight and provided with room, board, and continuous nursing service.

A grantor's presumed assent to the grantee's terms of agreement is based on the grantor's behavior, which may result from not expressly assenting to the consent directive offered, or from having no right to assent or dissent offered by the grantee.

Comment:Implied or "implicit" consent occurs when the behavior of the grantor is understood by a reasonable person to signal agreement to the grantee's terms.Usage Note:Implied consent with no opportunity to assent or dissent to certain terms is considered "basic consent".Examples:

* Healthcare: A patient schedules an appointment with a provider, and either does not take the opportunity to expressly assent or dissent to the provider's consent directive, does not have an opportunity to do so, as in the case where emergency care is required, or simply behaves as though the patient \[grantor\] agrees to the rights granted to the provider \[grantee\] in an implicit consent directive. * An injured and unconscious patient is deemed to have assented to emergency treatment by those permitted to do so under jurisdictional laws, e.g., Good Samaritan laws. * Non-healthcare: Upon receiving a driver's license, the driver is deemed to have assented without explicitly consenting to undergoing field sobriety tests. * A corporation that does business in a foreign nation is deemed to have deemed to have assented without explicitly consenting to abide by that nation's laws.

A grantor's presumed assent to the grantee's terms of agreement, which is based on the grantor's behavior, and includes a right to dissent to certain terms.

Comment:A grantor assenting to the grantee's terms of agreement may or may not exercise a right to dissent to grantor selected terms or to grantee's selected terms to which a grantor may dissent.Usage Note:Implied or "implicit" consent with an "opportunity to dissent" occurs when the grantor's behavior is understood by a reasonable person to signal assent to the grantee's terms of agreement whether the grantor requests or the grantee approves further restrictions, is considered "granular consent".Examples:

* Healthcare Examples: A healthcare provider deems a patient's assent to disclosure of health information to family members and friends, but offers an opportunity or permits the patient to dissent to such disclosures. * A health information exchanges deems a patient to have assented to disclosure of health information for treatment purposes, but offers the patient an opportunity to dissents to disclosure to particular provider organizations. * Non-healthcare Examples: A bank deems a banking customer's assent to specified collection, access, use, or disclosure of financial information as a requirement of holding a bank account, but provides the user an opportunity to limit third-party collection, access, use or disclosure of that information for marketing purposes.

Definition:Services provided directly and through contracted and operated indigenous peoples health programs.Example:Indian Health Service in the U.S.

**Description:**Contrast agent required for imaging study.

**Description:**Provision of prescription or direction to consume a product for purposes of bowel clearance in preparation for a colonoscopy.

**Description:**Provision of medication as a preventative measure during a treatment or other period of increased risk.

**Description:**Provision of medication during pre-operative phase; e.g., antibiotics before dental surgery or bowel prep before colon surgery.

**Description:**Provision of medication for pregnancy --e.g., vitamins, antibiotic treatments for vaginal tract colonization, etc.

Communication of an agent to a living subject via an undetermined route.

Definition:Consent to access healthcare information. Definition:Consent to access or "read" only, which entails that the information is not to be copied, screen printed, saved, emailed, stored, re-disclosed or altered in any way. This level ensures that data which is masked or to which access is restricted will not be.Example:Opened and then emailed or screen printed for use outside of the consent directive purpose. Definition:Consent to access and save only, which entails that access to the saved copy will remain locked.

Authorization to collect, access, use, or disclose specified patient health information in accordance with jurisdictional law, organizational policy, or a patient's consent directive, which may be implied, deemed, opt-in, opt-out, or explicit.

Authorization to collect, access, use, or disclose specified patient health information as explicitly consented to by the subject of the information or the subject's representative.

Authorization to collect, access, use, or disclose specified patient health information in accordance with judicial system protocol, such as in the case of a subpoena or court order.

Authorization to collect, access, use, or disclose specified patient health information where deemed necessary to avert potential danger to other persons in accordance with jurisdictional law, organizational policy, or standards of practice. For example, disclosure about a person threatening violence.

Authorization to collect, access, use, or disclose specified patient health information in accordance with emergency information transfer protocol dictated by jurisdictional law, organization policy, or standards of practice. For example, sharing of health information during disaster response.

Authorization to obtain information with no further permission to collect and store it.

Authorization to gather and store information.

Authorization to alter or remove identifying characteristics of an entity or individual that is a subject of the information.

Authorization to make information known to another party.

Authorization to alter information in order to conceal it from unauthorized recipients.

Authorization to access information within a specific context for communication purposes only. Storing, manipulating, and further disclosure are prohibited and may be technically disabled.

Authorization to remove information that a recipient is not authorized to access.

Authorization to make disclosed information known to another party.

Authorization to alter or relink deidentified information so that an entity or individual that is the subject of that information identifiable.

Authorization to employ or alter information.

Authorization to collect, access, use, or disclose specified patient health information necessary to avert potential public welfare risk in accordance with jurisdictional law, organizational policy, or standards of practice. For example, reporting that a person is a victim of abuse or demonstrating suicidal tendencies.

Authorization to collect, access, use, or disclose specified patient health information for public health, welfare, and safety purposes in accordance with jurisdictional law, organizational policy, or standards of practice. For example, public health reporting of notifiable conditions.

The initial quantity of the specimen in inventory

The first immunization administration in a series intended to produce immunity

Description:Exposure participants' interaction occurred in the course of one or both participants being incarcerated at a correctional facility

Proposed therapy may be inappropriate or contraindicated because of a recorded patient intolerance to the proposed product. (Intolerances are non-immune based sensitivities.)

Intermediate diagnoses are those diagnoses documented for administrative purposes during the course of a hospital stay.

**Definition:**The therapy action is being performed outside the bounds of the time period requested

An observation that relates to factors that may potentially cause interference with the observation

Description:Exposure interaction was intimate, i.e. participants are intimate companions (e.g. spouses, domestic partners).

List of intolerance observations.

**Definition:**A monitoring program that focuses on a drug which is under investigation and has not received regulatory approval for the condition being investigated

Payment is based on a payment intent for a previously submitted Invoice, based on formal adjudication results..

Transaction counts and value totals by invoice type (e.g. RXDINV - Pharmacy Dispense)

Used by one system to inform another that the container is in position for specimen transfer (e.g., container removal from track, pipetting, etc.).

Criteria for specifying the entities to be evaluated by a specific quality measure, based on a shared common set of characteristics (within a specific measurement set to which a given measure belongs).

Criteria for specifying the patients to be evaluated by a specific quality measure, based on a shared common set of characteristics (within a specific measurement set to which a given measure belongs). Details often include information based upon specific age groups, diagnoses, diagnostic and procedure codes, and enrollment periods.

Definition:Information re-disclosed without the patient's consent.

Premium paid on service fees in compensation for practicing in a remote location.

There is a clinical issue for the therapy that makes continuation of the therapy inappropriate.

Open Issue:The definition of this code does not correctly represent the concept space of its specializations (children)

Describes the items counted by the measure (e.g., patients, encounters, procedures, etc.)

Jurisdictional policy on collection, access, use, or disclosure of controlled unclassified information as defined by applicable jurisdictional law.

Jurisdictional policy on collection, access, use, or disclosure of de-identified information as defined by applicable jurisdictional law.

Jurisdictional policy on collection, access, use, or disclosure of information as defined by applicable jurisdictional law.

Jurisdictional policy on collection, access, use, or disclosure of information in a limited data set as defined by applicable jurisdictional law.

Jurisdictional policy on collection, access, use, or disclosure of information deemed non-sensitive by applicable jurisdiction law.

Jurisdictional policy on collection, access, use, or disclosure of information deemed public by applicable jurisdiction law.

Jurisdictional policy on collection, access, use, or disclosure of specified controlled unclassified information as defined by applicable jurisdictional policy.

Jurisdictional policy on collection, access, use, or disclosure of uncontrolled unclassified information as defined by applicable jurisdictional policy.

A significant word that aids in discoverability.

The ID of the patient, order, etc., was not found. Used for transactions other than additions, e.g. transfer of a non-existent patient.

The ID of the patient, order, etc., already exists. Used in response to addition transactions (Admit, New Order, etc.).

Description:Metadata associated with the identification (e.g. name or gender) does not match the identification being verified.

Categorization of types of observation that capture the main clinical knowledge subject which may be a medication, a laboratory test, a disease.

Categorization of types of observation that capture a knowledge subtopic which might be treatment, etiology, or prognosis.

Used by one system to inform another that the container has been released from that system.

Proposed therapy may be inappropriate or contraindicated due to recent lab test results

Description:All information pertaining to a patient's lab test records (orders & results)

Custodian security system must assign and bind security labels in order to classify information created in the information systems under its control for collection, access, use and disclosure in accordance with applicable jurisdictional privacy policies associated with the target information. The system must retain an immutable record of the assignment and binding.

Usage Note:In security systems, security policy label assignments do not change, they may supersede prior assignments, and such reassignments are always tracked for auditing and other purposes.

A clinician creates a request for a laboratory test to be done for a given patient.

Description:Lab Results Attachment

A person reviews a list of laboratory results of a given patient.

Proposed therapy may be inappropriate or contraindicated when breast-feeding

Communication of an agent from one living subject to another living subject through direct contact with mammalian milk or colostrum.

Knowingly over the payor's published time limit for this invoice possibly due to a previous payor's delays in processing. Additional reason information will be supplied.

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

**Description:**The length of the data specified is greater than the maximum length defined for the element.

**Description:**The length of the data specified falls out of the range defined for the element.

**Description:**The length of the data specified is less than the minimum length defined for the element.

A diet low in fat, particularly to patients with hepatic diseases.

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.

**Description:**Scope of responsibility taken-on for physician care of a patient as defined by a governmental licensing agency.

Definition:A policy under which the insurer agrees to pay a sum of money upon the occurrence of the covered partys death. In return, the policyholder agrees to pay a stipulated amount called a premium at regular intervals. Life insurance indemnifies the beneficiary for the loss of the insurable interest that a beneficiary has in the life of a covered party. For persons related by blood, a substantial interest established through love and affection, and for all other persons, a lawful and substantial economic interest in having the life of the insured continue. An insurable interest is required when purchasing life insurance on another person. Specific exclusions are often written into the contract to limit the liability of the insurer; for example claims resulting from suicide or relating to war, riot and civil commotion.

*Discussion:*A life insurance policy may be used by the covered party as a source of health care coverage in the case of a viatical settlement, which is the sale of a life insurance policy by the policy owner, before the policy matures. Such a sale, at a price discounted from the face amount of the policy but usually in excess of the premiums paid or current cash surrender value, provides the seller an immediate cash settlement. Generally, viatical settlements involve insured individuals with a life expectancy of less than two years. In countries without state-subsidized healthcare and high healthcare costs (e.g. United States), this is a practical way to pay extremely high health insurance premiums that severely ill people face. Some people are also familiar with life settlements, which are similar transactions but involve insureds with longer life expectancies (two to fifteen years).

An observation used to describe the Lipemia Index of the specimen. It is recommended to use the optical turbidity at 600 nm (in absorbance units).

Policy for handling information related to an information subject's living arrangement, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's living arrangement, the disclosure of which could impact the privacy, well-being, or safety of that subject.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.

Temporary supply of a product without transfer of ownership for the product.

Transaction counts and value totals by service location (e.g clinic).

Policy for handling information related to the location of the information subject, which will be afforded heightened confidentiality. Description: Policies may govern sensitivity of information related to the location of the information subject, the disclosure of which could impact the privacy, well-being, or safety of that subject.

Usage Notes:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.

A low protein diet for patients with renal failure.

A strictly liquid diet, that can be fully absorbed in the intestine, and therefore may not contain fiber. Used before enteral surgeries.

Providers and care givers who have an established relationship per criteria determined by policy are considered to have an established care provision relations with a healthcare consumer, and may be authorized to access the consumer's health information because of that relationship. Providers and care givers should only have access to that information while participating in legitimate relationship workflows or for other authorized uses.

Security Compartment Labels assigned to a consumer's information use in legitimate relationship workflows should be met or exceeded by the Security Compartment attribute claimed by a participant in a legitimate relationship workflow who is requesting access to that information.

A diet low in sodium for patients with congestive heart failure and/or renal failure.

Definition:An insurance policy that covers benefits for long-term care services people need when they no longer can care for themselves. This may be due to an accident, disability, prolonged illness or the simple process of aging. Long-term care services assist with activities of daily living including:

* Help at home with day-to-day activities, such as cooking, cleaning, bathing and dressing * Care in the community, such as in an adult day care facility * Supervised care provided in an assisted living facility * Skilled care provided in a nursing home

Description:Exposure participants' interaction occurred in the course of one or both participants being resident at a long term care facility (second participant may be a visitor, worker, resident or a physical place or object within the facility).

**Description:**A drug that can be prescribed (and reimbursed) only if it meets certain criteria.

Used by one system to inform another that the container did not arrive at its next expected location.

Manual review of the invoice is requested. Additional information to be supplied. This may be used in the case of an appeal.

An increase in the amount charged as a percentage of the amount. For example, 12% markup on product cost.

Policy for handling information related to an information subject's marital status, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's marital status, the disclosure of which could impact the privacy, well-being, or safety of that subject.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.

A clinician reviews a work list of medications to be administered to a given patient.

Custodian system must render information unreadable and unusable by algorithmically transforming plaintext into ciphertext. User may be provided a key to decrypt per license or "shared secret".

**Description:**The number of repeating elements is above the maximum number of repetitions allowed.

Definition:Government mandated program providing coverage, disability income, and vocational rehabilitation for injuries sustained in the work place or in the course of employment. Employers may either self-fund the program, purchase commercial coverage, or pay a premium to a government entity that administers the program. Employees may be required to pay premiums toward the cost of coverage as well.

Managed care policies specifically exclude coverage for losses insured under a disability policy, workers' compensation program, liability insurance (including automobile insurance); or for medical expenses, coverage for on-site medical clinics or for limited dental or vision benefits when these are provided under a separate policy.

Discussion:Managed care policies are offered by managed care plans that contract with selected providers or health care organizations to provide comprehensive health care at a discount to covered parties and coordinate the financing and delivery of health care. Managed care uses medical protocols and procedures agreed on by the medical profession to be cost effective, also known as medical practice guidelines. Providers are typically reimbursed for covered services by a capitated amount on a per member per month basis that may reflect difference in the health status and level of services anticipated to be needed by the member.

The State of Michigan standard privacy consent form for sharing of health information specific to behavioral health and substance use treatment in accordance with Public Act 129 of 2014. In Michigan, while providers are not required to use this new standard form (MDHHS-5515), they are required to accept it.

Usage Note:For legislative background, current MDHHS-5515 consent directive form, and provider and patient FAQs see http://www.michigan.gov/mdhhs/0,5885,7-339-71550\_2941\_58005-343686--,00.html

The State of Michigan standard privacy consent form for sharing of health information specific to behavioral health governed by the Michigan Mental Health Code Act 258 of 1974, which require patient authorization for purposes other than treatment, payment, and coordination of care, in accordance with Public Act 129 of 2014.

Usage Note:For legislative background, current MDHHS-5515 consent directive form, and provider and patient FAQs see http://www.michigan.gov/mdhhs/0,5885,7-339-71550\_2941\_58005-343686--,00.html

The State of Michigan standard privacy consent form for sharing of health information specific to substance use information governed under US 42 CFR Part 2 in accordance with Public Act 129 of 2014.

Usage Note:For legislative background, current MDHHS-5515 consent directive form, and provider and patient FAQs see http://www.michigan.gov/mdhhs/0,5885,7-339-71550\_2941\_58005-343686--,00.html

**Description:**The maximum quantity of this drug allowed to be administered within a particular time-range (month, year, lifetime) has been reached or exceeded.

Provision of diagnostic and/or therapeutic treatment.

**Definition:**All information pertaining to a patient's medical condition records.

List of medications.

A clinician creates a request for the administration of one or more medications to a given patient.

The end date of the measurement period.

Description:All information pertaining to a patient's mental health records. Definition:A health insurance policy that covers benefits for mental health services and prescriptions. Definition:Government administered and funded mental health program for beneficiaries meeting financial and mental health status criteria. Administration, funding levels, eligibility criteria, covered benefits, provider types, and financial participation are typically set by a regulatory process. Payer responsibilities for administering the program may be delegated to contractors.Example:In the U.S., states receive funding for substance use programs from the Substance Abuse Mental Health Administration (SAMHSA).

Policy for handling information related to psychological disorders, which is afforded heightened confidentiality. Mental health information may be deemed specifically sensitive and distinct from physical health, substance use disorders, and behavioral disabilities and disorders in some jurisdictions.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code.

A person reviews organisms of microbiology results of a given patient.

A person reviews a list of microbiology results of a given patient.

A person reviews the sensitivity test of microbiology results of a given patient.

Definition:A government program that provides coverage for health services to military personnel, retirees, and dependents. A covered party who is a subscriber can choose from among Fee-for-Service (FFS) plans, and their Preferred Provider Organizations (PPO), or Plans offering a Point of Service (POS) Product, or Health Maintenance Organizations.Example:In the U.S., TRICARE, CHAMPUS.

Custodian must limit access and disclosure to the minimum information required to support an authorized user's purpose of use.

Usage Note:Limiting the information available for access and disclosure to that an authorized user or receiver "needs to know" in order to perform permitted workflow or purpose of use.

**Definition:**The therapy action is being performed too soon after the previous occurrence based on the requested frequency

**Description:**The number of repeating elements is below the minimum number of repetitions allowed.

A charge to compensate the provider when a patient does not show for an appointment.

**Description:**The specified element must be specified with a non-null value under certain conditions. In this case, the conditions are true but the element is still missing or null.

**Description:**The specified element is mandatory and was not included in the instance.

A person reviews a list of medication orders submitted to a given patient

Description:Digital Model Attachment

Transaction counts and value totals for each calendar month within the date range specified.

A supply of a manufacturer sample

The start date of the measurement period.

The method of adjusting for clinical severity and conditions present at the start of care that can influence patient outcomes for making valid comparisons of outcome measures across providers. Indicates whether an eMeasure is subject to the statistical process for reducing, removing, or clarifying the influences of confounding factors to allow more useful comparisons.

Describes how to combine information calculated based on logic in each of several populations into one summarized result. It can also be used to describe how to risk adjust the data based on supplemental data elements described in the eMeasure. (e.g., pneumonia hospital measures antibiotic selection in the ICU versus non-ICU and then the roll-up of the two).

Open Issue:The description does NOT align well with the definition used in the HQMF specfication; correct the MSGAGG definition, and the possible distinction of MSRAGG as a child of AGGREGATE.

Information on whether an increase or decrease in score is the preferred result. This should reflect information on which way is better, an increase or decrease in score.

The list of jurisdiction(s) for which the measure applies.

Defines the observation to be performed for each patient or event in the measure population. Measure observations for each case in the population are aggregated to determine the overall measure score for the population.

Examples:

* the median time from arrival in the Emergency Room to departure * the median time from decision to admit to a hospital to the actual admission for Emergency Room patients

Criteria for specifying the measure population as a narrative description (e.g., all patients seen in the Emergency Department during the measurement period). This is used only in continuous variable eMeasures.

Criteria for specifying subjects who should be removed from the eMeasure's Initial Population and Measure Population. Measure Population Exclusions are used in Continuous Variable measures to help narrow the Measure Population before determining the value(s) of the continuous variable(s).

Type of person or organization that is expected to report the issue.

The maximum time that may elapse following completion of the measure until the measure report must be sent to the receiver.

Indicates how the calculation is performed for the eMeasure (e.g., proportion, continuous variable, ratio)

Location(s) in which care being measured is rendered

Usage Note: MSRSET is used rather than RoleCode because the setting applies to what is being measured, as opposed to participating directly in the health quality measure documantion itself).

The time period for which the eMeasure applies.

Indicates whether the eMeasure is used to examine a process or an outcome over time (e.g., Structure, Process, Outcome).

Policy for handling information related to sexual assault or repeated, threatening sexual harassment that occurred while the patient was in the military, which is afforded heightened confidentiality.

Access control concerns for military sexual trauma is based on the patient being subject to control by a higher ranking military perpetrator and/or censure by others within the military unit. Due to the relatively unfettered access to healthcare information by higher ranking military personnel and those who have command over the patient, there is a need to sequester this information outside of the typical controls on access to military health records.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code.

Incident or accident as the result of a motor vehicle accident

A normal diet, i.e. no special preparations or restrictions for medical reasons. This is notwithstanding any preferences the patient might have regarding special foods, such as vegetarian, kosher, etc.

Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure

The requesting party has insufficient authorization to invoke the interaction.

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

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

Maximum net amount that will be covered for the product or service specified.

The act or process by which an acid and a base are combined in such proportions that the resulting compound is neutral.

A no fat diet for acute hepatic diseases.

Proposed therapy may interact with existing or recent natural health product therapy

Prohibition on disclosure without information subject's authorization.

Prohibition on collection or storage of the information.

No notification or opportunity is provided for a grantor to assent or dissent to a grantee's terms of agreement.

Comment:A "No Consent" policy scheme provides no opportunity for accommodation of an individual's preferences, and may not comply with Fair Information Practice Principles \[FIPP\] by enabling the data subject to object, access collected information, correct errors, or have accounting of disclosures.Usage Note:The grantee's terms of agreement, may be available to the grantor by reviewing the grantee's privacy policies, but there is no notice by which a grantor is apprised of the policy directly or able to acknowledge.Examples:

* Healthcare: Without notification or an opportunity to assent or dissent, a patient's health information is automatically included in and available (often according to certain rules) through a health information exchange. Note that this differs from implied consent, where the patient is assumed to have consented. * Without notification or an opportunity to assent or dissent, a patient's health information is collected, accessed, used, or disclosed for research, public health, security, fraud prevention, court order, or law enforcement. * Non-healthcare: Without notification or an opportunity to assent or dissent, a consumer's healthcare or non-healthcare internet searches are aggregated for secondary uses such as behavioral tracking and profiling. * Without notification or an opportunity to assent or dissent, a consumer's location and activities in a shopping mall are tracked by RFID tags on purchased items.

Prohibition on disclosure without organizational approved patient restriction.

Prohibition on disclosure without a consent directive from the information subject.

**Description:**More than one element with the same value exists in the set. Duplicates not permission in this set in a set.

The type of injury that the injury coding specifies.

Prohibition on Integration into other records.

Prohibition on disclosure except to entities on specific access list.

Prohibition on disclosure without an interagency service agreement or memorandum of understanding (MOU).

Non-Payment Data.

Any category of inpatient encounter except 'acute'

Proposed therapy may interact with a non-prescription drug (e.g. alcohol, tobacco, Aspirin)

Prohibition on disclosure without organizational authorization.

Prohibition on disclosing information to patient, family or caregivers without attending provider's authorization.

Usage Note:The information may be labeled with the ActInformationSensitivity TBOO code, triggering application of this RefrainPolicy code as a handling caveat controlling access.

Maps to FHIR NOPAT: Typically, this is used on an Alert resource, when the alert records information on patient abuse or non-compliance.

FHIR print name is "keep information from patient". Maps to the French realm - code: INVISIBLE\_PATIENT.

* displayName: Document non visible par le patient * codingScheme: 1.2.250.1.213.1.1.4.13

French use case: A label for documents that the author chose to hide from the patient until the content can be disclose to the patient in a face to face meeting between a healthcare professional and the patient (in French law some results like cancer diagnosis or AIDS diagnosis must be announced to the patient by a healthcare professional and should not be find out by the patient alone).

Description:Element in submitted message will not persist in data storage based on detected issue.

Prohibition on collection of the information beyond time necessary to accomplish authorized purpose of use is prohibited.

An implied privacy consent directive or notification, which the data subject may or may not acknowledge. The notification specifies permitted actions, which may include access, use, or disclosure of any and all personal information. The notification specifies the scope of personal information, which may include de-identified information, and personal effects, such as biometrics, biospecimen or genetic material, that may be used to identify an individual in a registry or repository. The notification specifies the purposes for which personal information may be used such as treatment, payment, operations, research, information exchange, public health, disaster, quality and safety reporting; as required by law including court order, law enforcement, national security, military authorities; and for data analytics, marketing, and profiling.

Usage Notes:Map: An "implied" consent directive maps to ISO/TS 17975:2015(E) definition forImplied: Consent to Collect, Use and Disclose personal health information is implied by the actions or inactions of the individual and the circumstances under which it was implied".
Map: An "implied" consent directive maps to ISO/TS 17975:2015(E) definition forImplied: Consent to Collect, Use and Disclose personal health information is implied by the actions or inactions of the individual and the circumstances under which it was implied".

Prohibition on redisclosure without patient consent directive.

Prohibition on redisclosure without a consent directive from the information subject.

Prohibition on disclosure without authorization under jurisdictional law.

Prohibition on associating de-identified or pseudonymized information with other information in a manner that could or does result in disclosing information intended to be masked.

Prohibition on use of the information beyond the purpose of use initially authorized.

Communication of an agent from any entity to a living subject while the living subject is in the patient role in a healthcare facility.

**Definition:**The status of the request being fulfilled has changed such that it is no longer actionable. This may be because the request has expired, has already been completely fulfilled or has been otherwise stopped or disabled. (Not used for 'suspended' orders.)

**Definition:**The therapy being performed is not sufficiently equivalent to the therapy which was requested.

**Definition:**The therapy being performed is not generically equivalent (having the identical biological action) to the therapy which was requested.

**Definition:**The therapy being performed is not therapeutically equivalent (having the same overall patient effect) to the therapy which was requested.

Prohibition on disclosure except to principals with access permission to specific VIP information.

Criteria for specifying the processes or outcomes expected for each patient, procedure, or other unit of measurement defined in the denominator for proportion measures, or related to (but not directly derived from) the denominator for ratio measures (e.g., a numerator listing the number of central line blood stream infections and a denominator indicating the days per thousand of central line usage in a specific time period).

Criteria for specifying instances that should not be included in the numerator data. (e.g., if the number of central line blood stream infections per 1000 catheter days were to exclude infections with a specific bacterium, that bacterium would be listed as a numerator exclusion). Numerator Exclusions are used only in ratio eMeasures.

Used by one system to inform another that the specific container is being processed by the equipment. It is useful as a response to a query about Container Status, when the specific step of the process is not relevant.

Provision of care of women during pregnancy, childbirth and immediate postpartum period. Also known as Maternity.

Proposed therapy may be inappropriate or contraindicated due to conditions or characteristics of the patient

Description:Indicates the valid antigen count. Description:Indicates whether an antigen is valid or invalid.

An encounter where the patient usually will start in different encounter, such as one in the emergency department (EMER) but then transition to this type of encounter because they require a significant period of treatment and monitoring to determine whether or not their condition warrants an inpatient admission or discharge. In the majority of cases the decision about admission or discharge will occur within a time period determined by local, regional or national regulation, often between 24 and 48 hours.

Description:One or more records in the query response have a status of 'obsolete'.

A clinician creates a request for a service to be performed for a given patient.

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.

An expressed privacy consent directive permitting the collection of a some or all personal information, including de-identified information, and personal effects, such as biometrics, biospecimen or genetic material, which may be used to identify an individual in a registry or repository for purposes such as treatment, payment, operations, research, information exchange, public health, data analytics, marketing, and profiling.

Usage Note:Useful when a more specific jurisdictional or organizational consent directive policy or form is not specified, available, or known, for example, where an individual wishes to opt-in to collection of some or all of the individual's information by multiple registries and repositories.

Map: An "expressed" consent directive maps to ISO/TS 17975:2015(E) definitions for "Express or Expressed: Consent to Collect, Use and Disclose personal health information is expressly given by the subject of care" and "Opt-in".

Hypersensitivity resulting in an adverse reaction upon exposure to an agent.

An expressed privacy consent directive permitting access, use, or disclosure of a some or all personal information, including de-identified information, and personal effects, such as biometrics, biospecimen or genetic material, which may be used to identify an individual in a registry or repository for purposes such as treatment, payment, operations, research, information exchange, public health, data analytics, marketing, and profiling.

Usage Note:Useful when a more specific jurisdictional or organizational consent directive policy or form is not specified, available, or known, for example, where an individual wishes to opt-in to access, use, or disclosure of some or all of the individual's information by multiple registries and repositories.

Map: An "expressed" consent directive maps to ISO/TS 17975:2015(E) Express or Expressed: Consent to Collect, Use and Disclose personal health information is expressly given by the subject of care and "Opt-in".

Provision of treatment and/or diagnosis related to tumors and/or cancer.

**Definition:**A list of medications which the patient is intended to be administered only once.

An expressed privacy consent directive restricting or prohibiting collection of personal information, including de-identified information, and personal effects, such as biometrics, biospecimen or genetic material, which may be used to identify an individual in a registry or repository for purposes such as treatment, payment, operations, research, information exchange, public health, data analytics, marketing, and profiling.

Usage Note:Useful when a more specific jurisdictional or organizational consent directive policy or form is not specified, available, or known, for example, where an individual wishes to opt-out of access, use, or disclosure of some or all of the individual's information by multiple registries and repositories.

Map: An "expressed" opt-out to collection consent directive maps to ISO/TS 17975:2015(E) definitions for "Express or Expressed: Consent to Collect, Use and Disclose personal health information is expressly given by the subject of care" and "Express or Expressed (and Informed) Denial".

The medical service and/or product was provided to a patient that has coverage in another jurisdiction.

Premium paid on service fees in compensation for practicing at a location other than normal working location.

An expressed privacy consent directive restricting or prohibiting access, use, or disclosure of personal information, including de-identified information, and personal effects, such as biometrics, biospecimen or genetic material, which may be used to identify an individual in a registry or repository for purposes such as treatment, payment, operations, research, information exchange, public health, data analytics, marketing, and profiling.

Usage Note:Useful when a more specific jurisdictional or organizational consent directive policy or form is not specified, available, or known, for example, where an individual wishes to opt-out of access, use, or disclosure of some or all of the individual's information by multiple registries and repositories.

Map: An "expressed" opt-out to sharing consent directive maps to ISO/TS 17975:2015(E) definitions for "Express or Expressed: Consent to Collect, Use and Disclose personal health information is expressly given by the subject of care" and "Express or Expressed (and Informed) Denial".

Policy for handling information related to opioid use disorders and conditions caused by these disorders, which is afforded heightened confidentiality.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code.

A grantor's assent to the terms of an agreement offered by a grantee without an opportunity for to dissent to any terms.

Comment:Acceptance of a grantee's terms pertaining, for example, to permissible activities, purposes of use, handling caveats, expiry date, and revocation policies.Usage Note:Opt-in with no opportunity for a grantor to restrict certain permissions sought by the grantee is considered "basic consent".Examples:

* Healthcare: A patient \[grantor\] signs a provider's \[grantee's\] consent directive form, which lists permissible collection, access, use, or disclosure activities, purposes of use, handling caveats, and revocation policies. * Non-healthcare: An employee \[grantor\] signs an employer's \[grantee's\] non-disclosure and non-compete agreement.

A grantor's assent to the grantee's terms of an agreement with an opportunity for to dissent to certain grantor or grantee selected terms.

Comment:A grantor dissenting to the grantee's terms of agreement may or may not exercise a right to assent to grantor's pre-approved restrictions or to grantee's selected terms to which a grantor may dissent.Usage Note:Opt-in with restrictions is considered "granular consent" because the grantor has an opportunity to narrow the permissions sought by the grantee.Examples:

* Healthcare: A patient assent to grantee's consent directive terms for collection, access, use, or disclosure of health information, and dissents to disclosure to certain recipients as allowed by the provider's pre-approved restriction list. * Non-Healthcare: A cell phone user assents to the cell phone's privacy practices and terms of use, but dissents from location tracking by turning off the cell phone's tracking capability.

A grantor's dissent to the terms of agreement offered by a grantee without an opportunity for to assent to any terms.

Comment:Rejection of a grantee's terms of agreement pertaining, for example, to permissible activities, purposes of use, handling caveats, expiry date, and revocation policies.Usage Note:Opt-out with no opportunity for a grantor to permit certain permissions sought by the grantee is considered "basic consent".Examples:

* Healthcare: A patient \[grantor\] declines to sign a provider's \[grantee's\] consent directive form, which lists permissible collection, access, use, or disclosure activities, purposes of use, handling caveats, revocation policies, and consequences of not assenting. * Non-healthcare: An employee \[grantor\] refuses to sign an employer's \[grantee's\] agreement not to join unions or participate in a strike where state law protects employee's collective bargaining rights. * A citizen \[grantor\] refuses to enroll in mandatory government \[grantee\] health insurance based on religious beliefs, which is an exemption.

A grantor's dissent to the grantee's terms of agreement except for certain grantor or grantee selected terms.

Comment:A rejection of a grantee's terms of agreement while assenting to certain permissions sought by the grantee or requesting approval of additional grantor terms.Usage Note:Opt-out with exceptions is considered a "granular consent" because the grantor has an opportunity to accept certain permissions sought by the grantee or request additional grantor terms, while rejecting other grantee terms.Examples:

* Healthcare: A patient \[grantor\] dissents to a health information exchange consent directive with the exception of disclosure based on a limited "time to live" shared secret \[e.g., a token or password\], which the patient can give to a provider when seeking care. * Non-healthcare: A social media user \[grantor\] dissents from public access to their account, but assents to access to a circle of friends.

Prohibition on disclosure except as permitted by the information originator.

A person reviews a list of orders submitted to a given patient.

The service provided is required for orthodontic purposes. If the covered party has orthodontic coverage, then the service may be paid.

Medicines designated in this way may be supplied for patient use without a prescription. The exact form of categorisation will vary in different realms.

Conveys the mandated workflow action that an information custodian, receiver, or user must perform.

Usage Notes:Per ISO 22600-2, ObligationPolicy instances 'are event-triggered and define actions to be performed by manager agent'. Per HL7 Composite Security and Privacy Domain Analysis Model: This value set refers to the action required to receive the permission specified in the privacy rule. Per OASIS XACML, an obligation is an operation specified in a policy or policy that is performed in conjunction with the enforcement of an access control decision.
Per ISO 22600-2, ObligationPolicy instances 'are event-triggered and define actions to be performed by manager agent'. Per HL7 Composite Security and Privacy Domain Analysis Model: This value set refers to the action required to receive the permission specified in the privacy rule. Per OASIS XACML, an obligation is an operation specified in a policy or policy that is performed in conjunction with the enforcement of an access control decision.

Organizational policy on collection, access, use, or disclosure of basic controlled unclassified information as defined by the organization or by applicable jurisdictional law.

Organizational policy on collection, access, use, or disclosure of de-identified information as defined by the organization or by applicable jurisdictional law.

Organizational policy on collection, access, use, or disclosure of information, which does not conflict with jurisdictional law.

Organizational policy on collection, access, use, or disclosure of information in a limited data set as defined by the organization or by applicable jurisdictional law.

Organizational policy on collection, access, use, or disclosure of information deemed non-sensitive by the organization or by applicable jurisdictional law.

Organizational policy on collection, access, use, or disclosure of public information as defined by the organization or by applicable jurisdictional law.

Organizational policy on collection, access, use, or disclosure of specified controlled unclassified information as defined by the organization or by applicable jurisdictional law.

Organizational policy on collection, access, use, or disclosure of uncontrolled unclassified information as defined by the organization or governing jurisdiction.

Accommodations in which there is only 1 bed.

HealthCare facility preferred accommodation invoice.

Patient administration members who have access to healthcare consumer information as part of a patient administration workflows.

Security Compartment Labels assigned to consumer information used in these workflows should be met or exceeded by the Security Compartment attribute claimed by a participant in a patient administration workflow who is requesting access to that information.

Phenylketonuria diet.

Provision of care for patients who are living or dying from an advanced illness.

Paper documentation (or other physical format) with supporting or additional information to follow.

Patient is supplied with parenteral nutrition, typically described in terms of i.v. medications.

Communication of an agent from a living subject or environmental source to a living subject where the acquisition of the agent is not via the alimentary canal.

A person enters documentation about a given patient.

A person provides a patient-specific education handout to a patient.

A person (e.g., clinician, the patient herself) reviews patient information in the electronic medical record.

Policy for handling information related to an individual's location, which is deemed sensitive when the disclosure could impact the privacy, well-being, or safety of that subject, and requires additional protection.

Usage Note:If there is a jurisdictional, organizational, or individual mandate, then use the applicable ActPrivacyLaw or ActConsentDirective code from the ActCode system to and specify the law in addition to this more generic code.

**Definition:**The proposed therapy goes against preferences or consent constraints recorded in the patient's record.

**Definition:**The proposed therapy goes against preferences or consent constraints recorded in the patient's record. An alternate therapy meeting those constraints is available.

A pathologist enters a report for a given patient.

A person reviews a pathology report of a given patient.

Indicates that the ICSR is describing problems that a patient experienced after receiving a vaccine product.

The guarantor, who may be the patient, pays the entire charge for a service. Reasons for such action may include: there is no insurance coverage for the service (e.g. cosmetic surgery); the patient wishes to self-pay for the service; or the insurer denies payment for the service due to contractual provisions such as the need for prior authorization.

Transaction counts and value totals by each instance of an invoice payee.

Transaction counts and value totals by each instance of an invoice payor.

An account representing charges and credits (financial transactions) for a patient's encounter.

Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently nullified in the specified period and submitted electronically.

Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently nullified in the specified period and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently nullified in the specified period and submitted manually.

Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently nullified in the specified period and submitted manually.

Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently nullified in the specified period and submitted electronically.

Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently cancelled in the specified period and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently nullified in the specified period and submitted manually.

Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently nullified in the specified period and submitted manually.

Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually.

Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually.

Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually.

Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually.

Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically.

Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually.

Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually.

Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically.

Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually.

Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually.

Policy for specially protecting information reported by or about a patient, which is deemed sensitive within the enterprise (i.e., by default regardless of whether the patient requested that the information be deemed sensitive for another reason.) For example information reported by the patient about another person, e.g., a family member, may be deemed sensitive by default. Organizational policy may allow the sensitivity tag to be cleared on patient's request.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code.

For example, VA deems employee information sensitive by default. Information about a patient who is being stalked or a victim of abuse or violence may be deemed sensitive by default per a provider organization's policies.

Proposed therapy is outside of the standard practice for a pediatric patient.

Provision of diagnosis and treatment of diseases and disorders affecting children.

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.

Transaction counts and value totals for the date range specified.

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.

Custodian security system must persist the binding of security labels to classify information received or imported by information systems under its control for collection, access, use and disclosure in accordance with applicable jurisdictional privacy policies associated with the target information. The system must retain an immutable record of the assignment and binding.

Pharmaceutical care performed by a pharmacist.

Policy for handling information about a patient, which a physician or other licensed healthcare provider deems sensitive. Once tagged by the provider, this may trigger alerts for follow up actions according to organizational policy or jurisdictional law.

Usage Note:For use within an enterprise that provides heightened confidentiality to certain types of information designated by a physician as sensitive. If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.

Use cases in which this code could be used are, e.g., in systems that lack the ability to automatically detect sensitive information and must rely on manual tagging; a system that lacks an applicable sensitivity tag, or for ad hoc situations where criticality of the situation requires that the tagging be done immediately by the provider before coding or transcription of consult notes can be completed, e.g., upon detection of a patient with suicidal tendencies or potential for violence.

Provision of treatment for physical injury.

Public Insurance has been exhausted. Invoice has not been sent to Public Insuror and therefore no Explanation Of Benefits (EOB) is provided with this Invoice submission.

Payment initiated by the payor as the result of adjudicating a paper (original, may have been faxed) invoice.

Description:An interaction where the exposure participants were both present in the same location/place/space.

Communication of an agent from a living subject to the progeny of that living subject via agent migration across the maternal-fetal placental membranes while in utero.

A similar or identical therapy was recently ordered by a different practitioner.

This patient was recently supplied a similar or identical therapy from a different pharmacy or supplier.

Definition:A type of insurance that covers damage to or loss of the policyholderaTMs property by providing payments for damages to property damage or the injury or death of living subjects. The terms "casualty" and "liability" insurance are often used interchangeably. Both cover the policyholder's legal liability for damages caused to other persons and/or their property.

A single point denoted by a single (column,row) pair, or multiple points each denoted by a (column,row) pair.

A series of connected line segments with ordered vertices denoted by (column,row) pairs; if the first and last vertices are the same, it is a closed polygon.

Definition:A policy for a health plan that has features of both an HMO and a FFS plan. Like an HMO, a POS plan encourages the use its HMO network to maintain discounted fees with participating providers, but recognizes that sometimes covered parties want to choose their own provider. The POS plan allows a covered party to use providers who are not part of the HMO network (non-participating providers). However, there is a greater cost associated with choosing these non-network providers. A covered party will usually pay deductibles and coinsurances that are substantially higher than the payments when he or she uses a plan provider. Use of non-participating providers often requires the covered party to pay the provider directly and then to file a claim for reimbursement, like in an FFS plan. Definition:A network-based, managed care plan that allows a covered party to choose any health care provider. However, if care is received from a "preferred" (participating in-network) provider, there are generally higher benefit coverage and lower deductibles.

An amount that was owed to the payor as indicated, by a carry forward adjusment, in a previous payment advice

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.

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.

The dilution of the specimen made prior to being loaded onto analytical equipment

An observation about how important a preference is to the target of the preference.

Proposed therapy may be inappropriate or contraindicated during pregnancy

Policy for handling information about an individual's current or past pregnancy status, deemed sensitive by the individual or by policy, which may be afforded heightened confidentiality.

Usage Note:

Information about a patient's current or past pregnancy status may be considered sensitive in circumstances in which that status could result in discrimination or stigmatization.

A patient encounter where patient is scheduled or planned to receive service delivery in the future, and the patient is given a pre-admission account number. When the patient comes back for subsequent service, the pre-admission encounter is selected and is encapsulated into the service registration, and a new account number is generated.

Usage Note:This is intended to be used in advance of encounter types such as ambulatory, inpatient encounter, virtual, etc.

**Definition:**The same or similar treatment has previously been attempted with the patient without achieving a positive effect.

Custodian must create and/or maintain human readable security label tags as required by policy.

Map: Aligns with ISO 22600-3 Section A.3.4.3 description of privacy mark: "If present, the privacy-mark is not used for access control. The content of the privacy-mark may be defined by the security policy in force (identified by the security-policy-identifier) which may define a list of values to be used. Alternately, the value may be determined by the originator of the security-label."

**Description:**Indicates that a result is incomplete. There are further results to come. This maps to the 'active' state in the observation result status code.

**Definition:**A list of medications which the patient will consume intermittently based on the behavior of the condition for which the medication is indicated.

Professional association fee that is collected by the payor from the practitioner/provider on behalf of the association

List of problem observations.

A clinician enters a problem for a given patient.

A person reviews a list of problems of a given patient.

Custodian security system must take note that the data object contains inline security labels and process them.

Transaction counts and value totals by Provider Identifier.

Policy for specially protecting information reported by or about a patient, which the patient deems sensitive, and the patient requests that collection, access, use, or disclosure of that information be restricted. For example, a minor patient may request that information about reproductive health not be disclosed to the patient's family or to particular providers and payers.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.

Custodian system must strip information of data that would allow the identification of the source of the information or the information subject. Custodian may retain a key to relink data necessary to reidentify the information subject.

Tax levied by the provincial or state jurisdiction such as Provincial Sales Tax

**Definition:**All information pertaining to a patient's professional service records (such as smoking cessation, counseling, medication review, mental health).

Policy for handling psychiatry psychiatric disorder information, which is afforded heightened confidentiality.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.

Provision of treatment of psychiatric disorder relating to mental illness.

Policy for handling psychotherapy note information, which is afforded heightened confidentiality.

Usage Note:In some jurisdiction, disclosure of psychotherapy notes requires patient consent.

If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.

Description:Exposure participants' interaction occurred during the course of health care delivery by a provider (e.g. a physician treating a patient in her office).

Insurance policy funded by a public health system such as a provincial or national health plan. Examples include BC MSP (British Columbia Medical Services Plan) OHIP (Ontario Health Insurance Plan), NHS (National Health Service).

Allows provider to explain lateness of invoice to a subsequent payor.

Personal policy on collection, access, use, or disclosure of de-identified information as defined by the information subject or by applicable jurisdictional law.

Personal policy on collection, access, use, or disclosure of information.

Personal policy personal policy on collection, access, use, or disclosure of information in a limited data set by the information subject.

Personal policy on collection, access, use, or disclosure of information deemed non-sensitive by the information subject.

Personal policy on collection, access, use, or disclosure of information deemed public by the information subject.

An abstract code for human readable marks indicating, e.g., the level of confidentiality protection, an authorized compartment, the integrity, or the handling instruction required by applicable policy. Such markings must be displayed as directed by applicable policy on electronically rendered information content and any electronic transmittal envelope or container; or on hardcopy information and any physical transmittal envelope or container.

Examples of protocols for marking displays on electronic or hardcopy rendered content: Across the top or "banner" of each page ; as a watermark placed diagonally cross each page; at the bottom or "footer" of each page; and may be displayed at the beginning of any portion within the content that required markings different than other portions of the content. The banner or top of page marking typically acts as a "high watermark" by including all of the markings made on any marked portions within the entirety of the information content.

Usage Note:A "Privacy Mark" is a Security Control Observation (SECCONOBS) named tag set as specified by the HL7 Privacy and Security Classification System (HCS). A Privacy Mark Named Tag Set is valued with a Privacy Mark leaf code "tag", which is a member of the Security Control Observation Value (\_SecurityObservationValue) tag set. Related Security Control Observation named tag sets are Purpose of Use, Obligation Policy, and Refrain Policy, each with their own Security Control Observation Value tag sets.

Foundational standard definitions: ISO 22600-3 Section A.3.4.3 - If present, the privacy-mark is not used for access control. The content of the privacy-mark may be defined by the security policy in force (identified by the security-policy-identifier) which may define a list of values to be used. Alternately, the value may be determined by the originator of the security-label. IEEE Security Glossary Compendium 93- CESG Memorandum No.1 Issue 1.2 Oct 1992 - Human readable word or phrase acting as an indicator of all or part of the security constraints that apply to a document so marked. NOTE: A machine readable representation of a marking.

Comment:While policies requiring creators, processors, custodians, senders or recipients apply, enforce, and persist applicable Privacy Marks may be dictated by a jurisdiction, organization or personal privacy, security, or integrity policy, those required to comply may be governed under different policies, so compliance may need to be enforced through trust contracts. For example, information content marked with GDPR related policies may require adherence by processors or recipients outside of the European Union. For this reason, this code system is likely to evolve with the inclusion of multiple policy domains needing to communicate encoded policies in a standard, interoperable manner.

Status is used by one system to inform another that the processing has been completed, but the container has not been released from that system.

Policy for handling information related to an information subject's race, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's race, the disclosure of which could impact the privacy, well-being, or safety of that subject.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.

A radiologist enters a report for a given patient.

A person reviews a radiology report of a given patient.

Proposed therapy may be inappropriate or contraindicated because of a recorded patient allergy to a cross-sensitivity related product. (Allergies are immune based reactions.)

Proposed therapy may be inappropriate or contraindicated because of a recorded prior adverse reaction to a cross-sensitivity related product.

Succinct statement of the need for the measure. Usually includes statements pertaining to Importance criterion: impact, gap in care and evidence.

A diet that seeks to reduce body fat, typically low energy content (800-1600 kcal).

Proposed therapy may be inappropriate or contraindicated based on the potential for a patient reaction to the proposed product

The addition of calcium back to a specimen after it was removed by chelating agents

Retroactive adjustment such as fee rate adjustment due to contract negotiations.

Custodian system must remove information, which is not authorized to be access, used, or disclosed from records made available to otherwise authorized users.

Identifies bibliographic citations or references to clinical practice guidelines, sources of evidence, or other relevant materials supporting the intent and rationale of the eMeasure.

Specifies whether or not further testing may be automatically or manually initiated on specimens.

Rules of practice do not require a physician's referral for the provider to perform a billable service.

Definition:An agreement between two or more insurance companies by which the risk of loss is proportioned. Thus the risk of loss is spread and a disproportionately large loss under a single policy does not fall on one insurance company. Acceptance by an insurer, called a reinsurer, of all or part of the risk of loss of another insurance company.Discussion:Reinsurance is a means by which an insurance company can protect itself against the risk of losses with other insurance companies. Individuals and corporations obtain insurance policies to provide protection for various risks (hurricanes, earthquakes, lawsuits, collisions, sickness and death, etc.). Reinsurers, in turn, provide insurance to insurance companies.For example, an HMO may purchase a reinsurance policy to protect itself from losing too much money from one insured's particularly expensive health care costs. An insurance company issuing an automobile liability policy, with a limit of $100,000 per accident may reinsure its liability in excess of $10,000. A fire insurance company which issues a large policy generally reinsures a portion of the risk with one or several other companies. Also calledrisk control insurance or stop-loss insurance.

Policy for handling information related to an information subject's religious affiliation, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to an information subject's religion, the disclosure of which could impact the privacy, well-being, or safety of that subject.

Usage Notes:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
Description:A person enters a health care reminder for a given patient. Description:A person reviews a list of health care reminders for a given patient.

Temporary supply of a product with financial compensation, without transfer of ownership for the product.

This Observation Series type contains waveforms of a "representative beat" (a.k.a. "median beat" or "average beat"). The waveform samples are measured in relative time, relative to the beginning of the beat as defined by the Observation Series effective time. The waveforms are not directly acquired from the subject, but rather algorithmically derived from the "rhythm" waveforms.

The same service was delivered within a time period that would usually indicate a duplicate billing. However, the repeated service is a medical necessity and therefore not a duplicate.

**Description:**This observation represents an 'average' or 'expected' half-life typical of the product.

**Description:**The number of repeating elements falls outside the range of the allowed number of repetitions.

The value of the dilution of a sample after it had been analyzed at a prior dilution value

A security category label field value, which indicates that access and use of an IT resource is restricted to members of a research project.

Definition:Consent to have healthcare information in an electronic health record accessed for research purposes.

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.

Definition:A government mandated program with specific eligibility requirements based on premium contributions made during employment, length of employment, age, and employment status, e.g., being retired, disabled, or a dependent of a covered party under this program. Benefits typically include ambulatory, inpatient, and long-term care, such as hospice care, home health care and respite care.

Bonus payments based on performance, volume, etc. as agreed to by the payor.

A type of transaction that represents a reversal of a previous charge for a service or product. Expressed in monetary terms. It has the opposite effect of a standard charge.

A fill against an order that has already been filled (or partially filled) at least once.

A refill where the quantity supplied is equal to one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets.)

A refill where the quantity supplied is equal to one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets.) and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).

The first fill against an order that has already been filled at least once at another facility.

The first fill against an order that has already been filled at least once at another facility and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).

A refill where the quantity supplied is less than one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.)

A refill where the quantity supplied is less than one full repetition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.) and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).

A fill against an order that has already been filled (or partially filled) at least once and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).

This Observation type contains ECG "rhythm" waveforms. The waveform samples are measured in absolute time (a.k.a. "subject time" or "effective time"). These waveforms are usually "raw" with some minimal amount of noise reduction and baseline filtering applied.

Proposed therapy may be inappropriate or contraindicated because of a recorded patient intolerance to a cross-sensitivity related product. (Intolerances are non-immune based sensitivities.)

A person reviews a Risk Assessment Instrument report of a given patient.

List of risk factor observations.

A security category label field value, which indicates that access and use of an IT resource is restricted to members of records management department or workflow.

A fully specified bounded Region of Interest (ROI) delineates a ROI in which only those dimensions participate that are specified by boundary criteria, whereas all other dimensions are excluded. For example a ROI to mark an episode of "ST elevation" in a subset of the EKG leads V2, V3, and V4 would include 4 boundaries, one each for time, V2, V3, and V4.

A partially specified bounded Region of Interest (ROI) specifies a ROI in which at least all values in the dimensions specified by the boundary criteria participate. For example, if an episode of ventricular fibrillations (VFib) is observed, it usually doesn't make sense to exclude any EKG leads from the observation and the partially specified ROI would contain only one boundary for time indicating the time interval where VFib was observed.

A billing arrangement where funding is based on a list of individuals registered as patients of the Provider.

Proposed therapy may be inappropriate or contraindicated because of a potential patient reaction to a cross-sensitivity related product.

Definition:Consent to have de-identified healthcare information in an electronic health record that is accessed for research purposes, but without consent to re-identify the information under any circumstance. Definition:Consent to have de-identified healthcare information in an electronic health record that is accessed for research purposes re-identified under specific circumstances outlined in the consent.Example::Where there is a need to inform the subject of potential health issues.

Some form of prescription is required before the related medicine can be supplied for a patient. The exact form of regulation will vary in different realms.

Pharmacy dispense invoice for a compound.

**Definition:**All information pertaining to a patient's medication records (orders, dispenses and other active medications).

Pharmacy dispense invoice not involving a compound

A displayed mark rendered to end users as a prescribed text warning that the electronic or hardcopy information shall not be further disclosed without consent of the subject of the information. For example, in order to warn a recipient of 42 CFR Part 2 information of the redisclosure restrictions, the rule mandates that end users receive a written prohibition against redisclosure unless authorized by patient consent or otherwise permitted by Part 2. See 42 CFR § 2.32 Prohibition on re-disclosure. (a)Notice to accompany disclosure. Each disclosure made with the patient's written consent must be accompanied by one of the following written statements: (1) This information has been disclosed to you from records protected by federal confidentiality rules ( 42 CFR part 2). The federal rules prohibit you from making any further disclosure of information in this record that identifies a patient as having or having had a substance use disorder either directly, by reference to publicly available information, or through verification of such identification by another person unless further disclosure is expressly permitted by the written consent of the individual whose information is being disclosed or as otherwise permitted by 42 CFR part 2. A general authorization for the release of medical or other information is NOT sufficient for this purpose (see § 2.31). The federal rules restrict any use of the information to investigate or prosecute with regard to a crime any patient with a substance use disorder, except as provided at § § 2.12(c)(5) and 2.65; or (2) 42 CFR part 2 prohibits unauthorized disclosure of these records. https://www.law.cornell.edu/cfr/text/42/2.32

Usage Note:Example of marking requirement from SAMHSA FAQ Response to question 13:

Would a logon or splash page notification on an HIO's portal that contains the Part 2 notice prohibiting redisclosure be sufficient to meet Part 2's requirement that disclosures made with patient consent be accompanied by such a statement?

No. Part 2 requires each disclosure made with written patient consent to be accompanied by a written statement that the information disclosed is protected by federal law and that the recipient cannot make any further disclosure of it unless permitted by the regulations (42 CFR § 2.32). A logon page is the page where a user logs onto a computer system; a splash page is an introductory page to a web site. A logon or splash page notification on a HIO's portal including the statement as required by § 2.32 would not be sufficient notification regarding prohibitions on redisclosure since it would not accompany a specific disclosure. The notification must be tied to the Part 2 information being disclosed in order to ensure that the recipient of that information knows that specific information is protected by Part 2 and cannot be redisclosed except as authorized by the express written consent of the person to whom it pertains or as otherwise permitted by Part 2. https://www.samhsa.gov/about-us/who-we-are/laws-regulations/confidentiality-regulations-faqs

Conveys prohibited actions which an information custodian, receiver, or user is not permitted to perform unless otherwise authorized or permitted under specified circumstances.

Usage Notes:ISO 22600-2 species that a Refrain Policy "defines actions the subjects must refrain from performing". Per HL7 Composite Security and Privacy Domain Analysis Model: May be used to indicate that a specific action is prohibited based on specific access control attributes e.g., purpose of use, information type, user role, etc.
ISO 22600-2 species that a Refrain Policy "defines actions the subjects must refrain from performing". Per HL7 Composite Security and Privacy Domain Analysis Model: May be used to indicate that a specific action is prohibited based on specific access control attributes e.g., purpose of use, information type, user role, etc.

A displayed mark rendered to end users as "Restricted Confidentiality", which indicates that the electronic or hardcopy information they are viewing, must be protected at a restricted level of confidentiality protection as defined by HL7 Confidentiality code "R" (restricted). Examples: Includes information that is additionally protected such as sensitive conditions mental health, HIV, substance abuse, domestic violence, child abuse, genetic disease, and reproductive health; or sensitive demographic information such as a patient's standing as an employee or a celebrity. Use cases include a display to alert authorized EHR users that they are viewing additionally protected health information deemed sensitive by an applicable jurisdictional, organizational, or personal privacy policy.

Usage Note:The definition is based on HL7 Confidentiality code "R" (restricted), which is described as:

Privacy metadata indicating highly sensitive, potentially stigmatizing information, which presents a high risk to the information subject if disclosed without authorization. May be pre-empted by jurisdictional law, e.g., for public health reporting or emergency treatment. Foundational definitions of Confidentiality: From HL7 Confidentiality Concept Domain: Types of privacy metadata classifying an IT resource (data, information object, service, or system capability) according to its level of sensitivity, which is based on an analysis of applicable privacy policies and the risk of financial, reputational, or other harm to an individual or entity that could result if made available or disclosed to unauthorized individuals, entities, or processes.

Usage Note from HL7 Confidentiality code "R": Confidentiality codes may be used in security labels and privacy markings to classify IT resources based on sensitivity to indicate the obligation of a custodian or receiver to ensure that the protected resource is not made available or disclosed to individuals, entities, or processes (security principals) unless authorized per applicable policies. Confidentiality codes may also be used in the clearances of initiators requesting access to protected resources.

This metadata indicates that the receiver may be obligated to comply with applicable, prevailing (default) jurisdictional privacy law or disclosure authorization.

Map: Definition aligns with ISO 7498-2:1989 - Confidentiality is the property that information is not made available or disclosed to unauthorized individuals, entities, or processes. Map: Partial Map to ISO 13606-4 Sensitivity Level (3) Clinical Care: Default for normal clinical care access (i.e. most clinical staff directly caring for the patient should be able to access nearly all of the EHR). Maps to normal confidentiality for treatment information but not to ancillary care, payment and operations.

Uniquely designed and elegantly decorated accommodations with many amenities available for an additional charge.

**Definition:**A drug that requires prior approval (to be reimbursed) before being dispensed

**Description:**A drug that requires special access permission to be prescribed and dispensed.

Definition:Government administered and funded program to support provision of care to underserved populations through safety net clinics.Example:In the U.S., safety net providers such as federally qualified health centers (FQHC) receive funding under PHSA Section 330 grants administered by the Health Resources and Services Administration.

Transfer of ownership for a product for financial compensation.

Identifies the total net amount billed for all submitted Invoice Groupings within a time period and submitted electronically. Adjudicated invoice elements are included.

Identifies the total number of submitted Invoice Groupings within a time period and submitted electronically. Adjudicated invoice elements are included.

Identifies the total net amount billed for all submitted Invoice Groupings that were nullified within a time period and submitted electronically. Adjudicated invoice elements are included.

Identifies the total number of submitted Invoice Groupings that were nullified within a time period and submitted electronically. Adjudicated invoice elements are included.

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

Identifies the total net amount billed for all submitted Invoice Groupings that are pended or held by the payor, within a time period and submitted electronically. Adjudicated invoice elements are not included.

Identifies the total number of submitted Invoice Groupings that are pended or held by the payor, within a time period and submitted electronically. Adjudicated invoice elements are not included.

Policy for handling sickle cell disease information, which is afforded heightened confidentiality. Information handling protocols are based on organizational policies related to sickle cell disease information, which is deemed sensitive.

Usage Note:If there is a jurisdictional mandate, then the Act valued with this ActCode should be associated with an Act valued with any applicable laws from the ActPrivacyLaw code system.

A diet that avoids ingredients that might cause digestion problems, e.g., avoid excessive fat, avoid too much fiber (cabbage, peas, beans).

Description:The school the patient attended when immunized. Description:The school division or district associated with the patient during the immunization event.

Incident or accident is the result of a school place accident.

Description:Exposure participants' interaction occurred in an academic setting (e.g., participants are fellow students, or student and teacher).

Comparison of results across strata can be used to show where disparities exist or where there is a need to expose differences in results. For example, Centers for Medicare & Medicaid Services (CMS) in the U.S. defines four required Supplemental Data Elements (payer, ethnicity, race, and gender), which are variables used to aggregate data into various subgroups. Additional supplemental data elements required for risk adjustment or other purposes of data aggregation can be included in the Supplemental Data Element section.

Policy for handling sexual assault, abuse, or domestic violence information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to sexual assault, abuse, or domestic violence information that is deemed sensitive.

SDV code covers violence perpetrated by related and non-related persons. This code should be specific to physical and mental trauma caused by a related person only. The access control concerns are keeping the patient safe from the perpetrator who may have an abusive psychological control over the patient, may be stalking the patient, or may try to manipulate care givers into allowing the perpetrator to make contact with the patient. The definition needs to be clarified.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.

Type of security metadata observation made about the alteration integrity of an IT resource (data, information object, service, or system capability), which indicates the mechanism used for authorized transformations of the resource.

Examples:Types of security alteration integrity observation metadata, which may value the observation with a code used to indicate the mechanism used for authorized transformation of an IT resource, including:

* translation * syntactic transformation * semantic mapping * redaction * masking * pseudonymization * anonymization

Type of security metadata observation made about the category of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security category metadata is defined by ISO/IEC 2382-8:1998(E/F)/ T-REC-X.812-1995 as: "A nonhierarchical grouping of sensitive information used to control access to data more finely than with hierarchical security classification alone."

Rationale:A security category observation supports requirement to specify the type of IT resource to facilitate application of appropriate levels of information security according to a range of levels of impact or consequences that might result from the unauthorized disclosure, modification, or use of the information or information system. A resource is assigned to a specific category of information (e.g., privacy, medical, proprietary, financial, investigative, contractor sensitive, security management) defined by an organization or in some instances, by a specific law, Executive Order, directive, policy, or regulation. \[FIPS 199\]Examples:Types of security categories include:

* Compartment: A division of data into isolated blocks with separate security controls for the purpose of reducing risk. (ISO 2382-8). A security label tag that "segments" an IT resource by indicating that access and use is restricted to members of a defined community or project. (HL7 Healthcare Classification System) * Sensitivity: The characteristic of an IT resource which implies its value or importance and may include its vulnerability. (ISO 7492-2) Privacy metadata for information perceived as undesirable to share. (HL7 Healthcare Classification System)

Type of security metadata observation made about the classification of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security classification is defined by ISO/IEC 2382-8:1998(E/F)/ T-REC-X.812-1995 as: "The determination of which specific degree of protection against access the data or information requires, together with a designation of that degree of protection." Security classification metadata is based on an analysis of applicable policies and the risk of financial, reputational, or other harm that could result from unauthorized disclosure.

Rationale:A security classification observation may indicate that the confidentiality level indicated by an Act or Role confidentiality attribute has been overridden by the entity responsible for ascribing the SecurityClassificationObservationValue. This supports the business requirement for increasing or decreasing the level of confidentiality (classification or declassification) based on parameters beyond the original assignment of an Act or Role confidentiality.Examples:Types of security classification include: HL7 Confidentiality Codes such as very restricted, unrestricted, and normal. Intelligence community examples include top secret, secret, and confidential.Usage Note:Security classification observation type codes designate security label field types, which are valued with an applicable SecurityClassificationObservationValue code as the "security label tag".

Type of security metadata observation made about the control of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security control metadata convey instructions to users and receivers for secure distribution, transmission, and storage; dictate obligations or mandated actions; specify any action prohibited by refrain policy such as dissemination controls; and stipulate the permissible purpose of use of an IT resource.

Rationale:A security control observation supports requirement to specify applicable management, operational, and technical controls (i.e., safeguards or countermeasures) prescribed for an information system to protect the confidentiality, integrity, and availability of the system and its information. \[FIPS 199\]Examples:Types of security control metadata include:

* handling caveats * dissemination controls * obligations * refrain policies * purpose of use constraints

Type of security metadata observation made about the data integrity of an IT resource (data, information object, service, or system capability), which indicates the security mechanism used to preserve resource accuracy and consistency. Data integrity is defined by ISO 22600-23.3.21 as: "The property that data has not been altered or destroyed in an unauthorized manner", and by ISO/IEC 2382-8: The property of data whose accuracy and consistency are preserved regardless of changes made."

Examples:Types of security data integrity observation metadata, which may value the observation, include cryptographic hash function and digital signature.

Type of security metadata observation made about the integrity confidence of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions.

Examples:Types of security integrity confidence observation metadata, which may value the observation, include highly reliable, uncertain reliability, and not reliable.Usage Note:A security integrity confidence observation on an Act may indicate that a valued Act.uncertaintycode attribute has been overridden by the entity responsible for ascribing the SecurityIntegrityConfidenceObservationValue. This supports the business requirements for increasing or decreasing the assessment of the reliability or trustworthiness of an IT resource based on parameters beyond the original assignment of an Act statement level of uncertainty.

Type of security metadata observation made about the integrity of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions.

Rationale:A security integrity observation supports the requirement to guard against improper information modification or destruction, and includes ensuring information non-repudiation and authenticity. (44 U.S.C., SEC. 3542)Examples:Types of security integrity metadata include:

* Integrity status, which indicates the completeness or workflow status of an IT resource (data, information object, service, or system capability) * Integrity confidence, which indicates the reliability and trustworthiness of an IT resource * Integrity control, which indicates pertinent handling caveats, obligations, refrain policies, and purpose of use for the resource * Data integrity, which indicate the security mechanisms used to ensure that the accuracy and consistency are preserved regardless of changes made (ISO/IEC DIS 2382-8) * Alteration integrity, which indicate the security mechanisms used for authorized transformations of the resource * Integrity provenance, which indicates the entity responsible for a report or assertion relayed "second-hand" about an IT resource

Type of security metadata observation made about the integrity provenance of an IT resource (data, information object, service, or system capability), which indicates the entity that made assertions about the resource. The asserting entity may not be the original informant about the resource.

Examples:Types of security integrity provenance asserted by observation metadata, which may value the observation, including:

* assertions about an IT resource by a patient * assertions about an IT resource by a clinician * assertions about an IT resource by a device

Type of security metadata observation made about the provenance integrity of an IT resource (data, information object, service, or system capability), which indicates the lifecycle completeness of an IT resource in terms of workflow status such as its creation, modification, suspension, and deletion; locations in which the resource has been collected or archived, from which it may be retrieved, and the history of its distribution and disclosure. Integrity provenance metadata about an IT resource may be used to assess its veracity, reliability, and trustworthiness.

Examples:Types of security integrity provenance observation metadata, which may value the observation about an IT resource, include:

* completeness or workflow status, such as authentication * the entity responsible for original authoring or informing about an IT resource * the entity responsible for a report or assertion about an IT resource relayed "second-hand" * the entity responsible for excerpting, transforming, or compiling an IT resource

Type of security metadata observation made about the integrity provenance of an IT resource (data, information object, service, or system capability), which indicates the entity that reported the existence of the resource. The reporting entity may not be the original author of the resource.

Examples:Types of security integrity provenance reported by observation metadata, which may value the observation, include:

* reports about an IT resource by a patient * reports about an IT resource by a clinician * reports about an IT resource by a device

Type of security metadata observation made about the integrity status of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Indicates the completeness of an IT resource in terms of workflow status, which may impact users that are authorized to access and use the resource.

Examples:Types of security integrity status observation metadata, which may value the observation, include codes from the HL7 DocumentCompletion code system such as legally authenticated, in progress, and incomplete.

An observation identifying security metadata about an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security metadata are used to name security labels.

Rationale:According to ISO/TS 22600-3:2009(E) A.9.1.7 SECURITY LABEL MATCHING, Security label matching compares the initiator's clearance to the target's security label. All of the following must be true for authorization to be granted:

* The security policy identifiers shall be identical * The classification level of the initiator shall be greater than or equal to that of the target (that is, there shall be at least one value in the classification list of the clearance greater than or equal to the classification of the target), and * For each security category in the target label, there shall be a security category of the same type in the initiator's clearance and the initiator's classification level shall dominate that of the target.

Examples:SecurityObservationType security label fields include:

* Confidentiality classification * Compartment category * Sensitivity category * Security mechanisms used to ensure data integrity or to perform authorized data transformation * Indicators of an IT resource completeness, veracity, reliability, trustworthiness, or provenance.

Usage Note:SecurityObservationType codes designate security label field types, which are valued with an applicable SecurityObservationValue code as the "security label tag".

An observation identifying trust metadata about an IT resource (data, information object, service, or system capability), which may be used as a trust attribute to populate a computable trust policy, trust credential, trust assertion, or trust label field in a security label or trust policy, which are principally used for authentication, authorization, and access control decisions.

Transaction counts and value totals by each instance of a messaging application on a single processor. It is a registered identifier known to the receivers.

A billing arrangement where a Provider charges a sum to provide a group (volume) of interventions/procedures to one or more patients within a defined period of time, typically on the same date. Interventions/procedures included in the session may vary.

A subjective evaluation of the seriousness or intensity associated with another observation.

Policy for handling sexuality and reproductive health information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to sexuality and reproductive health information that is deemed sensitive.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.

Communication of an agent from one living subject to another living subject through direct contact with genital or oral tissues as part of a sexual act.

Types of sensitivity policies that apply to Acts. Act.confidentialityCode is defined in the RIM as "constraints around appropriate disclosure of information about this Act, regardless of mood."

Usage Note:ActSensitivity codes are used to bind information to an Act.confidentialityCode according to local sensitivity policy so that those confidentiality codes can then govern its handling across enterprises. Internally to a policy domain, however, local policies guide the access control system on how end users in that policy domain are able to use information tagged with these sensitivity values.

An emergency supply where the expectation is that a formal order authorizing the supply will be provided at a later date.

Definition:A social service program funded by a public or governmental entity.Example:Programs providing habilitation, food, lodging, medicine, transportation, equipment, devices, products, education, training, counseling, alteration of living or work space, and other resources to persons meeting eligibility criteria. Description:An interaction where the exposure participants are social associates or members of the same extended family

Accommodations in which there are 2 beds.

That total amount of the eligible charges which a covered party must periodically pay for services and/or products prior to the Medicaid program providing any coverage. This amount represents the covered party's spend down that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results

Policy for handling information deemed specially protected by law or policy including substance abuse, substance use, psychiatric, mental health, behavioral health, and cognitive disorders, which is afforded heightened confidentiality.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code.
Definition:A characteristic of an oral solid dosage form of a medicinal product, indicating whether it has one or more coatings such as sugar coating, film coating, or enteric coating. Only coatings to the external surface or the dosage form should be considered (for example, coatings to individual pellets or granules inside a capsule or tablet are excluded from consideration).Constraints:The Observation.value must be a Boolean (BL) with true for the presence or false for the absence of one or more coatings on a solid dosage form. Definition:A characteristic of an oral solid dosage form of a medicinal product, specifying the color or colors that most predominantly define the appearance of the dose form. SPLCOLOR is not an FDA specification for the actual color of solid dosage forms or the names of colors that can appear in labeling.Constraints:The Observation.value must be a single coded value or a list of multiple coded values, specifying one or more distinct colors that approximate of the color(s) of distinct areas of the solid dosage form, such as the different sides of a tablet or one-part capsule, or the different halves of a two-part capsule. Bands on banded capsules, regardless of the color, are not considered when assigning an SPLCOLOR. Imprints on the dosage form, regardless of their color are not considered when assigning an SPLCOLOR. If more than one color exists on a particular side or half, then the most predominant color on that side or half is recorded. If the gelatin capsule shell is colorless and transparent, use the predominant color of the contents that appears through the colorless and transparent capsule shell. Colors can include: Black;Gray;White;Red;Pink;Purple;Green;Yellow;Orange;Brown;Blue;Turquoise. Description:A characteristic representing a single file reference that contains two or more views of the same dosage form of the product; in most cases this should represent front and back views of the dosage form, but occasionally additional views might be needed in order to capture all of the important physical characteristics of the dosage form. Any imprint and/or symbol should be clearly identifiable, and the viewer should not normally need to rotate the image in order to read it. Images that are submitted with SPL should be included in the same directory as the SPL file. Definition:A characteristic of an oral solid dosage form of a medicinal product, specifying the alphanumeric text that appears on the solid dosage form, including text that is embossed, debossed, engraved or printed with ink. The presence of other non-textual distinguishing marks or symbols is recorded by SPLSYMBOL.Examples:Included in SPLIMPRINT are alphanumeric text that appears on the bands of banded capsules and logos and other symbols that can be interpreted as letters or numbers.Constraints:The Observation.value must be of type Character String (ST). Excluded from SPLIMPRINT are internal and external cut-outs in the form of alphanumeric text and the letter 'R' with a circle around it (when referring to a registered trademark) and the letters 'TM' (when referring to a 'trade mark'). To record text, begin on either side or part of the dosage form. Start at the top left and progress as one would normally read a book. Enter a semicolon to show separation between words or line divisions. Definition:A characteristic of an oral solid dosage form of a medicinal product, specifying the number of equal pieces that the solid dosage form can be divided into using score line(s).Example:One score line creating two equal pieces is given a value of 2, two parallel score lines creating three equal pieces is given a value of 3.Constraints:Whether three parallel score lines create four equal pieces or two intersecting score lines create two equal pieces using one score line and four equal pieces using both score lines, both have the scoring value of 4. Solid dosage forms that are not scored are given a value of 1. Solid dosage forms that can only be divided into unequal pieces are given a null-value with nullFlavor other (OTH). Description:A characteristic of an oral solid dosage form of a medicinal product, specifying the two dimensional representation of the solid dose form, in terms of the outside perimeter of a solid dosage form when the dosage form, resting on a flat surface, is viewed from directly above, including slight rounding of corners. SPLSHAPE does not include embossing, scoring, debossing, or internal cut-outs. SPLSHAPE is independent of the orientation of the imprint and logo. Shapes can include: Triangle (3 sided); Square; Round; Semicircle; Pentagon (5 sided); Diamond; Double circle; Bullet; Hexagon (6 sided); Rectangle; Gear; Capsule; Heptagon (7 sided); Trapezoid; Oval; Clover; Octagon (8 sided); Tear; Freeform. Definition:A characteristic of an oral solid dosage form of a medicinal product, specifying the longest single dimension of the solid dosage form as a physical quantity in the dimension of length (e.g., 3 mm). The length is should be specified in millimeters and should be rounded to the nearest whole millimeter.Example:SPLSIZE for a rectangular shaped tablet is the length and SPLSIZE for a round shaped tablet is the diameter. Definition:A characteristic of an oral solid dosage form of a medicinal product, to describe whether or not the medicinal product has a mark or symbol appearing on it for easy and definite recognition. Score lines, letters, numbers, and internal and external cut-outs are not considered marks or symbols. See SPLSCORING and SPLIMPRINT for these characteristics.Constraints:The Observation.value must be a Boolean (BL) with <u>true</u> indicating the presence and <u>false</u> for the absence of marks or symbols.Example:

Incident or accident is the result of a sporting accident.

**Description:**Specimen has been received by the participating organization/department.

An encounter where the patient is admitted to a health care facility for a predetermined length of time, usually less than 24 hours.

Policy for handling information related to a provider of sensitive services, which will be afforded heightened confidentiality. Description: Policies may govern sensitivity of information related to providers who deliver sensitive healthcare services in order to protect the privacy, well-being, and safety of the provider and of patients receiving sensitive services.

Usage Notes:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.
If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.

**Description:**Specimen has been placed into storage at a participating location.

Policy for handling sexually transmitted disease information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to sexually transmitted disease information that is deemed sensitive.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.

The act of putting something away for safe keeping. The "something" may be physical object such as a specimen, or information, such as observations regarding a specimen.

**Description:**Specimen has been put in transit to a participating receiver.

Describes the strata for which the measure is to be evaluated. There are three examples of reasons for stratification based on existing work. These include: (1) evaluate the measure based on different age groupings within the population described in the measure (e.g., evaluate the whole \[age 14-25\] and each sub-stratum \[14-19\] and \[20-25\]); (2) evaluate the eMeasure based on either a specific condition, a specific discharge location, or both; (3) evaluate the eMeasure based on different locations within a facility (e.g., evaluate the overall rate for all intensive care units and also some strata include additional findings \[specific birth weights for neonatal intensive care units\]).

Proposed therapy may be inappropriate or ineffective because the start of administration is too late after the onset of the condition

Definition:A health insurance policy that covers benefits for substance use services. Definition:Government administered and funded substance use program for beneficiaries meeting financial, substance use behavior, and health status criteria. Beneficiaries may be required to enroll as a result of legal proceedings. Administration, funding levels, eligibility criteria, covered benefits, provider types, and financial participation are typically set by a regulatory process. Payer responsibilities for administering the program may be delegated to contractors.Example:In the U.S., states receive funding for substance use programs from the Substance Abuse Mental Health Administration (SAMHSA). Definition:A government health program that provides coverage on a fee for service basis for health services to persons meeting eligibility criteria such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds.Discussion:The structure and business processes for underwriting and administering a subsidized fee for service program is further specified by the Underwriter and Payer Role.class and Role.code. Definition:A government health program that provides coverage for health services to persons meeting eligibility criteria such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds. Definition:A government health program that provides coverage through managed care contracts for health services to persons meeting eligibility criteria such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds.Discussion:The structure and business processes for underwriting and administering a subsidized managed care program is further specified by the Underwriter and Payer Role.class and Role.code. Description:An interaction where the exposure participants shared or co-used a common substance (e.g. drugs, needles, or common food item). Definition:A government health program that provides coverage for health services to persons meeting eligibility criteria for a supplemental health policy or program such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds.Example:Supplemental health coverage program may cover the cost of a health program or policy financial participations, such as the copays and the premiums, and may provide coverage for services in addition to those covered under the supplemented health program or policy. In the U.S., Medicaid programs may pay the premium for a covered party who is also covered under the Medicare program or a private health policy.Discussion:The structure and business processes for underwriting and administering a subsidized supplemental retiree health program is further specified by the Underwriter and Payer Role.class and Role.code.

Policy for handling information related to alcohol or drug use disorders and conditions caused by these disorders, which is afforded heightened confidentiality.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code.

A diet that is not intended to be complete but is added to other diets.

Description:One or more records in the query response have been suppressed due to consent or privacy restrictions.

Provision of surgical treatment.

Definition:
  • A risk or part of a risk for which there is no normal insurance market available.

  • Insurance written by unauthorized insurance companies. Surplus lines insurance is insurance placed with unauthorized insurance companies through licensed surplus lines agents or brokers.

An abstract code for displayed Security Label tags.

Usage Note:These marks may be based on any of the HL7 Security Labeling related codes from various code systems and values sets, which are organized according to the HL7 Privacy and Security Classification System into HL7 Security Observation Type Named Tag Sets and valued with codes associated with the HL7 Security Observation Value Tag Set Names.

Types of security policies that further specify the ActClassPolicy value set.

Examples:

* obligation to encrypt * refrain from redisclosure without consent

This is not really a diet, since it contains little nutritional value, but is essentially just water. Used before coloscopy examinations.

A fill where the remainder of a 'complete' fill is provided after a trial fill has been provided.

Policy for handling information not to be initially disclosed or discussed with patient except by a physician assigned to patient in this case. Information handling protocols based on organizational policies related to sensitive patient information that must be initially discussed with the patient by an attending physician before being disclosed to the patient.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.Open Issue:This definition conflates a rule and a characteristic, and there may be a similar issue with ts sibling codes.

A fill where the remainder of a 'complete' fill is provided after a trial fill has been provided and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).

Description:The patient's teacher when immunized.

A fill where a small portion is provided to allow for determination of the therapy effectiveness and patient tolerance.

A fill where a small portion is provided to allow for determination of the therapy effectiveness and patient tolerance and also where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).

**Description:**Proposed therapy may be inappropriate or ineffective based on the proposed start or end time.

A sequence of values in the "absolute" time domain. This is the same time domain that all HL7 timestamps use. It is time as measured by the Gregorian calendar

A sequence of values in a "relative" time domain. The time is measured relative to the earliest effective time in the Observation Series containing this sequence.

**Definition:**The therapy is being performed at a time which diverges from the time the therapy was requested

Definition:Life insurance under which the benefit is payable only if the insured dies during a specified period. If an insured dies during that period, the beneficiary receives the death payments. If the insured survives, the policy ends and the beneficiary receives nothing.

The patient is receiving a subsequent fill significantly later than would be expected based on the amount previously supplied and the therapy dosage instructions

The patient is receiving a subsequent fill significantly earlier than would be expected based on the amount previously supplied and the therapy dosage instructions

Proposed therapy may interact with an existing or recent therapeutic product

Fees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee.

Can be a URL or hyperlinks that link to the transmission formats that are specified for a particular reporting program.

Transfer of ownership for a product.

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.

Description:An interaction where the exposure participants traveled together in/on the same vehicle/trip (e.g. concurrent co-passengers).

Communication of an agent from one living subject to another living subject through direct contact with blood or blood products where the contact with blood is part of a therapeutic procedure.

Type of security metadata about the formal declaration by an authority or neutral third party that validates the technical, security, trust, and business practice conformance of Trust Agents to facilitate security, interoperability, and trust among participants within a security domain or trust framework.

Type of security metadata observation made about the formal declaration by an authority or neutral third party that validates the technical, security, trust, and business practice conformance of Trust Agents to facilitate security, interoperability, and trust among participants within a security domain or trust framework.

Type of security metadata about privacy and security requirements with which a security domain must comply. \[ISO IEC 10181-1\]

Type of security metadata observation made about privacy and security requirements with which a security domain must comply. \[ISO IEC 10181-1\]

Type of security metadata about the digital quality or reliability of a trust assertion, activity, capability, information exchange, mechanism, process, or protocol.

Type of security metadata about a set of security-relevant data issued by a security authority or trusted third party, together with security information which is used to provide the integrity and data origin authentication services for an IT resource (data, information object, service, or system capability). \[Based on ISO IEC 10181-1\]

Type of security metadata observation made about a set of security-relevant data issued by a security authority or trusted third party, together with security information which is used to provide the integrity and data origin authentication services for an IT resource (data, information object, service, or system capability). \[Based on ISO IEC 10181-1\]

For example,

* A Certificate Policy (CP), which is a named set of rules that indicates the applicability of a certificate to a particular community and/or class of application with common security requirements. For example, a particular Certificate Policy might indicate the applicability of a type of certificate to the authentication of electronic data interchange transactions for the trading of goods within a given price range. \[Trust Service Principles and Criteria for Certification Authorities Version 2.0 March 2011 Copyright 2011 by Canadian Institute of Chartered Accountants. * A Certificate Practice Statement (CSP), which is a statement of the practices which an Authority employs in issuing and managing certificates. \[Trust Service Principles and Criteria for Certification Authorities Version 2.0 March 2011 Copyright 2011 by Canadian Institute of Chartered Accountants.\]

Type of security metadata about a complete set of contracts, regulations, or commitments that enable participating actors to rely on certain assertions by other actors to fulfill their information security requirements. \[Kantara Initiative\]

Type of security metadata observation made about a complete set of contracts, regulations or commitments that enable participating actors to rely on certain assertions by other actors to fulfill their information security requirements. \[Kantara Initiative\]

Type of security metadata observation made about the digital quality or reliability of a trust assertion, activity, capability, information exchange, mechanism, process, or protocol.

Type of security metadata about a security architecture system component that supports enforcement of security policies.

Type of security metadata observation made about a security architecture system component that supports enforcement of security policies.

A code representing Title 38 Section 7332, which is a US Federal law stipulating the privacy rights of veterans diagnosed and treated for substance use disorders, infection with the human immunodeficiency virus, or sickle cell anemia.

https://www.gpo.gov/fdsys/granule/USCODE-2011-title38/USCODE-2011-title38-partV-chap73-subchapIII-sec7332/content-detail.html . (1) Records of the identity, diagnosis, prognosis, or treatment of any patient or subject which are maintained in connection with the performance of any program or activity (including education, training, treatment, rehabilitation, or research) relating to drug abuse, alcoholism or alcohol abuse, infection with the human immunodeficiency virus, or sickle cell anemia which is carried out by or for the Department under this title shall, except as provided in subsections (e) and (f), be confidential, and (section 5701 of this title to the contrary notwithstanding) such records may be disclosed only for the purposes and under the circumstances expressly authorized under subsection (b). (2) Paragraph (1) prohibits the disclosure to any person or entity other than the patient or subject concerned of the fact that a special written consent is required in order for such records to be disclosed. (b) (1) The content of any record referred to in subsection (a) may be disclosed by the Secretary in accordance with the prior written consent of the patient or subject with respect to whom such record is maintained, but only to such extent, under such circumstances, and for such purposes as may be allowed in regulations prescribed by the Secretary. (2) Whether or not any patient or subject, with respect to whom any given record referred to in subsection (a) is maintained, gives written consent, the content of such record may be disclosed by the Secretary as follows: (A) To medical personnel to the extent necessary to meet a bona fide medical emergency. (B) To qualified personnel for the purpose of conducting scientific research, management audits, financial audits, or program evaluation, but such personnel may not identify, directly or indirectly, any individual patient or subject in any report of such research, audit, or evaluation, or otherwise disclose patient or subject identities in any manner. (C) (i) In the case of any record which is maintained in connection with the performance of any program or activity relating to infection with the human immunodeficiency virus, to a Federal, State, or local public-health authority charged under Federal or State law with the protection of the public health, and to which Federal or State law requires disclosure of such record, if a qualified representative of such authority has made a written request that such record be provided as required pursuant to such law for a purpose authorized by such law. (ii) A person to whom a record is disclosed under this paragraph may not redisclose or use such record for a purpose other than that for which the disclosure was made. (D) If authorized by an appropriate order of a court of competent jurisdiction granted after application showing good cause therefor. In assessing good cause the court shall weigh the public interest and the need for disclosure against the injury to the patient or subject, to the physician-patient relationship, and to the treatment services. Upon the granting of such order, the court, in determining the extent to which any disclosure of all or any part of any record is necessary, shall impose appropriate safeguards against unauthorized disclosure. (E) To an entity described in paragraph (1)(B) of section 5701(k) of this title, but only to the extent authorized by such section. (F) (i) To a representative of a patient who lacks decision-making capacity, when a practitioner deems the content of the given record necessary for that representative to make an informed decision regarding the patient's treatment. (ii) In this subparagraph, the term "representative" means an individual, organization, or other body authorized under section 7331 of this title and its implementing regulations to give informed consent on behalf of a patient who lacks decision-making capacity. (G) To a State controlled substance monitoring program, including a program approved by the Secretary of Health and Human Services under section 399O of the Public Health Service Act (42 U.S.C. 280g-3), to the extent necessary to prevent misuse and diversion of prescription medicines. (H) (i) To a non-Department entity (including private entities and other Federal agencies) for purposes of providing health care, including hospital care, medical services, and extended care services, to Veterans or performing other health care-related activities or functions. (ii) An entity to which a record is disclosed under this subparagraph may not disclose or use such record for a purpose other than that for which the disclosure was made or as permitted by law. (I) To a third party in order to recover or collect reasonable charges for care furnished to, or paid on behalf of, a Veteran in connection with a non-service connected disability as permitted by section 1729 of this title or for a condition for which recovery is authorized or with respect to which the United States is deemed to be a third party beneficiary under the Act entitled 'An Act to provide for the recovery from tortiously liable third persons of the cost of hospital and medical care and treatment furnished by the United States' (Public Law 87-693; 42 U.S.C. 2651 et seq.; commonly known as the 'Federal Medical Care Recovery Act').

Usage Note:Used to indicate the legal authority for assigning security labels to governed information. In this case, where collection, access, use, or disclosure of healthcare information is governed by 38 U.S. Code Section 7332 - Confidentiality of certain medical records https://www.gpo.gov/fdsys/granule/USCODE-2011-title38/USCODE-2011-title38-partV-chap73-subchapIII-sec7332/content-detail.html use "Title38Section7332" as the security label policy code.

Since information governed by a Title 38 Section 7332 has a level of confidentiality protection that is more stringent than the normal level of protection under HIPAA 45 CFR Section 164.506 Uses and disclosures to carry out treatment, payment, or health care operations https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-506.pdf, assign the HL7 Confidentiality code "R" (restricted).

A supply action that provides sufficient material for a single dose.

A supply action that provides sufficient material for a single dose via multiple products. E.g. 2 50mg tablets for a 100mg unit dose.

The filtration of a colloidal substance through a semipermeable medium that allows only the passage of small molecules.

Definition:Life insurance under which the benefit is payable upon the insuredaTMs death or diagnosis of a terminal illness. If an insured dies during that period, the beneficiary receives the death payments. If the insured survives, the policy ends and the beneficiary receives nothing Definition:A form of insurance protection that provides additional liability coverage after the limits of your underlying policy are reached. An umbrella liability policy also protects you (the insured) in many situations not covered by the usual liability policies. Definition:An automobile insurance policy under which the insurance company will indemnify a loss for which another motorist is liable if that motorist is unable to pay because he or she is uninsured. Coverage under the policy applies to bodily injury damages only. Injuries to the covered party caused by a hit-and-run driver are also covered.

Maximum unit price that will be covered for the authorized product or service.

Maximum number of items that will be covered of the product or service specified.

The service provided is not related to another billed service. For example, 2 unrelated services provided on the same day to the same patient which may normally result in a refused payment for one of the items.

**Description:**United Nations Standard Products and Services Classification, managed by Uniform Code Council (UCC): www.unspsc.org

**Description:**Universal Product Code is one of a wide variety of bar code languages widely used in the United States and Canada for items in stores.

Custodian security system must declassify information assigned security labels by instantiating a new version of the classified information so as to break the binding of the classifying security label when assigning a new security label that marks the information as classified at a more protected level in accordance with applicable jurisdictional privacy policies associated with the target information. The system must retain an immutable record of the previous assignment and binding.

Premium paid on service fees in compensation for providing an expedited response to an urgent situation.

An informed assertion by an adult, or the parent/guardian of a minor who is a candidate research subject, of the individual's willingness to participate in unspecified research studies, including storage, maintenance, and secondary research use of identifiable biospecimens and data. If broad consent is obtained, any subsequent storage, maintenance, and secondary research uses of the individual’s identifiable biospecimens and data consistent with the broad consent would not require additional consent, so long as additional conditions are met, including limited review by an IRB. The consent is legally binding. Background: In the US, informed assent is governed under 49 CFR § 11.116 - General Requirements for Informed Consent. Available at https://www.law.cornell.edu/cfr/text/49/11.116

Usage notes.

An informed assertion by a minor who is a candidate research subject, of the individual's willingness to participate in research. Assent means a child's affirmative agreement to participate in a clinical investigation. Mere failure to object should not, absent affirmative agreement, be construed as assent. The minor's assent must be accompanied by parental or guardian consent that the minor participate in a specified research. The assent is not legally binding, however, the accompanying consent is legally binding. Background: In the US, informed assent is governed under 21 CFR Part 50, Subpart D - Additional Safeguards for Children in Clinical Investigations. Available at https://www.law.cornell.edu/cfr/text/21/part-50/subpart-D

An informed assertion by an adult, or the parent/guardian of a minor who is a candidate research subject, of the individual's willingness to participate in a specified research study. The consent is legally binding. Background: In the US, informed assent is governed under 49 CFR § 11.116 - General Requirements for Informed Consent. Available at https://www.law.cornell.edu/cfr/text/49/11.116

A displayed mark, required to be rendered as "(U)", indicating that a portion of an electronic or hardcopy information is neither Executive Order 13556 nor classified information authorities cover as protected. Although this information is not controlled or classified, agencies must still handle it in accordance with Federal Information Security Modernization Act (FISMA) requirements. From CUI Glossary https://www.archives.gov/cui/registry/cui-glossary.html

Usage Note:Regulatory Source: 32 CFR § 2002.20 Marking. Federal Register Page 63344 63344 (ii) Authorized holders permitted to designate CUI must portion mark both CUI and uncontrolled unclassified portions.

CUI Marking Handbook https://www.archives.gov/files/cui/20161206-cui-marking-handbook-v1-1.pdf

CUI Portion Marking: Portion marking of CUI is optional in a fully unclassified document, but is permitted and encouraged to facilitate information sharing and proper handling of the information. Agency heads may approve the required use of CUI Portion marking on all CUI generated within their agency. As such, users should consult their agency CUI policy when creating CUI documents. When CUI Portion Markings are used and a portion does not contain CUI a "U" is placed in parentheses to indicate that the portion contains Uncontrolled Unclassified Information. (Page 14)

CUI Portion Markings are placed at the beginning of the portion to which they apply and must be used throughout the entire document. They are presented in all capital letters and separated as indicated in this handbook and the CUI Registry. The presence of EVEN ONE item of CUI in a document requires CUI marking of that document. Because of this, CUI Portion Markings can be of great assistance in determining if a document contains CUI and therefore must be marked as such. Remember: When portion markings are used and any portion does not contain CUI, a "(U)" is placed in front of that portion to indicate that it contains Uncontrolled - or non-CUI - Unclassified Information. (Page 15)

Indicates that the ICSR is describing a problem with the actual vaccine product such as physical defects (cloudy, particulate matter) or inability to confer immunity.

**Description:**The specified element did not pass business-rule validation.

Communication of an agent from a living subject acting as a required intermediary in the agent transmission process to a recipient living subject via direct contact.

The provider has received a verbal permission from an authoritative source to perform the service or supply the item being invoiced.

Definition:Services provided directly and through contracted and operated veteran health programs.

**Definition:**Indicates that the paper version of the record has, should be or is being verified against the electronic version.

Policy for handling information related to harm by violence, which is afforded heightened confidentiality. Harm by violence is perpetrated by an unrelated person.

Access control concerns for information about mental or physical harm resulting from violence caused by an unrelated person may include manipulation of care givers or access to records that enable the perpetrator contact or locate the patient, but the perpetrator will likely not have established abusive psychological control over the patient.

Usage Note:If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code.
Definition:Set of codes for a policy that provides coverage for health care expenses arising from vision services.

A health insurance policy that covers benefits for vision care services, prescriptions, and products.

Diet with low content of the amino-acids valin, leucin, and isoleucin, for "maple syrup disease."

An observation that reports the volume of a sample.

A patient encounter where the patient and the practitioner(s) are not in the same physical location. Examples include telephone conference, email exchange, robotic surgery, and televideo conference.

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

Accommodations in which there are 3 or more beds.

Communication of an agent from a contaminated water source to a living subject whether the water is ingested as a food or not. The route of entry of the water may be through any bodily orifice.

Insurance policy for injuries sustained in the work place or in the course of employment.

Transaction counts and value totals for each calendar week within the date range specified.

Description:A person enters a wellness or preventive care reminder for a given patient. Description:A person reviews a list of wellness or preventive care reminders for a given patient. Description:Work Injury related additional Information Attachment Description:Exposure interaction occurred in a work setting, i.e. participants are co-workers.

Incident or accident is the result of a work place accident

Definition:Government mandated program providing coverage, disability income, and vocational rehabilitation for injuries sustained in the work place or in the course of employment. Employers may either self-fund the program, purchase commercial coverage, or pay a premium to a government entity that administers the program. Employees may be required to pay premiums toward the cost of coverage as well.

Used by one system to inform another that the container is no longer available within the scope of the system (e.g., tube broken or discarded).

Description:Digital X-Ray Attachment

Transaction counts and value totals for each calendar year within the date range specified.

An account represents a grouping of financial transactions that are tracked and reported together with a single balance. Examples of account codes (types) are Patient billing accounts (collection of charges), Cost centers; Cash.

Includes coded responses that will occur as a result of the adjudication of an electronic invoice at a summary level and provides guidance on interpretation of the referenced adjudication results.

Catagorization of grouping criteria for the associated transactions and/or summary (totals, subtotals).

Explanatory codes that provide information derived by an Adjudicator during the course of adjudicating an invoice.

Codes from this domain are purely informational and do not materially affect the adjudicated invoice. That is, these codes do not impact or explain financial adjustments to an invoice. A companion domain (ActAdjudicationReasonCode) includes reasons which have a financial impact on an Invoice (claim).

Example adjudication information code is 54540 - Patient has reached Plan Maximum for current year.

Actions to be carried out by the recipient of the Adjudication Result information.

Identifies types of detectyed issues for Act class "ALRT" for the administrative and patient administrative acts domains.

Codes dealing with the management of Detected Issue observations for the administrative and patient administrative acts domains.

**Definition:**An identifying modifier code for healthcare interventions or procedures.

Definition:An identifying code for billable services, as opposed to codes for similar services used to identify them for functional purposes.

The type of provision(s) made for reimbursing for the deliver of healthcare services and/or goods provided by a Provider, over a specified period.

Type of bounded ROI.

**Description:**The type and scope of responsibility taken-on by the performer of the Act for a specific subject of care.

Description:Coded types of attachments included to support a healthcare claim.

Denotes the specific service that has been performed. This is obtained from the professional service catalog pertaining to the discipline of the health service provider. Professional services are generally cognitive in nature and exclude surgical procedures. E.g. Provided training, Provided drug therapy review, Gave smoking-cessation counseling, etc.

Specifies the type or actual definition of a contractually binding agreement or a non-binding representation of that agreement between a grantor and a grantee as to the exchange of the grantee's considerations in return for the grantor's control of certain assets. The type of assets exchanged include rights, license, terms of service, valued items, information and real property assets and control over such assets such as physical and locatable property; intellectual property; biospecimen; genomic and genetic information related to an individual including that disclosed by genetically related individuals with or without the individual's consent; personal identifiable, pseudonymized, anonymized, de-identified per some rubric, and relinkable variants.

Usage Note:Types or actual definitions of a contractually binding agreement or a non-binding representation of that agreement include:

* \_ActDecision (formally ActConsentDirective), which specifies the type of decision made by the grantor. The decision types are mapped to ISO/TS 17975 Health informatics - Principles and data requirements for consent in the Collection, Use or Disclosure of personal health information; * \_ActPrivacyConsentDirective, which is the parent of types of registry participation consent directives, and of realm specific privacy consent directive policies such as \_USPrivacyConsentDirective and \_GDPRPrivacyConsentDirective.

Specifies the type of agreement between one or more grantor and grantee in which rights and obligations related to one or more shared items of interest are allocated.

Usage Note:Such agreements may be considered "consent directives" or "contracts" depending on the context, and are considered closely related or synonymous from a legal perspective.Examples:

* Healthcare Privacy Consent Directive permitting or restricting in whole or part the collection, access, use, and disclosure of health information, and any associated handling caveats. * Healthcare Medical Consent Directive to receive medical procedures after being informed of risks and benefits, thereby reducing the grantee's liability. * Research Informed Consent for participation in clinical trials and disclosure of health information after being informed of risks and benefits, thereby reducing the grantee's liability. * Substitute decision maker delegation in which the grantee assumes responsibility to act on behalf of the grantor. * Contracts in which the agreement requires assent/dissent by the grantor of terms offered by a grantee, a consumer opts out of an "award" system for use of a retailer's marketing or credit card vendor's point collection cards in exchange for allowing purchase tracking and profiling. * A mobile device or App privacy policy and terms of service to which a user must agree in whole or in part in order to utilize the service. * Agreements between a client and an authorization server or between an authorization server and a resource operator and/or resource owner permitting or restricting e.g., collection, access, use, and disclosure of information, and any associated handling caveats.

Definition:The type of consent directive, e.g., to consent or dissent to collect, access, or use in specific ways within an EHRS or for health information exchange; or to disclose health information for purposes such as research.

Constrains the ActCode to the domain of Container Registration

An observation form that determines parameters or attributes of an Act. Examples are the settings of a ventilator machine as parameters of a ventilator treatment act; the controls on dillution factors of a chemical analyzer as a parameter of a laboratory observation act; the settings of a physiologic measurement assembly (e.g., time skew) or the position of the body while measuring blood pressure.

Control variables are forms of observations because just as with clinical observations, the Observation.code determines the parameter and the Observation.value assigns the value. While control variables sometimes can be observed (by noting the control settings or an actually measured feedback loop) they are not primary observations, in the sense that a control variable without a primary act is of no use (e.g., it makes no sense to record a blood pressure position without recording a blood pressure, whereas it does make sense to record a systolic blood pressure without a diastolic blood pressure).

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

Response to an insurance coverage eligibility query or authorization request.

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

Criteria that are applicable to the authorized coverage.

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.

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.

Definition:Set of codes indicating the type of insurance policy or program that pays for the cost of benefits provided to covered parties.

Codes representing the types of covered parties that may receive covered benefits under a policy or program.

**Description:**The type and scope of legal and/or professional responsibility taken-on by the performer of the Act for a specific subject of care as described by a credentialing agency, i.e. government or non-government agency. Failure in executing this Act may result in loss of credential to the person or organization who participates as performer of the Act. Excludes employment agreements.

**Example:**Hospital license; physician license; clinic accreditation.

**Description:**The type and scope of legal and/or professional responsibility taken-on by the performer of the Act for a specific subject of care as described by an agency for credentialing individuals.

**Description:**The type and scope of legal and/or professional responsibility taken-on by the performer of the Act for a specific subject of care as described by an agency for credentialing programs within organizations.

Specifies the type of agreement between one or more grantor and grantee in which rights and obligations related to one or more shared items of interest are allocated.

Usage Note:Such agreements may be considered "consent directives" or "contracts" depending on the context, and are considered closely related or synonymous from a legal perspective.Examples:

* Healthcare Privacy Consent Directive permitting or restricting in whole or part the collection, access, use, and disclosure of health information, and any associated handling caveats. * Healthcare Medical Consent Directive to receive medical procedures after being informed of risks and benefits, thereby reducing the grantee's liability. * Research Informed Consent for participation in clinical trials and disclosure of health information after being informed of risks and benefits, thereby reducing the grantee's liability. * Substitute decision maker delegation in which the grantee assumes responsibility to act on behalf of the grantor. * Contracts in which the agreement requires assent/dissent by the grantor of terms offered by a grantee, a consumer opts out of an "award" system for use of a retailer's marketing or credit card vendor's point collection cards in exchange for allowing purchase tracking and profiling. * A mobile device or App privacy policy and terms of service to which a user must agree in whole or in part in order to utilize the service. * Agreements between a client and an authorization server or between an authorization server and a resource operator and/or resource owner permitting or restricting e.g., collection, access, use, and disclosure of information, and any associated handling caveats.

Identifies types of detected issues for Act class "ALRT"

Codes dealing with the management of Detected Issue observations

Accommodation type. In Intent mood, represents the accommodation type requested. In Event mood, represents accommodation assigned/used. In Definition mood, represents the available accommodation type.

Domain provides codes that qualify the ActEncounterClass (ENC)

Concepts that identify the type or nature of exposure interaction. Examples include "household", "care giver", "intimate partner", "common space", "common substance", etc. to further describe the nature of interaction.

Identifies types of detected issues for Act class "ALRT" for the financial acts domain.

Codes dealing with the management of Detected Issue observations for the financial acts domain.

European Union General Data Protection Regulation (GDPR) consent directives.

GDPR is a regulation on the protection of natural persons with regard to the processing of personal data and on the free movement of such data, and repealing Directive 95/46/EC (Data Protection Directive). Promulgated by the European Parliament and Council of the European Union. Regulation available at L119, 4 May 2016, p. 1-88.

GDPR privacy policies specifying types of lawful personal data processing based on a controller meeting one or more processing condition such as specified by law, compliance with data controller legal obligations, protection of data subject's vital interests, perform tasks in the public interest, related to legal claims, research and statistics, management of health or social care systems, legitimate interests of controller or third party. Processing sensitive personal data, including genetic, biometric and health data, as well as personal data from which racial and ethnic origin, political opinions, religious or ideological convictions or membership in a union can be attributed to a person, requires meeting at least one sensitive personal processing condition.

GDPR 'processing' means any operation or set of operations which is performed on personal data or on sets of personal data, whether or not by automated means, such as collection, recording, organisation, structuring, storage, adaptation or alteration, retrieval, consultation, use, disclosure by transmission, dissemination or otherwise making available, alignment or combination, restriction, erasure or destruction. Article 4 https://gdpr-info.eu/art-4-gdpr/

Usage Note:

* Confidentiality: e.g., U (unrestricted) for anonymized personal information; L (low) for pseudonymized U (unrestricted) for anonymized personal information; M (moderate) for indirectly identifiable information such as test scores and work times; N (normal) for personal information; and R (restricted) for sensitive personal information * DPR sensitivity \[personal data revealing racial or ethnic origin, political opinions, religious or philosophical beliefs, or trade union membership, and the processing of genetic data, biometric data for the purpose of uniquely identifying a natural person, data concerning health or data concerning a natural person's sex life or sexual orientation, some of which are defined at Article 4 https://gdpr-info.eu/art-4-gdpr/ * GDPR processing policies and GDPR ConsentDirectiveTypes, such as data subject consent and research consent. * Other security category codes, such as compartment codes for legitimate relationship, * Handling instructions including * Purpose of use stipulated in a GDPR consent or contract restricting processing or related to the scope of the processing policy such as public health, research, and legal obligations * Obligation policies such as GDPR Information Obligations https://gdpr-info.eu/issues/information-obligations, data minimization and deleting when processing is complete * Refrain policies such as no relinking

See Intersoft GDPR at https://gdpr-info.eu/issues/personal-data/ Art. 4 GDPR Definitions https://gdpr-info.eu/art-4-gdpr/ Art. 9 GDPR Processing of special categories of personal data https://gdpr-info.eu/art-9-gdpr/ Relevant Recitals (26) Not applicable to anonymous data (30) Online identifiers for profiling and identification (34) Genetic data (35) Health data (51) Protecting sensitive personal data at Intersoft GDPR briefing papers and navigating tool https://gdpr-info.eu/

Authorities

* European Data Protection Supervisor - Security Measures for Personal Data Processing (Link) * Data Protection Authority Isle of Man - Know your data - Mapping the 5 W's (Link) * Data Protection Authority UK - Key definitions (Link) * European Commission - What is personal data? (Link) * European Commission - What personal data is considered sensitive? (Link) * EU publications - Handbook on European data protection law - Personal data, page 83 (Link)

Expert contribution A&L Goodbody - The GDPR: A Guide for Businesses - Definition of Personal & Sensitive Data, Page 8 (Link) Bird & Bird - Sensitive data and lawful processing (Link) https://ec.europa.eu/commission/priorities/justice-and-fundamental-rights/data-protection/2018-reform-eu-data-protection-rules\_en General Data Protection Regulation https://eur-lex.europa.eu/legal-content/EN/TXT/?qid=1528874672298&uri=CELEX%3A32016R0679 Communication on data protection - guidance on direct application of the GDPR http://eur-lex.europa.eu/legal-content/EN/TXT/?qid=1517578296944&uri=CELEX%3A52018DC0043 Intersoft GDPR briefing papers and navigating tool https://gdpr-info.eu/

Specifies types of consent directives authorizing a registry or repository to collect and, under certain terms, manage the access, use, and disclosure of personal information, including de-identified information, and personal effects, such as biometrics, biospecimen or genetic material, which may be used to identify an individual.

Registries governed by registry consent directives are data management systems, which use metadata to support the collection, access, use, and disclosure of personal information or effects as well as observational or analytic information generated about personal information or effects stored in federated repositories. Such registries are used for a variety of purposes by federated health information exchanges, health information systems, personal record systems, and research organizations to locate and retrieve personal information or effects as well as observational or analytic information generated about personal information stored externally to their systems.

Repositories governed by registry consent directives are data stores used to collect, access, use, and disclose personal information or effects as well as observational or analytic information generated about personal information or effects and metadata used to manage the repository contents. Such repositories are used for a variety of purposes by centralized health information exchanges, health information systems used by providers and payers, personal record systems, and research organizations. A repository typically includes a registry component that provides the data store with content management capabilities for internal purposes. A repository may also interface with one or more external registries, which provide federated content management.

Definition:Set of codes indicating the type of health insurance policy that covers health services provided to covered parties. A health insurance policy is a written contract for insurance between the insurance company and the policyholder, and contains pertinent facts about the policy owner (the policy holder), the health insurance coverage, the insured subscribers and dependents, and the insurer. Health insurance is typically administered in accordance with a plan, which specifies (1) the type of health services and health conditions that will be covered under what circumstances (e.g., exclusion of a pre-existing condition, service must be deemed medically necessary; service must not be experimental; service must provided in accordance with a protocol; drug must be on a formulary; service must be prior authorized; or be a referral from a primary care provider); (2) the type and affiliation of providers (e.g., only allopathic physicians, only in network, only providers employed by an HMO); (3) financial participations required of covered parties (e.g., co-pays, coinsurance, deductibles, out-of-pocket); and (4) the manner in which services will be paid (e.g., under indemnity or fee-for-service health plans, the covered party typically pays out-of-pocket and then file a claim for reimbursement, while health plans that have contractual relationships with providers, i.e., network providers, typically do not allow the providers to bill the covered party for the cost of the service until after filing a claim with the payer and receiving reimbursement).

Code identifying the type of identification document (e.g. passport, drivers license)

**Implementation Note:**The proposal called for a domain, but a code was also provided. When codes are available for the value set the code IDENTDOC (identity document) will be used as the headcode for the specializable value set.

Set of codes indicating the type of incident or accident.

Description:The type of health information to which the subject of the information or the subject's delegate consents or dissents.

Concepts conveying the context in which authorization given under jurisdictional law, by organizational policy, or by a patient consent directive permits the collection, access, use or disclosure of specified patient health information.

The type of action permitted on information by jurisdictional, organizational, or personal policy.

**Definition:**Indicates the set of information types which may be manipulated or referenced, such as for recommending access restrictions.

Information management directives related to privacy, security, integrity, and control concerns, which may be governed by specific laws; based on private sector self-governance; adopted "best practices" recognized by a community of interest; or terms of license, participation, or service as implemented in jurisdictional, organizational, or personal policies.

Types of sensitivity policies that apply to Acts. Act.confidentialityCode is defined in the RIM as "constraints around appropriate disclosure of information about this Act, regardless of mood."

Usage Note:ActSensitivity codes are used to bind information to an Act.confidentialityCode according to local sensitivity policy so that those confidentiality codes can then govern its handling across enterprises. Internally to a policy domain, however, local policies guide the access control system on how end users in that policy domain are able to use information tagged with these sensitivity values.

Set of codes indicating the type of insurance policy or other source of funds to cover healthcare costs.

Definition:Set of codes indicating the type of insurance policy. Insurance, in law and economics, is a form of risk management primarily used to hedge against the risk of potential financial loss. Insurance is defined as the equitable transfer of the risk of a potential loss, from one entity to another, in exchange for a premium and duty of care. A policy holder is an individual or an organization enters into a contract with an underwriter which stipulates that, in exchange for payment of a sum of money (a premium), one or more covered parties (insureds) is guaranteed compensation for losses resulting from certain perils under specified conditions. The underwriter analyzes the risk of loss, makes a decision as to whether the risk is insurable, and prices the premium accordingly. A policy provides benefits that indemnify or cover the cost of a loss incurred by a covered party, and may include coverage for services required to remediate a loss. An insurance policy contains pertinent facts about the policy holder, the insurance coverage, the covered parties, and the insurer. A policy may include exemptions and provisions specifying the extent to which the indemnification clause cannot be enforced for intentional tortious conduct of a covered party, e.g., whether the covered parties are jointly or severably insured.Discussion:In contrast to programs, an insurance policy has one or more policy holders, who own the policy. The policy holder may be the covered party, a relative of the covered party, a partnership, or a corporation, e.g., an employer. A subscriber of a self-insured health insurance policy is a policy holder. A subscriber of an employer sponsored health insurance policy is holds a certificate of coverage, but is not a policy holder; the policy holder is the employer. See CoveredRoleType.

Codes representing a grouping of invoice elements (totals, sub-totals), reported through a Payment Advice or a Statement of Financial Activity (SOFA). The code can represent summaries by day, location, payee and other cost elements such as bonus, retroactive adjustment and transaction fees.

Codes representing adjustments to a Payment Advice such as retroactive, clawback, garnishee, etc.

Codes representing a grouping of invoice elements (totals, sub-totals), reported through a Payment Advice or a Statement of Financial Activity (SOFA). The code can represent summaries by day, location, payee, etc.

An identifying data string for healthcare products.

An identifying data string for healthcare procedures.

Codes representing a service or product that is being invoiced (billed). The code can represent such concepts as "office visit", "drug X", "wheelchair" and other billable items such as taxes, service charges and discounts.

An identifying data string for A substance used as a medication or in the preparation of medication.

The billable item codes to identify adjudicator specified components to the total billing of a claim.

The detail item codes to identify charges or changes to the total billing of a claim due to insurance rules and payments.

The billable item codes to identify modifications to a billable item charge. As for example after hours increase in the office visit fee.

The billable item codes to identify provider supplied charges or changes to the total billing of a claim.

An identifying data string for oral health procedure codes, e.g. extract tooth.

An identifying data string for medical facility accommodations.

The billable item codes to identify modifications to a billable item charge by a tax factor applied to the amount. As for example 7% provincial sales tax.

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.

Identifies the different types of summary information that can be reported by queries dealing with Statement of Financial Activity (SOFA). The summary information is generally used to help resolve balance discrepancies between providers and payors.

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.

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.

Includes coded responses that will occur as a result of the adjudication of an electronic invoice at a summary level and provides guidance on interpretation of the referenced adjudication results.

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.

Provides codes associated with ActClass value of LIST (working list)

Definition:An identifying code for billable medical services, as opposed to codes for similar services to identify them for clinical purposes.

General category of medical service provided to the patient during their encounter.

**Definition:**A collection of concepts that identifies different types of 'duration-based' mediation working lists.

**Examples:**"Continuous/Chronic" "Short-Term" and "As Needed"

Identifies types of monitoring programs

Definition:An identifying code for billable services that are not medical procedures, such as social services or governmental program services.Example:Building a wheelchair ramp, help with groceries, giving someone a ride, etc.

**Description:**Concepts representing indications (reasons for clinical action) other than diagnosis and symptoms.

Identifies the type of verification investigation being undertaken with respect to the subject of the verification activity.

Examples:
  • Verification of eligibility for coverage under a policy or program - aka enrolled/covered by a policy or program

  • Verification of record - e.g., person has record in an immunization registry

  • Verification of enumeration - e.g. NPI

  • Verification of Board Certification - provider specific

  • Verification of Certification - e.g. JAHCO, NCQA, URAC

  • Verification of Conformance - e.g. entity use with HIPAA, conformant to the CCHIT EHR system criteria

  • Verification of Provider Credentials

  • Verification of no adverse findings - e.g. on National Provider Data Bank, Health Integrity Protection Data Base (HIPDB)

**Description:**An identifying code for oral health interventions/procedures.

The type of order that was fulfilled by the clinical service

**Description:**Provides a categorization for annotations recorded directly against the patient .

Definition:A code specifying the particular kind of Patient Safety Incident that the Incident class instance represents.

**Examples:**"Medication incident", "slips, trips and falls incident".The actual value set for the domain will be determined by each (realm) implementation, whose Patient Safety terminology will be specific, although probably linked to the WHO Patient Safety Taxonomy that is currently under development

Definition: Characterizes how a patient was or will be transported to the site of a patient encounter.

Examples:Via ambulance, via public transit, on foot.

Code identifying the method or the movement of payment instructions.

Codes are drawn from X12 data element 591 (PaymentMethodCode)

Identifies types of dispensing events

A mandate, regulation, obligation, principle, requirement, rule, or expectation of how an entity is to conduct itself or execute an activity, which may be dictated and enforced by an authority of competent jurisdiction.

Specifies types of consent directives governing the collection, access, use, or disclosure of personal information, including de-identified information, and personal effects, such as biometrics, biospecimen or genetic material, which may be used to identify an individual.

A jurisdictional mandate, regulation, obligation, requirement, rule, or expectation deeming certain information to be private to an individual or organization, which is imposed on:

* The activity of a governed party * The behavior of a governed party * The manner in which an act is executed by a governed party

A policy deeming certain information to be private to an individual or organization.

Definition:A mandate, obligation, requirement, rule, or expectation relating to privacy.Discussion:* ActPrivacyPolicyType codes support the designation of the 1..\* policies that are applicable to an Act such as a Consent Directive, a Role such as a VIP Patient, or an Entity such as a patient who is a minor. 1..\ActPrivacyPolicyType values may be associated with an Act or Role to indicate the policies that govern the assignment of an Act or Role confidentialityCode. Use of multiple ActPrivacyPolicyType values enables fine grain specification of applicable policies, but must be carefully assigned to ensure cogency and avoid creation of conflicting policy mandates.Usage Note:Statutory title may be named in the ActClassPolicy Act Act.title to specify which privacy policy is being referenced.

An Act which characterizes a Privilege can have additional observations to provide a finer definition of the requested or conferred privilege. This domain describes the categories under which this additional information is classified.

This domain includes observations used to characterize a privilege, under which this additional information is classified.

*Examples:*A privilege to prescribe drugs has a RESTRICTION that excludes prescribing narcotics; a surgical procedure privilege has a PRE-CONDITION that it requires prior Board approval.

**Description:**Describes the high level classification of professional services for grouping.

**Examples:**Education, Counseling, Surgery, etc.

An identifying code for healthcare interventions/procedures.

The method that a product is obtained for use by the subject of the supply act (e.g. patient). Product examples are consumable or durable goods.

Definition:A set of codes used to indicate coverage under a program. A program is an organized structure for administering and funding coverage of a benefit package for covered parties meeting eligibility criteria, typically related to employment, health, financial, and demographic status. Programs are typically established or permitted by legislation with provisions for ongoing government oversight. Regulations may mandate the structure of the program, the manner in which it is funded and administered, covered benefits, provider types, eligibility criteria and financial participation. A government agency may be charged with implementing the program in accordance to the regulation. Risk of loss under a program in most cases would not meet what an underwriter would consider an insurable risk, i.e., the risk is not random in nature, not financially measurable, and likely requires subsidization with government funds.Discussion:Programs do not have policy holders or subscribers. Program eligibles are enrolled based on health status, statutory eligibility, financial status, or age. Program eligibles who are covered parties under the program may be referred to as members, beneficiaries, eligibles, or recipients. Programs risk are underwritten by not for profit organizations such as governmental entities, and the beneficiaries typically do not pay for any or some portion of the cost of coverage. See CoveredPartyRoleType.

This is the domain of registry types. Examples include Master Patient Registry, Staff Registry, Employee Registry, Tumor Registry.

**Description:**An access control object used to manage permissions and capabilities of users within information systems. (See HL7 RBAC specification fo examples of thes objects.)

Identifies the type of observation that is made about a specimen that may affect its processing, analysis or further result interpretation

Transportation of a specimen.

Set of codes related to specimen treatments

Description:Describes the type of substance administration being performed. This should not be used to carry codes for identification of products. Use an associated role or entity to carry such information.

Identifies types of detected issues regarding the administration or supply of an item to a patient.

Description:A task or action that a user may perform in a clinical information system (e.g., medication order entry, laboratory test results review, problem list entry).

Codes used to identify different types of 'duration-based' working lists. Examples include "Continuous/Chronic", "Short-Term" and "As-Needed".

Characterizes how a transportation act was or will be carried out.

Examples:Via private transport, via public transit, via courier.

Specific US privacy consent directives in accordance with US federal, state, regional, organizational, or personal privacy policies.

Definition:A jurisdictional mandate in the U.S. relating to privacy.Usage Note:ActPrivacyLaw codes may be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialtyCode complies. May be used to further specify rationale for assignment of other ActPrivacyPolicy codes in the US realm, e.g., ETH and 42CFRPart2 can be differentiated from ETH and Title38Part1.

Administration of the proposed therapy may be inappropriate or contraindicated as proposed

Description:

Represents types of consent that patient must sign prior to receipt of service, which is required for billing purposes.

Examples:

* Advanced beneficiary medically necessity notice. * Advanced beneficiary agreement to pay notice. * Advanced beneficiary requests payer billed.

Definition:Indicates the class of actions taken with regard to a substance administration related adverse event. This characterization offers a judgment of the practitioner's response to the patient's problem.Examples:Example values include dose withdrawn, dose reduced, dose not changed.NOTE:The concept domain is currently supported by a value set created by the International Conference on Harmonization

**Description:**Physicians Current Procedural Terminology (CPT) Manual is a listing of descriptive terms and identifying codes for reporting medical services and procedures performed by physicians. Available for the AMA at the address listed for CPT above. These codes are found in Appendix A of CPT 2000 Standard Edition. (CPT 2000 Standard Edition, American Medical Association, Chicago, IL).

**Description:**Physicians Current Procedural Terminology (CPT) Manual is a listing of descriptive terms and identifying codes for reporting medical services and procedures performed by physicians. Available for the AMA at the address listed for CPT above. These codes are found in Appendix A of CPT 2000 Standard Edition. (CPT 2000 Standard Edition, American Medical Association, Chicago, IL).

Code for the mechanism by which disease was acquired by the living subject involved in the public health case. Includes sexually transmitted, airborne, bloodborne, vectorborne, foodborne, zoonotic, nosocomial, mechanical, dermal, congenital, environmental exposure, indeterminate.

Identifies types of issues detected regarding the performance of a clinical action on a patient.

Used in a patient care message to report and query simple clinical (non-lab) observations.

DEA schedule for a drug.

Proposed therapy may be contraindicated or ineffective based on an existing or recent drug therapy

Types of sensitivity policies that may apply to a sensitive attribute on an Entity.

Usage Note:EntitySensitivity codes are used to convey a policy that is applicable to sensitive information conveyed by an entity attribute. May be used to bind a Role.confidentialityCode associated with an Entity per organizational policy. Role.confidentialityCode is defined in the RIM as "an indication of the appropriate disclosure of information about this Role with respect to the playing Entity."

FDA label data

Description:None provided

**Description:**Health Care Financing Administration Common Procedural Coding System (HCPCS) Codes are procedure identifying codes. HCPCS is Health Care Finance AdministrationaTMs (HFCA) coding scheme to group procedures performed for payment to providers. contains codes for medical equipment, injectable drugs, transportation services, and other services not found in CPT4.

**Description:**External value set for accommodation types used in the U.S. Health Care Financing Administration (HCFA) Common Procedure Coding System (HCPCS) including modifiers.

**Description:**Accommodation type. In Intent mood, represents the accommodation type requested. In Event mood, represents accommodation assigned/used. In Definition mood, represents the available accommodation type.

Domain provides the root for HL7-defined detailed or rich codes for the Act classes.

The trigger event referenced by the Control Act instance. Values are drawn from the available trigger events used in the release of HL7 identified by the versionCode.

**Description:**International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS) are procedure identifying codes. ICD-10-PCS describes the classification of inpatient procedures for statistical purposes.

**Description:**International Classification of Diseases, 9th Revision, Procedure Coding System (ICD-9-PCS) are procedure identifying codes. ICD-9-PCS describes the classification of inpatient procedures for statistical purposes.

Description:Observation codes which describe characteristics of the immunization material. Description:Includes those concepts that are provided to justify the fact that an adverse event or product problem is required to be reported in an expedited fashion. Description:Includes relevant pieces of information about a product or its process of creation. The vocabulary domain is used to characterize products when they are cited in adverse event or product problem reports.

**Examples:**Weight, color, dimensions.

A code that is used to indicate the type of case safety report received from sender. The current code example reference is from the International Conference on Harmonisation (ICH) Expert Workgroup guideline on Clinical Safety Data Management: Data Elements for Transmission of Individual Case Safety Reports. The unknown/unavailable option allows the transmission of information from a secondary sender where the initial sender did not specify the type of report.

Example concepts include: Spontaneous, Report from study, Other.

A mandate, obligation, requirement, rule, or expectation characterizing the value or importance of a resource and may include its vulnerability. (Based on ISO7498-2:1989. Note: The vulnerability of personally identifiable sensitive information may be based on concerns that the unauthorized disclosure may result in social stigmatization or discrimination.) Description: Types of Sensitivity policy that apply to Acts or Roles. A sensitivity policy is adopted by an enterprise or group of enterprises (a 'policy domain') through a formal data use agreement that stipulates the value, importance, and vulnerability of information. A sensitivity code representing a sensitivity policy may be associated with criteria such as categories of information or sets of information identifiers (e.g., a value set of clinical codes or branch in a code system hierarchy). These criteria may in turn be used for the Policy Decision Point in a Security Engine. A sensitivity code may be used to set the confidentiality code used on information about Acts and Roles to trigger the security mechanisms required to control how security principals (i.e., a person, a machine, a software application) may act on the information (e.g., collection, access, use, or disclosure). Sensitivity codes are never assigned to the transport or business envelope containing patient specific information being exchanged outside of a policy domain as this would disclose the information intended to be protected by the policy. When sensitive information is exchanged with others outside of a policy domain, the confidentiality code on the transport or business envelope conveys the receiver's responsibilities and indicates the how the information is to be safeguarded without unauthorized disclosure of the sensitive information. This ensures that sensitive information is treated by receivers as the sender intends, accomplishing interoperability without point to point negotiations.

Usage Note:Sensitivity codes are not useful for interoperability outside of a policy domain because sensitivity policies are typically localized and vary drastically across policy domains even for the same information category because of differing organizational business rules, security policies, and jurisdictional requirements. For example, an employee's sensitivity code would make little sense for use outside of a policy domain. 'Taboo' would rarely be useful outside of a policy domain unless there are jurisdictional requirements requiring that a provider disclose sensitive information to a patient directly. Sensitivity codes may be more appropriate in a legacy system's Master Files in order to notify those who access a patient's orders and observations about the sensitivity policies that apply. Newer systems may have a security engine that uses a sensitivity policy's criteria directly. The specializable InformationSensitivityPolicy Act.code may be useful in some scenarios if used in combination with a sensitivity identifier and/or Act.title.

Total counts and total net amounts adjudicated for all Invoice Groupings that were adjudicated within a time period based on the adjudication date of the Invoice Grouping.

Total counts and total net amounts paid for all Invoice Groupings that were paid within a time period based on the payment date.

Total counts and total net amounts billed for all Invoice Groupings that were submitted within a time period. Adjudicated invoice elements are included.

**Definition:**The set of LOINC codes for the act of determining the period of time that has elapsed since an entity was born or created.

**Description:**To allow queries to specify useful information about the age of the patient without disclosing possible protected health information.

**Description:**Dianostic procedures ordered or performed to evaluate whether a sensitivity to a substance is present. This test may be associated with specimen collection and/or substance administration challenge actiivities.

**Example:**Skin tests and eosinophilia evaluations.

Indicates the type of allergy test performed or to be performed. E.g. the specific antibody or skin test performed

**Description:**A kind of observation that allows a Secondary Observation (source act) to assert (at various levels of probability) that the target act of the association (which may be of any type of act) is implicated in the etiology of another observation that is named as the subject of the Secondary Observation

**Example:**Causality assertions where an accident is the cause of a symptom; predisposition assertions where the genetic state plus environmental factors are implicated in the development of a disease; reaction assertions where a substance exposure is associated with a finding of wheezing.

Definition:

The set of observation type concepts that can be used to express pre-conditions to a particular dosage definition.

Rationale: Used to constrain the set of observations to those related to the applicability of a dosage, such as height, weight, age, pregnancy, liver function, kidney function, etc. For example, in drug master-file type records indicating when a specified dose is applicable.

Includes all codes defining types of indications such as diagnosis, symptom and other indications such as contrast agents for lab tests

Distinguishes the kinds of coded observations that could be the trigger for clinical issue detection. These are observations that are not measurable, but instead can be defined with codes. Coded observation types include: Allergy, Intolerance, Medical Condition, Pregnancy status, etc.

Distinguishes between the kinds of measurable observations that could be the trigger for clinical issue detection. Measurable observation types include: Lab Results, Height, Weight.

Codes used to define various metadata aspects of a health quality measure.

Definition:An observation related to a query response.

**Example:**The degree of match or match weight returned by a matching algorithm in a response to a query.

Identifies the kinds of observations that can be performed

Definition:Identifies the type of Vision Prescription Observation that is being described.

Indicates the type of characteristics a patient should have for a given therapy to be appropriate. E.g. Weight, Age, certain lab values, etc.

Description:Reporting codes that are related to an immunization event.

Observation types for specifying criteria used to assert that a subject is included in a particular population.

Types of observations that can be made about Preferences.

Shape of the region on the object being referenced

Types of sensitivity policies that apply to Roles.

Usage Notes:RoleSensitivity codes are used to bind information to a Role.confidentialityCode per organizational policy. Role.confidentialityCode is defined in the RIM as "an indication of the appropriate disclosure of information about this Role with respect to the playing Entity."
RoleSensitivity codes are used to bind information to a Role.confidentialityCode per organizational policy. Role.confidentialityCode is defined in the RIM as "an indication of the appropriate disclosure of information about this Role with respect to the playing Entity."

Types of measurement observations typically performed in a clinical (non-lab) setting. E.g. Height, Weight, Blood-pressure

The specific chemical or radiological substance administered or to be administered into the body for therapeutic effect.

Supplying the product at this time may be inappropriate or indicate compliance issues with the associated therapy

Proposed therapy may be inappropriate or ineffective based on the proposed start or end time.

Code retired in December 2019 and replaced by code HIPAAConsent. Originally entered with copy/paste error in code value.

A code representing U.S. Public Law 104-191 Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule (45 CFR Section 164.522), which stipulates the process by which a covered entity seeks agreement from an individual regarding how it will use and disclose the individual's protected health information for treatment, payment, and health care operations is termed a "consent." The Privacy Rule permits, but does not require, a covered entity to voluntarily obtain patient consent for uses and disclosures of protected health information for treatment, payment, and health care operations. Covered entities that do so have complete discretion to design a process that best suits their needs. From https://www.hhs.gov/hipaa/for-professionals/faq/264/what-is-the-difference-between-consent-and-authorization/index.html. The provisions relating to consent are largely contained in Section 164.522 Rights to request privacy protection for protected health information https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-522.pdf.

Usage Note:Used to indicate the legal authority for assigning security labels to governed information. In this case, where collection, access, use, or disclosure of healthcare information is governed by 45 CFR Section 164.522 use "HIPAAConsent" as the security label policy code.

Since information governed by a 45 CFR Section 164.522 has a level of confidentiality protection that is more stringent than the normal level of protection under HIPAA 45 CFR Section 164.506 Uses and disclosures to carry out treatment, payment, or health care operations https://www.gpo.gov/fdsys/pkg/CFR-2017-title45-vol1/pdf/CFR-2017-title45-vol1-sec164-506.pdf, assign the HL7 Confidentiality code "R" (restricted).

UPDATE:

A qualitative measure of the degree of exposure to the causative agent. This includes concepts such as "low", "medium" and "high". This quantifies how the quantity that was available to be administered to the target differs from typical or background levels of the substance.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. Description:Exposure to an agent at a relatively high level above background. Description:Exposure to an agent at a relatively low level above background. Description:Exposure to an agent at a relatively moderate level above background.A

A qualitative measure of the degree of exposure to the causative agent. This includes concepts such as "low", "medium" and "high". This quantifies how the quantity that was available to be administered to the target differs from typical or background levels of the substance.

UPDATE:

Processing consideration and clarification codes.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Electronic form with supporting information to follow.

Fax with supporting information to follow.

Represents the last invoice from the perspective of the provider.

Paper documentation (or other physical format) with supporting information to follow.

UPDATE:

OpenIssue: In Ballot 2009May, a strong Negative vote was lodged against several of the concept definitions in the vocabulary used for Act.moodCode. The vote was found "Persuasive With Mod", with the understanding that M and M would undertake a detailed review of these concept definitions for a future release of the RIM.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. A property that indicates the status of the concept. One of active, experimental, deprecated, or retired. The formal name for the class clone under this code An additional concept code that was also attributed to a concept Definition:An act that has been scheduled to be performed at a specific place and time. Definition:A request act that is specialized for the appointment scheduling request/fulfillment cycle. An appointment request is fulfilled only and completely by an appointment (APT), i.e., all that the appointment request intends is to create an appointment *(the actual act may well not happen if that is the professional decision during the appointment)*. Deprecation Comment:This concept This codes should no longer be used. Instead, set attribute Act.isCriterionInd to "true" and use the desired mood for your criterion.Definition:A condition that must be true for the source act to be considered. Definition:A definition of a kind of act that can occur .OpenIssue:The semantic constructs embodied in DEF and CRT moods seem indistinguishable, and their uses can readily be determined by the context in which these are used. Therefore, this OpenIssue has been created to declare that it is likely that ActMood.DEF will be "retired" in the future in favor of the more general ActMood.CRT. Definition:An act that actually happens (may be an ongoing act or a documentation of a past act). Deprecation Comment:This concept This codes should no longer be used. Instead, set attribute Act.isCriterionInd to "true" and use the desired mood for your criterion.Definition:A criterion (CRT) that has\_match = an event (EVN). Definition:An act that is considered to have some noteworthy likelihood of occurring in the future (has\_match = event).

**Examples:**Prognosis of a condition, Expected date of discharge from hospital, patient will likely need an emergency decompression of the intracranial pressure by morning.

**UsageNotes:**INT (intent) reflects a plan for the future, which is a declaration to do something. This contrasts with expectation, which is a prediction that something will happen in the future. GOL (goal) reflects a hope rather than a prediction. RSK (risk) reflects a potential negative event that may or may not be expected to happen.

INT (intent) reflects a plan for the future, which is a declaration to do something. This contrasts with expectation, which is a prediction that something will happen in the future. GOL (goal) reflects a hope rather than a prediction. RSK (risk) reflects a potential negative event that may or may not be expected to happen.
Definition:An expectation that is considered to be desirable to occur in the future

**Examples:**Target weight below 80Kg, Stop smoking, Regain ability to walk, goal is to administer thrombolytics to candidate patients presenting with acute myocardial infarction.

UsageNotes:INT (intent) reflects a plan for the future, which is a declaration to do something. This contrasts with goal which doesn't represent an intention to act, merely a hope for an eventual result. A goal is distinct from the intended actions to reach that goal. "I will reduce the dose of drug x to 20mg" is an intent. "I hope to be able to get the patient to the point where I can reduce the dose of drug x to 20mg" is a goal. EXPEC (expectation) reflects a prediction rather than a hope. RSK (risk) reflects a potential negative event rather than a hope.
INT (intent) reflects a plan for the future, which is a declaration to do something. This contrasts with goal which doesn't represent an intention to act, merely a hope for an eventual result. A goal is distinct from the intended actions to reach that goal. "I will reduce the dose of drug x to 20mg" is an intent. "I hope to be able to get the patient to the point where I can reduce the dose of drug x to 20mg" is a goal. EXPEC (expectation) reflects a prediction rather than a hope. RSK (risk) reflects a potential negative event rather than a hope.

A criterion expressed over goals (ActMood.GOL).

Definition:An intention or plan for an act.>UsageNotes:The final outcome of the intent, the act that is intended to occur, is always an event. However the final outcome may be reached indirectly via steps through other intents, such as promise, permission request, or an appointment that may lead to an actual event to occur. Alternatively, the intended act may never occur.

A criterion expressed over intents (ActMood.INT).

Definition:One of a set of acts that specify an option for the property values that the parent act may have. Typically used in definitions or orders to describe alternatives. An option can only be used as a group, that is, all assigned values must be used together. The actual mood of the act is the same as the parent act, and they must be linked by an actrelationship with type = OPTN. Definition:A request act that is specialized for an event request/fulfillment cycle.UsageNotes:The fulfillment cycle may involve intermediary fulfilling acts in moods such as PRMS, APT, or even another RQO before being fulfilled by the final event.UsageNotes:The concepts of a "request" and an "order" are viewed as different, because there is an implication of a mandate associated with order. In practice, however, this distinction has no general functional value in the inter-operation of health care computing. "Orders" are commonly refused for a variety of clinical and business reasons, and the notion of a "request" obligates the recipient (the fulfiller) to respond to the sender (the author). Indeed, in many regions, including Australia and Europe, the common term used is "request."

Thus, the concept embodies both notions, as there is no useful distinction to be made. If a mandate is to be associated with a request, this will be embodied in the "local" business rules applied to the transactions. Should HL7 desire to provide a distinction between these in the future, the individual concepts could be added as specializations of this concept.

The critical distinction here, is the difference between this concept and an "intent", of which it is a specialization. An intent involves decisions by a single party, the author. A request, however, involves decisions by two parties, the author and the fulfiller, with an obligation on the part of the fulfiller to respond to the request indicating that the fulfiller will indeed fulfill the request.

The concepts of a "request" and an "order" are viewed as different, because there is an implication of a mandate associated with order. In practice, however, this distinction has no general functional value in the inter-operation of health care computing. "Orders" are commonly refused for a variety of clinical and business reasons, and the notion of a "request" obligates the recipient (the fulfiller) to respond to the sender (the author). Indeed, in many regions, including Australia and Europe, the common term used is "request." Thus, the concept embodies both notions, as there is no useful distinction to be made. If a mandate is to be associated with a request, this will be embodied in the "local" business rules applied to the transactions. Should HL7 desire to provide a distinction between these in the future, the individual concepts could be added as specializations of this concept. The critical distinction here, is the difference between this concept and an "intent", of which it is a specialization. An intent involves decisions by a single party, the author. A request, however, involves decisions by two parties, the author and the fulfiller, with an obligation on the part of the fulfiller to respond to the request indicating that the fulfiller will indeed fulfill the request.
Definition:A kind of act that defines a permission that has been granted. Definition:A request for a permission to perform the act. Typically a payer (or possibly a supervisor) is being requested to give permission to perform the act. As opposed to the RQO, the requestee is not asked to perform or cause to perform the act but only to give the permission. Definition:A commitment to perform an act (may be either solicited or unsolicited). The committer becomes responsible to the other party for executing the act, and, as a consequence, the other party may rely on the first party to perform or cause to perform the act.UsageNotes:Commitments may be retracted or cancelled. Commitments may be retracted or cancelled.

A criterion expressed over promises (ActMood.PRMS).

Definition:A suggestion that an act might be performed. Not an explicit request, and professional responsibility may or may not be present. Definition:A suggestion that an act should be performed with an acceptance of some degree of professional responsibility for the resulting act. Not an explicit request. .UsageNotes:Where there is no clear definition or applicable concept of "professional responsibility", RMD becomes indistinguishable from PRP. . Where there is no clear definition or applicable concept of "professional responsibility", RMD becomes indistinguishable from PRP. .

A criterion expressed over requests or orders (ActMood.RQO).

**Definition:**An act that may occur in the future and which is regarded as undesirable

**Examples:**Increased risk of DVT, at risk for sub-acute bacterial endocarditis.

**UsageNotes:**Note: An observation in RSK mood expresses the undesirable act, and not the underlying risk factor. A risk factor that is present (e.g. obesity, smoking, etc) should be expressed in event mood. INT (intent) reflects a plan for the future, which is a declaration to do something. This contrasts with RSK (risk), which is the potential that something negative will occur that may or may not ever happen. GOL (goal) reflects a hope to achieve something. EXPEC (expectation) is the prediction of a positive or negative event. This contrasts with RSK (risk), which is the potential that something negative will occur that may or may not ever happen, and may not be expected to happen.

Note: An observation in RSK mood expresses the undesirable act, and not the underlying risk factor. A risk factor that is present (e.g. obesity, smoking, etc) should be expressed in event mood. INT (intent) reflects a plan for the future, which is a declaration to do something. This contrasts with RSK (risk), which is the potential that something negative will occur that may or may not ever happen. GOL (goal) reflects a hope to achieve something. EXPEC (expectation) is the prediction of a positive or negative event. This contrasts with RSK (risk), which is the potential that something negative will occur that may or may not ever happen, and may not be expected to happen.

A criterion expressed over risks (ActMood.RSK).

Definition:A kind of act that may occur during the specified time period. Definition:A request (or order) for an act that is part of a defined request/fulfillment cycle.UsageNotes:Use of an HL7 defined request/fulfillment framework is not required to use this mood code. Use of an HL7 defined request/fulfillment framework is not required to use this mood code.

These are moods describing activities as they progress in the business cycle, from defined, through planned and ordered to completed.

Definition:A desire to have an act occur. Definition:A possible act. Definition:An act that expresses condition statements for other acts.
UPDATE:

A set of codes (e.g., for routine, emergency), specifying the urgency under which the Act happened, can happen, is happening, is intended to happen, or is requested/demanded to happen.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

As soon as possible, next highest priority after stat.

Filler should contact the placer as soon as results are available, even for preliminary results. (Was "C" in HL7 version 2.3's reporting priority.)

Filler should contact the placer (or target) to schedule the service. (Was "C" in HL7 version 2.3's TQ-priority component.)

Filler should contact the placer to schedule the service. (Was "C" in HL7 version 2.3's TQ-priority component.)

Filler should contact the service recipient (target) to schedule the service. (Was "C" in HL7 version 2.3's TQ-priority component.)

Beneficial to the patient but not essential for survival.

An unforeseen combination of circumstances or the resulting state that calls for immediate action.

Used to indicate that a service is to be performed prior to a scheduled surgery. When ordering a service and using the pre-op priority, a check is done to see the amount of time that must be allowed for performance of the service. When the order is placed, a message can be generated indicating the time needed for the service so that it is not ordered in conflict with a scheduled operation.

An "as needed" order should be accompanied by a description of what constitutes a need. This description is represented by an observation service predicate as a precondition.

Routine service, do at usual work hours.

A report should be prepared and sent as quickly as possible.

With highest priority (e.g., emergency).

It is critical to come as close as possible to the requested time (e.g., for a through antimicrobial level).

Drug is to be used as directed by the prescriber.

Calls for prompt action.

UPDATE:

A set of codes specifying the motivation, cause, or rationale of an Act, when such rationale is not reasonably represented as an ActRelationship of type "has reason" linking to another Act.

Examples:Example reasons that might qualify for being coded in this field might be: "routine requirement", "infectious disease reporting requirement", "on patient request", "required by law".
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired..

**Description:**Operational activities conducted for the purposes of meeting of criteria defined by an accrediting entity for an activity, product, or service

Accommodation requested is not available.

Order was created with incorrect data and is changed to reflect the intended accuracy of the order.

Definition:To evaluate for service authorization, payment, reporting, or performance/outcome measures. Description:Storage conditions caused the substance to be ineffective.

A person becomes eligible for a program based on age.

Example:In the U.S., a person who is 65 years of age or older is eligible for Medicare.
Definition:Patient has had a prior allergic intolerance response to alternate product or one of its components.

**Definition:**Patient has already been given a new (renewal) prescription.

**Description:**This therapy has been ordered as a backup to a preferred therapy. This order will be released when and if the preferred therapy is unsuccessful.

**Description:**The decision on which the recorded information was based was changed before the decision had an effect.

**Example:**Aborted prescription before patient left office, released prescription before suspend took effect.

To perform one or more operations on information for conducting scientific investigations to obtain health care knowledge. Use of the data must be related to specified biomedical basic or applied research. For example, research on rare plants to determine whether biologic properties may be useful for pharmaceutical development. May be used in combination with clinical trial and other healthcare research purposes of use.

The time slots previously allocated are now blocked and no longer available for booking Appointments

To perform policy override operations on information for provision of immediately needed health care for an emergent condition affecting potential harm, death or patient safety by end users who are not provisioned for this purpose of use. Includes override of organizational provisioning policies and may include override of subject of care consent directive restricting access.

Map:Partially Maps to ISO 14265 Classification Term "Emergency care provision to an individual subject of care" described as "To inform persons needing to provide health care services to the subject of care urgently, possibly needing to over-ride the policies and consents pertaining to Purpose 1 above." Purpose 1 is equivalent to HL7 treatment purpose of use: "Clinical care provision to an individual subject of care" described as "To inform persons or processes responsible for providing health care services to the subject of care." The ISO description conflates both of the proposed specializations of HL7 ETREAT: break the glass and the typically broader access to health information normally available to providers who are provisioned for emergency workflows on a regular basis, e.g., Emergency Room providers. Examples of greater access than is normally accessible by providers based on the need to know are access to sensitive information for which access typically requires a patient's consent. This is not an override of a patient's dissent to disclose sensitive information in cases where the applicable policy waives the need for that consent to access this information. In US, Title 38 Section 7332 and 42 CFR Part 2 both permit emergency access without the need to override a patient's consent directive; rather, this access is a limitation to the patient's right to dissent from disclosure.

To perform analytics, evaluation and other secondary uses of treatment and healthcare related information to manage the quality, efficacy, patient safety, population health, and cost effectiveness of healthcare delivery. Explicitly excludes the use of information to organize the delivery of health care for care coordination and case management, or to provide healthcare treatment.

Usage Note:The concept of care management is narrower than the list of activities related to more general organizational objectives such as provider profiling, education of healthcare and non-healthcare professionals; insurance underwriting, premium rating, reinsurance; organizational legal, medical review, auditing, compliance and fraud and abuse detection; business planning, development, and restructuring; fund-raising; and customer service.Map:Maps to ISO 14265 Classification Term "Health service management and quality assurance" described as "To inform persons or processes responsible for determining the availability, quality, safety, equity and cost-effectiveness of health care services."

There is a semantic gap in concepts. This classification term is described as activities, i.e., "to inform persons" or "to inform processes" rather than the rationale for performing actions/operations on information related to the activity.

**Description:**The level of coverage under the policy or program is available only to children

**Description:**Information has changed since the record was created.

**Description:**Clarification is required before the order can be acted upon.

Order is changed based on a clinical reason.

To perform one or more operations on information for conducting scientific investigations in accordance with clinical trial protocols to obtain health care knowledge.

To perform one or more operations on information for conducting scientific investigations in accordance with clinical trial protocols to obtain health care knowledge without provision of patient care. May be post-coordinated or used with other purposes of use such as disease, discipline, specialty, population origins or ancestry, translational healthcare research. For example, a clinical trial conducted on laboratory specimens collected from a specified patient population.

To perform one or more operations on information for conducting scientific investigations with patient care in accordance with clinical trial protocols to obtain health care knowledge. May be post-coordinated or used with other purposes of use such as disease, discipline, specialty, population origins or ancestry, translational healthcare research. For example, an "off-label" drug used for cancer therapy administer to a specified patient population.

To perform health care as part of the clinical trial protocol.

To perform one or more operations on information for provision of additional clinical evidence in support of a request for coverage or payment for health services.

To perform one or more actions on information in order to organize the provision and case management of an individual's healthcare, including: Monitoring a person's goals, needs, and preferences; acting as the communication link between two or more participants concerned with a person's health and wellness; organizing and facilitating care activities and promoting self-management by advocating for, empowering, and educating a person; and ensuring safe, appropriate, non-duplicative, and effective integrated care.

Usage Note:Use when describing these functions: 1. Monitoring a person's goals, needs, and preferences. 2. Acting as the communication link between two or more participants concerned with a person's health and wellness. 3. Organizing and facilitating care activities and promoting self-management by advocating for, empowering, and educating a person. 4. Ensuring safe, appropriate, non-duplicative, and effective integrated care.

The goal is to clearly differentiate this type of coordination of care from HIPAA Operations by specifying that these actions on information are undertaken in the provision of healthcare treatment.

For similar uses of this concept, see SAMHSA Confidentiality of Substance Use Disorder Patient Records Supplemental notice of proposed rulemaking, which differentiates concepts of care coordination and case management for the provision of treatment as specifically distinct from activities related to health care delivery management and the operations of organizational entities involved in the delivery of healthcare.

Map:Maps to ISO 14265 Classification Terms: "Support of care activities within the provider organisation for an individual subject of care" described as "To inform persons or processes enabling others to provide health care services to the subject of care." "Subject of Care Uses" described as "To inform the subject of care in support of his or her own interests."
Description:Cold chain was not maintained for the substance. Definition:Patient has compliance issues with medication such as differing appearance, flavor, size, shape or consistency.

**Description:**Operational activities required to meet a mandate related to an activity, product, or service

**Definition:**Contraindication identified

To perform one or more operations on information for conducting prior authorization or predetermination of coverage for services.

To perform one or more operations on information for conducting activities related to coverage under a program or policy.

When a client has no contact with the health system for an extended period, coverage is suspended. Client will be reinstated to original start date upon proof of identification, residency etc.

Example: Coverage may be suspended during a strike situation, when employer benefits for employees are not covered (i.e. not in effect).

A person becomes eligible for insurance or a program because of crime related health condition or injury.

Example:A person is a claimant under the U.S. Crime Victims Compensation program.

Indicates that the decision to substitute or to not substitute was driven by a desire to maintain consistency with a pre-existing therapy. I.e. The performer provided the same item/service as had been previously provided rather than providing exactly what was ordered, or rather than substituting with a lower-cost equivalent.

The Patient is deceased

Client deceased.

**Description:**The level of coverage under the policy or program is available only to a subscriber's dependents.

A person becomes a claimant under a disability income insurance policy or a disability rehabilitation program because of a health condition or injury which limits the person's ability to earn an income or function without institutionalization.

To perform one or more operations on information used for provision of immediately needed health care to a population of living subjects located in a disaster zone.

**Description:**The medication is no longer being manufactured or is otherwise no longer available.

To perform one or more operations on information used for cadaveric organ, eye or tissue donation.

**Description:**The medication is being re-prescribed at a different dosage.

**Description:**The current level of the medication in the patient's system is too high. The medication is suspended to allow the level to subside to a safer level.

To perform one or more operations on information for conducting scientific investigations to obtain health care knowledge. Use of the data must be related to specified conditions, diagnosis, or disease healthcare research. For example, conducting cancer research by testing reaction of tumor cells to certain biologics. May be used in combination with clinical trial and other healthcare research purposes of use.

**Description:**The level of coverage under the policy or program is available to an employee and his or her children.

**Description:**The information was recorded incorrectly or was recorded in the wrong record.

To perform one or more operations on information used for conducting eligibility determination for coverage in a program or policy. May entail review of financial status or disability assessment.

To perform one or more operations on information used for conducting eligibility verification of coverage in a program or policy. May entail provider contacting coverage source (e.g., government health program such as workers compensation or health plan) for confirmation of enrollment, eligibility for specific services, and any applicable copays.

**Description:**The level of coverage under the policy or program is available only to an employee.

A person becomes eligible for insurance provided as an employment benefit based on employment status.

**Description:**Operational activities conducted to administer information relating to entities involves with an activity, product, or service

To perform one or more operations on information used for enrolling a covered party in a program or policy. May entail recording of covered party's and any dependent's demographic information and benefit choices.

Moved to an error in placing the patient in the original location.

To perform one or more operations on information for provision of immediately needed health care for an emergent condition in an emergency room or similar emergent care context by end users provisioned for this purpose, which does not constitute as policy override such as in a "Break the Glass" purpose of use.

Map:Partially Maps to ISO 14265 Classification Term "Emergency care provision to an individual subject of care" described as "To inform persons needing to provide health care services to the subject of care urgently, possibly needing to over-ride the policies and consents pertaining to Purpose 1 above." Purpose 1 is equivalent to HL7 treatment purpose of use: "Clinical care provision to an individual subject of care" described as "To inform persons or processes responsible for providing health care services to the subject of care."

The ISO description conflates both of the proposed specializations of HL7 ETREAT: break the glass and the typically broader access to health information normally available to providers who are provisioned for emergency workflows on a regular basis, e.g., Emergency Room providers. Examples of greater access than is normally accessible by providers based on the need to know are access to sensitive information for which access typically requires a patient's consent. This is not an override of a patient's dissent to disclose sensitive information in cases where the applicable policy waives the need for that consent to access this information. In US, Title 38 Section 7332 and 42 CFR Part 2 both permit emergency access without the need to override a patient's consent directive; rather, this access is a limitation to the patient's right to dissent from disclosure.

There is a semantic gap in concepts. This classification term is described as activities "to inform persons" rather than the rationale for performing actions/operations on information related to the activity.

**Description:**The level of coverage under the policy or program is available to an employee and his or her spouse.

To perform one or more operations on information for provision of immediately needed health care for an emergent condition.

Description:The lot from which the substance was drawn was expired.

**Description:**The level of coverage under the policy or program is available to a subscriber's family.

**Definition:**Request for further authorization must be done through patient's family physician.

To perform one or more operations on information in response to a request by a family member authorized by the patient.

Ordered quantity has already been completely fulfilled.

Patient unable to pay and not covered by insurance

A person becomes eligible for a program based on financial criteria.

Example:A person whose family income is below a financial threshold for eligibility for Medicaid or SCHIP.

**Description:**Previously recorded information was erroneous and is being corrected.

Accommodation is assigned for floor convenience.

**Definition:**The bulk supply is issued to replenish a ward for local dispensing. (Includes both mobile and fixed-location ward stocks.)

**Definition:**Order to be fulfilled was aborted

**Definition:**Order to be fulfilled was suspended

Indicates that the decision to substitute or to not substitute was driven by a policy expressed within the formulary.

To perform one or more operations on information used for fraud detection and prevention processes.

**Definition:**The order has been stopped by the prescriber but this fact has not necessarily captured electronically.

**Example:**A verbal stop, a fax, etc.

**Definition:**Order has not been fulfilled within a reasonable amount of time, and may not be current.

**Definition:**Data needed to safely act on the order which was expected to become available independent of the order is not yet available

**Example:**Lab results, diagnostic imaging, etc.

**Definition:**Product not available or manufactured. Cannot supply.

**Definition:**The dispenser has ethical, religious or moral objections to fulfilling the order/dispensing the product.

**Definition:**Fulfiller not able to provide appropriate care associated with fulfilling the order.

**Example:**Therapy requires ongoing monitoring by fulfiller and fulfiller will be ending practice, leaving town, unable to schedule necessary time, etc.

To perform one or more operations on information used within government processes.

To perform one or more operations on information for conducting activities related to meeting accreditation criteria.

To perform one or more operations on information used for conducting activities required to meet a mandate.

To perform one or more operations on information used for handling deceased patient matters.

To perform one or more operation operations on information used to manage a patient directory.

Examples:

* facility * enterprise * payer * health information exchange patient directory

To perform one or more actions on information used for conducting administrative and contractual activities by or on behalf of organizational entities responsible for delivery of an individual's benefits in a healthcare program, health plan or insurance. Explicitly excludes the use of information to organize the delivery of health care for care coordination and case management, or to provide healthcare treatment.

Usage Note:Examples of activities conducted under this purpose of use: provider profiling, risk adjustment, underwriting, fraud and abuse, quality improvement population health and care management. Aligns with HIPAA Operation POU minus coordination of care or other treatment related activities. Similar to the description in SAMHSA Confidentiality of Substance Use Disorder Patient Records Supplemental notice of proposed rulemaking.Map:Maps to ISO 14265 Classification Term "Administration of care for an individual subject of care" described as "To inform persons or processes responsible for enabling the availability of resources or funding or permissions for providing health care services to the subject of care."

However, this classification term is described as activities, i.e., "to inform persons" or "to inform processes" rather than the rationale for performing actions/operations on information related to the activity.

A person becomes eligible for a program because of a qualifying health condition or injury.

Examples:A person is determined to have a qualifying health conditions include pregnancy, HIV/AIDs, tuberculosis, end stage renal disease, breast or cervical cancer, or other condition requiring specialized health services, hospice, institutional or community based care provided under a program

To perform one or more operations on information for conducting activities required by legal proceeding.

To perform one or more operations on information for marketing services and products related to health care.

**Definition:**The original reason for suspending the medication has ended.

Definition:

To perform one or more operations on information used for conducting administrative and contractual activities related to the provision of health care.

**Description:**The patient has been admitted to a care facility and their community medications are suspended until hospital discharge.

To perform one or more operations on information used for assessing results and comparative effectiveness achieved by health care practices and interventions.

To perform one or more operations on information for conducting financial or contractual activities related to payment for provision of health care.

To perform one or more operations on information used for conducting activities to meet program accounting requirements.

To perform one or more operations on information used for conducting administrative activities to improve health care quality.

To perform one or more operations on information for conducting scientific investigations to obtain health care knowledge. Use of the data iincludes basic and applied research such as biomedical, population origin or ancestry, translational research, and disease, discipline, specialty specific healthcare research and clinical trial research.

To perform one or more operations on information to administer the electronic systems used for the delivery of health care.

To perform one or more operations on information that is simulated or synthetic health data used for testing system capabilities outside of a production or operational system environment.

Usage Note:Data marked with a HTEST security label enables an access control system to permit interfacing systems or end users provisioned with a clearance, which includes a HTEST purpose of use attribute, to test, verify, or validate that a system or application will operate in production as intended based on design specifications.

**Definition:**Testing has shown that the patient already has immunity to the agent targeted by the immunization.

**Definition:**The patient's medical condition has nearly abated.

The covered party (patient) specified with the Invoice is not correct.

The billing information, specified in the Invoice Elements, is not correct. This could include incorrect costing for items included in the Invoice.

The policy specified with the Invoice is not correct. For example, it may belong to another Adjudicator or Covered Party.

The provider specified with the Invoice is not correct.

**Description:**The level of coverage under the policy or program is available to an individual.

**Description:**The therapy has been found to not have the desired therapeutic benefit on the patient.

The record is already in the requested state.

**Description:**The patient has an intolerance to the medication.

To perform one or more operations on information to assign, persist, and manage labels to healthcare data to characterize various aspects, such as its security classification, sensitivity, compartment, integrity, and provenance; applicable privacy, consent, security, provenance, and trust policies; and handling caveats such as purpose of use, obligations, and refrain policies.

Label management includes classification of target data by constructing and binding of a label set per applicable policies, security policy information file semantics, and classification guides. Label management also includes process and procedures for subsequent revision of a label for, e.g., reclassification, downgrading classification, and declassification.

Label revisions may be triggered by, e.g., expiry of classification period; changes in applicable policy, e.g., revocation of a consent directive; or changes in the governing policy domain in which the data is relocated or a copy of the data is sent. If a label is revised, an audit log should be kept and the provenance of the label changes should be tracked.

**Description:**The therapy would interfere with a planned lab test and the therapy is being withdrawn until the test is completed.

**Definition:**To provide information as a result of a subpoena.

**Definition:**The prescription may not be reassigned from the original pharmacy.

**Definition:**The bulk supply will be administered within a long term care facility.

Description:

Information is combined into the record.

The medical condition of the Patient has changed

Required for medical reasons(s).

**Definition:**The patient currently has a medical condition for which the vaccine is contraindicated or for which precaution is warranted.

To perform one or more operations on information to administer health care coverage to an enrollee under a policy or program.

To perform one or more operations on information to assign, persist, and manage metadata to healthcare data to characterize various aspects used for its indexing, discovery, retrieval, and processing by systems, applications, and end users. For example, master index identifier, media type, and location.

To perform one or more operations on information for conducting activities required by military processes, procedures, policies, or law.

To perform one or more operations on information for the process of releasing military personnel from their service obligations, which may include determining service merit, discharge benefits, and disability assessment.

To perform one or more operations on information used in training a machine learning (AI) model.

**Definition:**Therapy has been changed and new prescription issued

**Description:**Monitoring the patient while taking the medication, the decision has been made that the therapy is no longer appropriate.

The Physician is in a meeting. For example, he/she may request administrative time to talk to family after appointment

A person becomes eligible for a program based on more than one criterion.

Examples:In the U.S., a child whose familiy income meets Medicaid financial thresholds and whose age is less than 18 is eligible for the Early and Periodic Screening, Diagnostic, and Treatment program (EPSDT). A person whose family income meets Medicaid financial thresholds and whose age is 65 years or older is eligible for Medicaid and Medicare, and are referred to as dual eligibles.

**Definition:**Patient must see prescriber prior to further fills.

**Description:**New information has become available to supplement the record.

**Definition:**The current medication will be replaced by a new strength of the same medication.

**Definition:**A new therapy will be commenced when current supply exhausted.

Description:The agent does not have permission. Description:There is no match.

**Description:**Patient not available for a period of time due to a scheduled therapy, leave of absence or other reason.

Description:There is no permission.

**Definition:**Patient did not come to get medication

Description:There is no match for the product in the master file repository. Description:There is no match for the record in the database.

**Description:**The underlying condition has been resolved or has evolved such that a different treatment is no longer needed.

Description:There is no match for the service in the master file repository.

**Definition:**Original prescriber is no longer available to prescribe and no other prescriber has taken responsibility for the patient.

**Description:**The product does not have (or no longer has) coverage under the patientaTMs insurance policy.

**Definition:**Patient no longer or has never been under this prescribers care.

**Definition:**The user does not have permission

Description:The user does not have permission. Description:There is no match for the record and version.

**Definition:**The observation or test was neither defined or scheduled in the study protocol.

**Definition:**The bulk supply is intended for general clinician office use.

**Definition:**This medication is on hold.

**Description:**Administrative and contractual processes required to support an activity, product, or service

In the case of 'substitution', indicates that the substitution occurred because the ordered item was not in stock. In the case of 'no substitution', indicates that a cheaper equivalent was not substituted because it was not in stock.

**Definition:**There was no supply of the product on hand to perform the service.

**Description:**Operational activities conducted for the purposes of assessing the results of an activity, product, or service

The substance was administered outside of the recommended schedule or practice.

To perform one or more operations on information to which the patient has not consented by authorized entities for treating a condition which poses an immediate threat to the patient's health and which requires immediate medical intervention.

Usage Notes:The patient is unable to provide consent, but the provider determines they have an urgent healthcare related reason to access the record.
The patient is unable to provide consent, but the provider determines they have an urgent healthcare related reason to access the record.

To perform one or more operations on information to which the patient has not consented because deemed incompetent to provide consent.

Usage Note:Maps to v2 CON-16 Subject Competence Indicator (ID) 01791 Definition: Identifies whether the subject was deemed competent to provide consent. Refer to table HL7 Table 0136 - Yes/No Indicator and CON-23 Non-Subject Consenter Reason User-defined Table 0502 - Non-Subject Consenter Reason code NC "Subject is not competent to consent".

To perform one or more operations on information to which the patient declined to consent for providing health care.

Usage Notes:The patient, while able to give consent, has not. However the provider believes it is in the patient's interest to access the record without patient consent.
The patient, while able to give consent, has not. However the provider believes it is in the patient's interest to access the record without patient consent.

To perform one or more operations on information to which the patient has not consented for public safety reasons.

Usage Notes:The patient, while able to give consent, has not. However, the provider believes that access to masked patient information is justified because of concerns related to public safety.
The patient, while able to give consent, has not. However, the provider believes that access to masked patient information is justified because of concerns related to public safety.

To perform one or more operations on information to which the patient has not consented for third party safety.

Usage Notes:The patient, while able to give consent, has not. However, the provider believes that access to masked patient information is justified because of concerns related to the health and safety of one or more third parties.
The patient, while able to give consent, has not. However, the provider believes that access to masked patient information is justified because of concerns related to the health and safety of one or more third parties.

The Patient requested the action

To perform one or more operations on information used for operational activities conducted to administer the delivery of health care to a patient.

**Definition:**To obtain records as part of patient care.

**Definition:**Patient changed their mind regarding obtaining medication

**Definition:**Patient not eligible for drug

**Definition:**The patient or their guardian objects to receiving the vaccine.

**Definition:**Patient requests information from their profile.

To perform one or more operations on information in response to a patient's request.

To perform one or more operations on information in processes related to ensuring the safety of health care.

**Description:**Administrative, financial, and contractual processes related to payment for an activity, product, or service

To perform one or more operations on information used for monitoring performance of recommended health care practices and interventions.

**Definition:**The bulk supply is being transferred to another dispensing facility to.

**Example:**Alleviate a temporary shortage.

**Definition:**The patient or their guardian objects to receiving the vaccine because of philosophical beliefs.

The Physician requested the action

To apply algorithms (e.g. AI, CDS) to perform one or more operations on information to arrive at decision used in payment for provision of health care.

A person becomes a claimant under a property and casualty insurance policy because of a related health condition or injury resulting from a circumstance covered under the terms of the policy.

Example:A person is a claimant under a homeowners insurance policy because of an injury sustained on the policyholderaTMs premises.

To perform one or more operations on information, including genealogical pedigrees, historical records, surveys, family health data, health records, and genetic information, for conducting scientific investigations to obtain health care knowledge. Use of the data must be related to population origins and/or ancestry healthcare research. For example, gathering genetic specimens from a specific population in order to determine the ancestry and population origins of that group. May be used in combination with clinical trial and other healthcare research purposes of use.

To perform one or more operations on information for provision of health care to a population of living subjects, e.g., needle exchange program.

**Definition:**The observation or test occurred due to it being defined in the research protocol, and during an activity or event that was scheduled in the protocol.

**Definition:**To evaluate the provider's current practice for professional-improvement reasons.

To perform one or more operations on information in preparation for conducting scientific investigation to obtain health care knowledge, such as research on animals or review of patient health records, to determine the feasibility of a clinical trial study; assist with protocol design; or in preparation for institutional review board or ethics committee approval process. May be post-coordinated or used with other purposes of use such as disease, discipline, specialty, population origins or ancestry, translational healthcare research.

**Description:**The patient refused to take the product.

**Description:**The patient is pregnant or breast feeding. The therapy will be resumed when the pregnancy is complete and the patient is no longer breastfeeding.

**Description:**Operational activities conducted to meet program accounting requirements related to an activity, product, or service

**Description:**This product is not available or manufactured.

Description:The substance was recalled by the manufacturer.

**Definition:**The bulk supply is intended for dispensing according to a specific program.

**Example:**Mass immunization.

**Definition:**Patient does not meet required protocol

**Definition:**Provider is not authorized to prescribe or dispense

To perform one or more operations on information for conducting public health activities, such as the reporting of notifiable conditions.

To perform one or more operations on information in response to a request by a person appointed as the patient's legal representative.

Reason for performing one or more operations on information, which may be permitted by source system's security policy in accordance with one or more privacy policies and consent directives.

Usage Notes:The rationale or purpose for an act relating to the management of personal health information, such as collecting personal health information for research or public health purposes.
The rationale or purpose for an act relating to the management of personal health information, such as collecting personal health information for research or public health purposes.

**Description:**Operational activities conducted for the purposes of improving the quality of an activity, product, or service

**Definition:**Patient requested a revised quantity of medication

**Description:**The manufacturer or other agency has requested that stocks of a medication be removed from circulation.

To perform one or more operations on information used within the health records management process.

Client was registered in error.

**Description:**Review for the purpose of regulatory compliance.

**Definition:**The patient or their guardian objects to receiving the vaccine on religious grounds.

To perform one or more operations on information about the amount remitted for a health care claim.

**Description:**Item in current order is no longer in use as requested and a new one has/will be created to replace it.

**Description:**Current order was issued with incorrect data and a new order has/will be created to replace it.

**Description:**Investigative activities conducted for the purposes of obtaining knowledge

**Definition:**The event occurred so that a test or observation performed at a prior event could be performed again due to conditions set forth in the protocol.

Moved at the request of the patient.

Indicates that the decision to substitute or to not substitute was driven by a jurisdictional regulatory requirement mandating or prohibiting substitution.

**Definition:**To provide research data, as authorized by the patient.

**Description:**The patient is believed to be allergic to a substance that is part of the therapy and the therapy is being temporarily withdrawn to confirm.

**Definition:**The event occurred due to it being scheduled in the research protocol.

**Description:**The drug interacts with a short-term treatment that is more urgently required. This order will be resumed when the short-term treatment is complete.

**Description:**Another short-term co-occurring therapy fulfills the same purpose as this therapy. This therapy will be resumed when the co-occuring therapy is complete.

**Description:**The patient is believed to have an intolerance to a substance that is part of the therapy and the therapy is being temporarily withdrawn to confirm.

**Description:**The level of coverage under the policy or program is available to a subscriber's spouse and children

**Description:**The level of coverage under the policy or program is available only to a subscribers spouse

**Description:**Provision of a service, product, or capability to an individual or organization

A person becomes eligible for a program based on statutory criteria.

Examples:A person is a member of an indigenous group, a veteran of military service, or in the U.S., a recipient of adoption assistance and foster care under Title IV-E of the Social Security.

Renewing or original prescriber informed patient to stop using the medication.

To perform one or more operations on information in response to a request by a person authorized by the patient.

**Description:**The drug is contraindicated for patients receiving surgery and the patient is scheduled to be admitted for surgery in the near future. The drug will be resumed when the patient has sufficiently recovered from the surgery.

**Description:**Operational activities conducted to administer the electronic systems used for an activity, product, or service

To perform one or more operations on information to design, develop, implement, test, or deploy a healthcare system or application.

The prescribed product has specific clinical release or other therapeutic characteristics not shared by other substitutable medications.

To perform one or more operations on information used to prevent injury or disease to living subjects who may be the target of violence.

**Definition:**The patient should have medication remaining.

To perform one or more operations on information used in training and education.

To perform one or more operations on information for conducting scientific investigations to obtain health care knowledge related to evidence based medicine during the course of providing healthcare treatment. Sometimes referred to as "bench to bedside", which is the iterative feedback loop between healthcare research and clinical trials with input from information collected in the course of routine provision of healthcare. For example, by extending a patient encounter to conduct a survey related to a research topic such as attitudes about use of a wellness device that a patient agreed to use. May be used in combination with clinical trial and other healthcare research purposes of use.

To perform one or more operations on information for provision of health care.

To apply algorithms (e.g. AI, CDS) to perform one or more operations on information to arrive at decision used in health care treatment.

Definition:The specific manufactured drug is part of a clinical trial.

**Definition:**The event occurred in order to terminate the subject's participation in the study.

Information is separated from the record.

**Description:**<The patient is not (or is no longer) able to use the medication in a manner prescribed.

**Example:**CanaTMt swallow.

**Definition:**The target facility does not recognize the dispensing facility.

**Definition:**The event that occurred was initiated by a study participant (e.g. the subject or the investigator), and did not occur for protocol reasons.

**:**The observation or test occurred as defined in the research protocol, but at a point in time not specified in the study protocol.

**Definition:**The intended vaccine has expired or is otherwise believed to no longer be effective.

**Example:**Due to temperature exposure.

**Definition:**The patient or their guardian objects to receiving the vaccine because of concerns over its safety.

**Description:**To validate the patient's record.

**Example:**Merging or unmerging records.

A person becomes a claimant under a motor vehicle accident insurance because of a motor vehicle accident related health condition or injury.

**Description:**The patient was previously receiving a medication contraindicated with the current medication. The current medication will remain on hold until the prior medication has been cleansed from their system.

A person becomes eligible for insurance or a program because of a work related health condition or injury.

Example:A person is a claimant under the U.S. Black Lung Program.
Description:The record and version requested to update is not the current version.

Identifies the reason the patient is assigned to this accommodation type

Explanatory codes that describe reasons why an Adjudicator has financially adjusted an invoice (claim).

A companion domain (ActAdjudicationInformationCode) includes information reasons which do not have a financial impact on an invoice (claim).

Example adjudication reason code is AA-CLAIM-0011 - Only Basic Procedure/Test Eligible.

Codes from this domain further rationalizes ActAdjudicationCodes (e.g. AA - Adjudicated with Adjustment), which are used to describe the process of adjudicating an invoice. For AS - Adjudicated as Submitted, there should be no specification of ActAdjudicationReason codes, as there are no financial adjustments against the invoice.

Reason for Clinical Service being performed.

This domain excludes reasons specified by diagnosed conditions.

Examples of values from this domain include duplicate therapy and fraudulent prescription.

Definition:This domain is used to document reasons for providing a billable service; the billable services may include both clinical services and social services.

To perform one or more operations on information to which the patient has not consented as deemed necessary by authorized entities for providing care in the best interest of the patient; providing immediately needed health care for an emergent condition; or for protecting public or third party safety.

Usage Notes:Used to convey the reason that a provider or other entity may or has accessed personal healthcare information. Typically, this involves overriding the subject's consent directives.
Used to convey the reason that a provider or other entity may or has accessed personal healthcare information. Typically, this involves overriding the subject's consent directives.

**Description:**Represents the reason for 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.

**Description:**Identifies the reason or rationale for coverage of a service or product based on characteristics of the provider, e.g., contractual relationship to payor, such as in or out-of-network; relationship of the covered party to the provider.

**Example:**In closed managed care plan, a covered party is assigned a primary care provider who provides primary care services and authorizes referrals and ancillary and non-primary care services.

**Description:**Codes used to specify reasons or criteria relating to coverage provided under a policy or program. May be used to convey reasons pertaining to coverage contractual provisions, including criteria for eligibility, coverage limitations, coverage maximums, or financial participation required of covered parties.

**Description:**Identifies the reason or rationale for coverage of a service or product based on clinical efficacy criteria or practices prescribed by the payor.

**Description:**The rationale or purpose for an act relating to health information management, such as archiving information for the purpose of complying with an organization policy or jurisdictional law relating to data retention.

**Description:**The rationale or purpose for an act relating to the management of personal health information, such as collecting personal health information for research or public health purposes.

**Description:**A coded description of the reason for why a patient was administered an immunization.

**Examples:**Post Exposure - Reason, Universal Immunization Program, Outbreak Control, Universal School Program

Identifies the reason or rational for why a person is not eligibile for benefits under an insurance policy.

Examples are client deceased & adopted client has been given a new policy identifier.

**Description:**The rationale or purpose for an act relating to information management, such as archiving information for the purpose of complying with an enterprise data retention policy.

**Description:**The rationale or purpose for an act relating to the management of personal information, such as disclosing personal tax information for the purpose of complying with a court order.

Description:Types of reasons why a substance is invalid for use.

Domain specifies the codes used to describe reasons why a Provider is cancelling an Invoice or Invoice Grouping.

A coded description of the reason for why a patient did not receive a scheduled immunization.

(important for public health strategy

Indicates why a fulfiller refused to fulfill a supply order, and considered it important to notify other providers of their decision. E.g. "Suspect fraud", "Possible abuse", "Contraindicated".

(used when capturing 'refusal to fill' annotations)

**Definition:**Specifies the reason that an event occurred in a clinical research study.

**Definition:**SSpecifies the reason that a test was performed or observation collected in a clinical research study.

**Note:**This set of codes are not strictly reasons, but are used in the currently Normative standard. Future revisions of the specification will model these as ActRelationships and thes codes may subsequently be retired. Thus, these codes should not be used for new specifications.

**Description:**Indicates why the prescription should be suspended.

**Description:**Identifies reasons for nullifying (retracting) a particular control act.

**Examples:**"Entered in error", "altered decision", etc.

**Description:**Identifies reasons for nullifying (retracting) a particular control act.

Description:Reasons to refuse a transaction to be undone.

Identifies why a specific query, request, or other trigger event occurred.

Indicates why the ConditionaTMs status was changed to Nullified.Examplesadministrative error, diagnostic error.

Definition: Identifies the reason or rational for why a person is eligibile for benefits under an insurance policy or progam.

Examples:A person is a claimant under an automobile insurance policy are client deceased & adopted client has been given a new policy identifier. A new employee is eligible for health insurance as an employment benefit. A person meets a government program eligibility criteria for financial, age or health status.
Definition:Identifies the reason or rationale for coverage of a service or product based on coverage exclusions related to the risk of adverse selection by covered parties.

**Description:**Identifies the reason or rationale for coverage of a service or product based on financial participation responsibilities of the covered party.

**Description:**Identifies the reason or rationale for limitations on the coverage of a service or product based on coverage contract provisions.

**Example:**The maximum cost per unit; or the maximum number of units per period, which is typically the policy or program effective time.

Identifies the reason or rational for why a person is eligibile for benefits under an insurance policy or progam.

Examples:A person is a claimant under an automobile insurance policy are client deceased & adopted client has been given a new policy identifier. A new employee is eligible for health insurance as an employment benefit. A person meets a government program eligibility criteria for financial, age or health status.

**Description:**Identifies why a change is being made to a record.

Definition:This domain is used to document why the procedure is a duplicate of one ordered/charged previously for the same patient within the same date of service and has been determined to be medically necessary.Example:A doctor needs a different view in a chest X-Ray.

**Description:**Indicates the reason the medication order should be aborted.

**Definition:**A collection of concepts that indicate why the prescription should be released from suspended state.

Types of reason why a prescription is being changed.

The reason the action wasn't performed, e.g. why the medication was not taken. If an action wasn"t performed, it is often clinically important to know why the action wasn"t taken.

*Examples:*Patient refused, clinically inappropriate, absolute contraindication etc.

**Definition:**A collection of concepts identifying why the patient's profile is being queried.

**Definition:**Identifies why the dispense event was not completed.

**Definition:**A collection of concepts that indicates the reason for a "bulk supply" of medication.

**Definition:**Indicates why the request to transfer a prescription from one dispensing facility to another has been refused.

**Definition:**A collection of concepts that identifies why a renewal prescription has been refused.

Code assigned to indicate the rationale for not performing an evaluation investigation on a device for which a defect has been reported.

Examples include: device received in a condition that made analysis impossible, device evaluation anticipated but not yet begun, device not made by company.

The reason a referral was made.

*Examples:*Specialized Medical Assistance, Other Care Requirements.

Description:Identifies why a request to add (or activate) a record is being refused. Examples include the receiving system not able to match the identifier and find that record in the receiving system, having no permission, or a detected issue exists which precludes the requested action.

Reasons for cancelling or rescheduling an Appointment

Indicates why the act revision (status update) is being refused.

Reasons why substitution of a substance administration request is not permitted.

**Definition:**Indicates why the requested authorization to prescribe or dispense a medication has been refused.

**Definition:**A collection of concepts that indicates why the prescription should no longer be allowed to be dispensed (but can still administer what is already being dispensed).

The explanation for why a patient is moved from one location to another within the organization

UPDATE:

A code specifying when in the course of an Act a precondition for the Act is evaluated (e.g., before the Act starts for the first time, before every repetition, after each repetition but not before the first, or throughout the entire time of the Act.)

Discussion:This attribute is part of the workflow control suite of attributes. An action plan is a composite Act with component Acts. In a sequential plan, each component has a sequenceNumber that specifies the ordering of the plan steps. Before each step is executed and has preconditions these conditions are tested and if the test is positive, the Act has clearance for execution. The repeatNumber may indicate that an Act may be repeatedly executed. The checkpointCode is specifies when the precondition is checked and is analogous to the various conditional statements and loop constructs in programming languages "while-do" vs. "do-while" or "repeat-until" vs. "loop-exit".

For all checkpointCodes, except "end", preconditions are being checked at the time when the preceding step of the plan has terminated and this step would be next in the sequence established by the sequenceNumber attribute.

When the checkpointCode for a criterion of a repeatable Act is "end", the criterion is tested only at the end of each repetition of that Act. When the condition holds true, the next repetition is ready for execution.

When the checkpointCode is "entry" the criterion is checked at the beginning of each repetition (if any) whereas "beginning" means the criterion is checked only once before the repetition "loop" starts.

The checkpointCode "through" is special in that it requires the condition to hold throughout the execution of the Act, even throughout a single execution. As soon as the condition turns false, the Act should receive an interrupt event (see interruptibleInd) and will eventually terminate.

The checkpointCode "exit" is only used on a special plan step that represents a loop exit step. This allows an action plan to exit due to a condition tested inside the execution of this plan. Such exit criteria are sequenced with the other plan components using the ActRelationship.sequenceNumber.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Condition is tested every time before execution of the service (WHILE condition DO service).

Condition is tested at the end of a repeated service execution. The service is repeated only if the condition is true (DO service WHILE condition).

Condition is tested once before the service is executed (IF condition THEN service).

Condition must be true throughout the execution and the service is interrupted (asynchronously) as soon as the condition turns false (asynchronous WHILE loop). The service must be interruptible.

Condition is a loop checkpoint, i.e. it is a step of an activity plan and, if negative causes the containing loop to exit.

UPDATE:

A code specifying how concurrent Acts are resynchronized in a parallel branch construct.

Discussion:This attribute is part of the workflow control suite of attributes. An action plan is a composite Act with component Acts. In a sequential plan, each component has a sequenceNumber that specifies the ordering of the plan steps. Branches exist when multiple components have the same sequenceNumber. Branches are parallel if the splitCode specifies that more than one branch can be executed at the same time. The joinCode then specifies if and how the braches are resynchronized.

The principal re-synchronization actions are (1) the control flow waits for a branch to terminate (wait-branch), (2) the branch that is not yet terminated is aborted (kill-branch), (3) the branch is not re-synchronized at all and continues in parallel (detached branch).

A kill branch is only executed if there is at least one active wait (or exclusive wait) branch. If there is no other wait branch active, a kill branch is not started at all (rather than being aborted shortly after it is started.) Since a detached branch is unrelated to all other branches, active detached branches do not protect a kill-branch from being aborted.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Detach this branch from the other branches so it will not be resynchronized with the other branches.

When all other concurrent branches are terminated, interrupt and discontinue this branch.

Wait for this branch to terminate.

Wait for any one of the branches in the set of exclusive wait branches to terminate, then discontinue all the other exclusive wait branches.

UPDATE:

A code specifying how branches in an action plan are selected among other branches.

Discussion:This attribute is part of the workflow control suite of attributes. An action plan is a composite Act with component Acts. In a sequential plan, each component has a sequenceNumber that specifies the ordering of the plan steps. Branches exist when multiple components have the same sequenceNumber. The splitCode specifies whether a branch is executed exclusively (case-switch) or inclusively, i.e., in parallel with other branches.

In addition to exlusive and inclusive split the splitCode specifies how the pre-condition (also known as "guard conditions" on the branch) are evaluated. A guard condition may be evaluated once when the branching step is entered and if the conditions do not hold at that time, the branch is abandoned. Conversely execution of a branch may wait until the guard condition turns true.

In exclusive wait branches, the first branch whose guard conditions turn true will be executed and all other branches abandoned. In inclusive wait branches some branches may already be executed while other branches still wait for their guard conditions to turn true.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

The pre-condition associated with the branch is evaluated once and if true the branch may be entered. All other exclusive branches compete with each other and only one will be selected. This implements a COND, IF and CASE conditionals, or "XOR-split." The order in which the branches are considered may be specified in the priorityNumber attribute.

A branch is selected as soon as the pre-condition associated with the branch evaluates to true. If the condition is false, the branch may be entered later, when the condition turns true. All other exclusive branches compete with each other and only one will be selected. Each waiting branch executes in parallel with the default join code wait (see below). The order in which the branches are considered may be specified in the Service\_relationship.priority\_nmb.

A branch is executed if its associated preconditions permit. If associated preconditions do not permit, the branch is dropped. Inclusive branches are not suppressed and do not suppress other branches.

A branch is executed as soon as its associated conditions permit. If the condition is false, the branch may be entered later, when the condition turns true. Inclusive branches are not suppressed and do not suppress other branches. Each waiting branch executes in parallel with the default join code wait (see below).

UPDATE:

<ns1:p>Used to indicate that the target of the relationship will be a filtered subset of the total related set of targets.</ns1:p><ns1:p>Used when there is a need to limit the number of components to the first, the last, the next, the total, the average or some other filtered or calculated subset.</ns1:p>

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Restricted to the earliest known occurrence that occurred or was scheduled to occur in the past. The Act with the lowest effective time. ('now' is the time the instance is authored.)

Represents a 'summary' of all acts that are scheduled to occur in the future (whose effective time is greater than 'now' where is the time the instance is authored.). The effectiveTime represents the outer boundary of all occurrences, repeatNumber represents the total number of repetitions, etc.

An occurrence that is scheduled to occur in the future. An Act whose effective time is greater than 'now', where 'now' is the time the instance is authored.

Restricted to the latest known occurrence that is scheduled to occur. The Act with the highest known effective time.

The occurrence whose value attribute is greater than all other occurrences at the time the instance is created.

The occurrence whose value attribute is less than all other occurrences at the time the instance is created.

Restricted to the nearest recent known occurrence scheduled to occur in the future. The Act with the lowest effective time, still greater than 'now'. ('now' is the time the instance is authored.)

An occurrence that occurred or was scheduled to occur in the past. An Act whose effective time is less than 'now'. ('now' is the time the instance is authored.)

Represents a 'summary' of all acts that previously occurred or were scheduled to occur. The effectiveTime represents the outer boundary of all occurrences, repeatNumber represents the total number of repetitions, etc. ('now' is the time the instance is authored.)

Restricted to the most recent known occurrence that occurred or was scheduled to occur in the past. The Act with the most recent effective time, still less than 'now'. ('now' is the time the instance is authored.)

Represents a 'summary' of all acts that have occurred or were scheduled to occur and which are scheduled to occur in the future. The effectiveTime represents the outer boundary of all occurrences, repeatNumber represents the total number of repetitions, etc.

Used to indicate that the participation is a filtered subset of the total participations of the same type owned by the Act.

Used when there is a need to limit the participations to the first, the last, the next or some other filtered subset.

UPDATE:

The source is an excerpt from the target.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.. If true, indicates that ActRelationships or Participations of the specified type (and any specializations thereof) will normally conduct. For more usage information, refer to the Core Principles specification. If true, indicates that the Act attribute or association (as represented by a typeCode for eaither ActRelationship or Pareticipation is a descriptor of the document (record) represented by the act object. If false, indicates the property is a descriptor of the action itself, actual, intended, or potential. Applies to interpretation of attributes and associations with respect to changes in the value of Act.actionNegationInd and Act.moodCode. (See descriptions of these attributes for further discussion.) For example, in an order, the id attribute [isDocumentCharacteristic = true] is an identifier of the record of the order, not an identifier of the intended event. On the other hand, the code attribute [isDocumentCharacteristic = false] describes a characteristic of the intended event. Name of inboundRelationship from Act to ActReln Formal name of outboundRelationship from Act to ActReln Sort key for the inboundRelationship from Act to ActReln Sort key for the outboundRelationship from Act to ActReln Haven't a clue! Haven't a clue! The name of the assciation from ActRelationship to the source Act The name of the assciation from ActRelationship to the source Act An additional concept code that was also attributed to a concept Description:The source act is intended to provide active immunity against the effects of the target act (the target act describes an infectious disease) Description:The source act is intended to offer an additional treatment for the management or cure of a pre-existing adverse situation described by the target act. This is not limited to diseases but can apply to any adverse situation or condition of medical or technical nature. It is not a requirement that the non-adjunctive treatment is explicitly specified.

An addendum (source) to an existing service object (target), containing supplemental information. The addendum is itself an original service object linked to the supplemented service object. The supplemented service object remains in place and its content and status are unaltered.

The relationship that links to a Transportation Act (target) from another Act (source) indicating that the subject of the source Act entered into the source Act by means of the target Transportation act.

Description:A directed association between a source Act and a target Act.Usage Note:This code should never be transmitted in an instance as the value of ActRelationship.typeCode (attribute)

A relationship in which the target act authorizes or certifies the source act.

Definition:The source act is performed to block the effects of the target act. This act relationship should be used when describing near miss type incidents where potential harm could have occurred, but the action described in the source act blocked the potential harmful effects of the incident actually occurring.

Indicates that the target observation(s) provide an initial reference for the source observation or observation group.

UsageConstraints:Both source and target must be Observations or specializations thereof.
Description:An assertion that an act was the cause of another act.This is stronger and more specific than the support link. The source (cause) is typically an observation, but may be any act, while the target may be any act.Examples:

* a growth of Staphylococcus aureus may be considered the cause of an abscess * contamination of the infusion bag was deemed to be the cause of the infection that the patient experienced * lack of staff on the shift was deemed to be a supporting factor (proximal factor) causing the patient safety incident where the patient fell out of bed because the bed-sides had not been put up which caused the night patient to fall out of bed

A relationship that provides an ability to associate a financial transaction (target) as a charge to a clinical act (source). A clinical act may have a charge associated with the execution or delivery of the service.

The financial transaction will define the charge (bill) for delivery or performance of the service.

Charges and costs are distinct terms. A charge defines what is charged or billed to another organization or entity within an organization. The cost defines what it costs an organization to perform or deliver a service or product.

A contraindication is just a negation of a reason, i.e. it gives a condition under which the action is not to be done. Both, source and target can be any kind of service; target service is in criterion mood. How the strength of a contraindication is expressed (e.g., relative, absolute) is left as an open issue. The priorityNumber attribute could be used.

The target act is a component of the source act, with no semantics regarding composition or aggregation implied.

**Description:**The source act complies with, adheres to, conforms to, or is permissible under (in whole or in part) the policy, contract, agreement, law, conformance criteria, certification guidelines or requirement conveyed by the target act.

Examples for compliance relationships are: audits of adherence with a security policy, certificate of conformance to system certification requirements, or consent directive in compliance with or permissible under a privacy policy.

A relationship in which the source act's effective time is the same as the target act's effective time.

UsageNote:This code is reflexive. Therefore its inverse code is itself.

A relationship that provides an ability to associate a financial transaction (target) as a cost to a clinical act (source). A clinical act may have an inherit cost associated with the execution or delivery of the service.

The financial transaction will define the cost of delivery or performance of the service.

Charges and costs are distinct terms. A charge defines what is charged or billed to another organization or entity within an organization. The cost defines what it costs an organization to perform or deliver a service or product.

A relationship in which the source act is covered by or is under the authority of a target act. A financial instrument such as an Invoice Element is covered by one or more specific instances of an Insurance Policy.

A credit relationship ties a financial transaction (target) to an account (source). A credit, once applied (posted), may have either a positive or negative effect on the account balance, depending on the type of account. An asset account credit will decrease the account balance. A non-asset account credit will decrease the account balance.

A relationship from an Act to a Control Variable. For example, if a Device makes an Observation, this relates the Observation to its Control Variables documenting the device's settings that influenced the observation.

A debit relationship ties a financial transaction (target) to an account (source). A debit, once applied (posted), may have either a positive or negative effect on the account balance, depending on the type of account. An asset account debit will increase the account balance. A non-asset account debit will decrease the account balance.

The relationship that links to a Transportation Act (target) from another Act (source) indicating that the subject of the source Act departed from the source Act by means of the target Transportation act.

Description:The source act is intended to help establish the presence of a (an adverse) situation described by the target act. This is not limited to diseases but can apply to any adverse situation or condition of medical or technical nature.

The source act documents the target act.

Associates a derived Act with its input parameters. E.G., an anion-gap observation can be associated as being derived from given sodium-, (potassium-,), chloride-, and bicarbonate-observations. The narrative content (Act.text) of a source act is wholly machine-derived from the collection of target acts.

A relationship in which the source act's effective time is wholly within the target act's effective time (including end points, as defined in the act's effective times)

UsageNote:Inverse code isSBSEAE

A relationship in which the source act ends after the target act ends.

UsageNote:Inverse code isEBE

A relationship in which the source act's effective time ends after or concurrent with the end of the target act's effective time.

Usage Note:Inverse code is EBEORECW

A relationship in which the source act ends after the target act starts.

UsageNote:Inverse code isSBE

A relationship in which the source act's effective time ends after or concurrent with the start of the target act's effective time.

Usage Note:Inverse code is EBSORECWS

The source Act ends before the end of the target Act (i.e. if we say "ActOne EBE ActTwo", it means that ActOne ends before the end of ActTwo, therefore ActOne is the source and ActTwo is the target).

UsageNote:Inverse code isEAE

A relationship in which the source act's effective time ends before or concurrent with the end of the target act's effective time.

Usage Note:Inverse code is EAEORECW

A relationship in which the source act ends before the target act starts.

UsageNote:Inverse code isSAE

A relationship in which the source act's effective time ends before or concurrent with the start of the target act's effective time.

Usage Note:Inverse code is EASORECWS

A relationship in which the source act's effective time ends with the end of the target act's effective time.

UsageNote:This code is reflexive. Therefore its inverse code is itself.

The source Act ends when the target act starts (i.e. if we say "ActOne ECWS ActTwo", it means that ActOne ends when ActTwo starts, therefore ActOne is the source and ActTwo is the target).

UsageNote:Inverse code isSCWE

A relationship in which the source act ends within the target act's effective time (including end points, as defined in the act's effective times)

UsageNote:Inverse code isSBEEAE

Expresses an association that links two instances of the same act over time, indicating that the instance are part of the same episode, e.g. linking two condition nodes for episode of illness; linking two encounters for episode of encounter.

A relationship in which the source act's effective time ends near the end of the target act's effective time. Near is defined separately as a time interval.

Usage Note:Inverse code is ENS

A relationship in which the source act's effective time ends near the start of the target act's effective time. Near is defined separately as a time interval.

Usage Note:Inverse code is ENE

Indicates that the target Act provides evidence in support of the action represented by the source Act. The target is not a 'reason' for the source act, but rather gives supporting information on why the source act is an appropriate course of action. Possible targets might be clinical trial results, journal articles, similar successful therapies, etc.

Rationale:Provides a mechanism for conveying clinical justification for non-approved or otherwise non-traditional therapies.

**Description:**The source act is aggravated by the target act. (Example "chest pain" EXACBY "exercise")

This is the inversion of support. Used to indicate that a given observation is explained by another observation or condition.

The source act fulfills (in whole or in part) the target act. Source act must be in a mood equal or more actual than the target act.

The generalization relationship can be used to express categorical knowledge about services (e.g., amilorid, triamterene, and spironolactone have the common generalization potassium sparing diuretic).

A goal-evaluation links an observation (intent or actual) to a goal to indicate that the observation evaluates the goal. Given the goal and the observation, a "goal distance" (e.g., goal to observation) can be "calculated" and need not be sent explicitly.

A goal that one defines given a patient's health condition. Subsequently planned actions aim to meet that goal. Source is an observation or condition node, target must be an observation in goal mood.

Description:The source act is intented to provide immunity against the effects of the target act (the target act describes an infectious disease)

The source Act is independent of the time of the target Act.

UsageNote:This code is reflexive. Therefore its inverse code is itself.

Used to capture the link between a potential service ("master" or plan) and an actual service, where the actual service instantiates the potential service. The instantiation may override the master's defaults.

the target act documents a set of circumstances (events, risks) which prevent successful completion, or degradation of quality of, the source Act.

UsageNote:This provides the semantics to document barriers to care

Items located

A relationship that limits or restricts the source act by the elements of the target act. For example, an authorization may be limited by a financial amount (up to $500). Target Act must be in EVN.CRIT mood.

The target Acts are aggregated by the source Act. Target Acts may have independent existence, participate in multiple ActRelationships, and do not contribute to the meaning of the source.

UsageNotes:This explicitly represents the conventional notion of aggregation. The target Act is part of a collection of Acts (no implication is made of cardinality, a source of Acts may contain zero, one, or more member target Acts).

It is expected that this will be primarily used with \_ActClassRecordOrganizer, BATTERY, and LIST

This explicitly represents the conventional notion of aggregation. The target Act is part of a collection of Acts (no implication is made of cardinality, a source of Acts may contain zero, one, or more member target Acts). It is expected that this will be primarily used with _ActClassRecordOrganizer, BATTERY, and LIST
Definition:Indicates that the attributes and associations of the target act provide metadata (for example, identifiers, authorship, etc.) for the source act.Constraint:Source act must have either a mood code that is not "EVN" (event) or its "isCriterion" attribute must set to "true". Target act must be an Act with a mood code of EVN and with isCriterionInd attribute set to "true".

An assertion that a new observation may be the manifestation of another existing observation or action. This assumption is attributed to the same actor who asserts the manifestation. This is stronger and more specific than an inverted support link. For example, an agitated appearance can be asserted to be the manifestation (effect) of a known hyperthyroxia. This expresses that one might not have realized a symptom if it would not be a common manifestation of a known condition. The target (cause) may be any service, while the source (manifestation) must be an observation.

The source act removes or lessens the occurrence or effect of the target act.

Definition: Used to link a newer version or 'snapshot' of a business object (source) to an older version or 'snapshot' of the same business object (target).

*Usage:*The identifier of the Act should be the same for both source and target. If the identifiers are distinct, RPLC should be used instead.

Name from source to target = "modifiesPrior"

Name from target to source = "modifiesByNew"

A trigger-match links an actual service (e.g., an observation or procedure that took place) with a service in criterion mood. For example if the trigger is "observation of pain" and pain is actually observed, and if that pain-observation caused the trigger to fire, that pain-observation can be linked with the trigger.

Description:The source act is intended to provide long term maintenance improvement or management of a pre-existing adverse situation described by the target act. This is not limited to diseases but can apply to any adverse situation or condition of medical or technical nature.

Used to assign a "name" to a condition thread. Source is a condition node, target can be any service.

A desired state that a service action aims to maintain. E.g., keep systolic blood pressure between 90 and 110 mm Hg. Source is an intervention service. Target must be an observation in criterion mood.

A desired outcome that a service action aims to meet finally. Source is any service (typically an intervention). Target must be an observation in criterion mood.

The source act is a single occurrence of a repeatable target act. The source and target act can be in any mood on the "completion track" but the source act must be as far as or further along the track than the target act (i.e., the occurrence of an intent can be an event but not vice versa).

A relationship between a source Act that provides more detailed properties to the target Act.

The source act thus is a specialization of the target act, but instead of mentioning all the inherited properties it only mentions new property bindings or refinements.

The typical use case is to specify certain alternative variants of one kind of Act. The priorityNumber attribute is used to weigh refinements as preferred over other alternative refinements.

Example: several routing options for a drug are specified as one SubstanceAdministration for the general treatment with attached refinements for the various routing options.

Relates either an appointment request or an appointment to the order for the service being scheduled.

An observation that should follow or does actually follow as a result or consequence of a condition or action (sometimes called "post-conditional".) Target must be an observation as a goal, risk or any criterion. For complex outcomes a conjunction attribute (AND, OR, XOR) can be used. An outcome link is often inverted to describe an outcome assessment.

A relationship in which the source act's effective time overlaps the target act's effective time in any way.

UsageNote:This code is reflexive. Therefore its inverse code is itself.
Description:The source act is intended to provide palliation for the effects of the target act.

The source Act is a composite of the target Acts. The target Acts do not have an existence independent of the source Act.

*UsageNote:* In UML 1.1, this is a "composition" defined as:"A form of aggregation with strong ownership and coincident lifetime as part of the whole. Parts with non-fixed multiplicity may be created after the composite itself, but once created they live and die with it (i.e., they share lifetimes). Such parts can also be explicitly removed before the death of the composite. Composition may be recursive."
Description:The source act is intended to provide passive immunity against the effects of the target act (the target act describes an infectious disease).

This is a very unspecific relationship from one item of clinical information to another. It does not judge about the role the pertinent information plays.

A requirement to be true before a service is performed. The target can be any service in criterion mood. For multiple pre-conditions a conjunction attribute (AND, OR, XOR) is applicable.

A relationship in which the target act is a predecessor instance to the source act. Generally each of these instances is similar, but no identical. In healthcare coverage it is used to link a claim item to a previous claim item that might have claimed for the same set of services.

Description:The source act is intended to reduce the risk of of an adverse situation to emerge as described by the target act. This is not limited to diseases but can apply to any adverse situation or condition of medical or technical nature.

The target observation qualifies (refines) the semantics of the source observation.

UsageNote:This is not intended to replace concept refinement and qualification via vocabulary. It is used when there are multiple components which together provide the complete understanding of the source Act.

**Description:**A relationship in which the target act is carried out to determine whether an effect attributed to the source act can be recreated.

Definition:The source act is performed to recover from the effects of the target act.

A relationship in which the target act is referred to by the source act. This permits a simple reference relationship that distinguishes between the referent and the referee.

Reference ranges are essentially descriptors of a class of result values assumed to be "normal", "abnormal", or "critical." Those can vary by sex, age, or any other criterion. Source and target are observations, the target is in criterion mood. This link type can act as a trigger in case of alarms being triggered by critical results.

**Description:**The source act is wholly or partially alleviated by the target act. (Example "chest pain" RELVBY "sublingual nitroglycerin administration")

A relationship between a source Act that seeks to reverse or undo the action of the prior target Act.

Example: A posted financial transaction (e.g., a debit transaction) was applied in error and must be reversed (e.g., by a credit transaction) the credit transaction is identified as an undo (or reversal) of the prior target transaction.

Constraints: the "completion track" mood of the target Act must be equally or more "actual" than the source act. I.e., when the target act is EVN the source act can be EVN, or any INT. If the target act is INT, the source act can be INT.

A noteworthy undesired outcome of a patient's condition that is either likely enough to become an issue or is less likely but dangerous enough to be addressed.

A replacement source act replaces an existing target act. The state of the target act being replaced becomes obselete, but the act is typically still retained in the system for historical reference. The source and target must be of the same type.

Description:The reason or rationale for a service. A reason link is weaker than a trigger, it only suggests that some service may be or might have been a reason for some action, but not that this reason requires/required the action to be taken. Also, as opposed to the trigger, there is no strong timely relation between the reason and the action. As well as providing various types of information about the rationale for a service, the RSON act relationship is routinely used between a SBADM act and an OBS act to describe the indication for use of a medication. Child concepts may be used to describe types of indication.Discussion:In prior releases, the code "SUGG" (suggests) was expressed as "an inversion of the reason link." That code has been retired in favor of the inversion indicator that is an attribute of ActRelationship.

A relationship in which the source act starts after the target act ends.

UsageNote:Inverse code isEBS

A relationship in which the source act's effective time starts after or concurrent with the end of the target act's effective time.

Usage Note:Inverse code is SBEORSCWE

The source Act starts after the start of the target Act (i.e. if we say "ActOne SAS ActTwo", it means that ActOne starts after the start of ActTwo, therefore ActOne is the source and ActTwo is the target).

UsageNote:Inverse code isSBS

The source Act starts after start of the target Act and ends after end of the target Act.

UsageNote:Inverse code isSBSEBE

The source Act starts after start of the target Act, and ends with the target Act.

UsageNote:Inverse code isSBSECWE

A relationship in which the source act's effective time starts after or concurrent with the start of the target act's effective time.

Usage Note:Inverse code is SBSORSCW

The source Act start after the start of the target Act, and contains the end of the target Act.

UsageNote:Inverse code isSBSEASEBE

The source Act starts before the end of the target Act (i.e. if we say "ActOne SBE ActTwo", it means that ActOne starts before the end of ActTwo, therefore ActOne is the source and ActTwo is the target).

UsageNote:Inverse code isEAS

The source Act contains the end of the target Act.

UsageNote:Inverse code isEDU

A relationship in which the source act's effective time starts before or concurrent with the end of the target act's effective time.

Usage Note:Inverse code is SAEORSCWE

A relationship in which the source act begins before the target act begins.

UsageNote:Inverse code isSAS

The source Act contains the time of the target Act.

UsageNote:Inverse code isDURING

The source Act contains the start of the target Act.

UsageNote:Inverse code isSDU

The source Act contains the start of the target Act, and ends before the end of the target Act.

UsageNote:Inverse code isSASSBEEAS

The source Act starts before the start of the target Act, and ends before the end of the target Act.

UsageNote:Inverse code isSASEAE

The source Act starts before the start of the target Act, and ends with the target Act.

UsageNote:Inverse code isSASECWE

A relationship in which the source act's effective time starts before or concurrent with the start of the target act's effective time.

Usage Note:Inverse code is SASORSCW

Associates a specific time (and associated resources) with a scheduling request or other intent.

A relationship in which the source act's effective time starts with the start of the target act's effective time.

UsageNote:This code is reflexive. Therefore its inverse code is itself.

The source Act starts when the target act ends (i.e. if we say "ActOne SCWE ActTwo", it means that ActOne starts when ActTwo ends, therefore ActOne is the source and ActTwo is the target).

UsageNote:Inverse code isSBSECWS

The source Act starts with the target Act, and ends after the end of the target Act.

The source Act starts with.the target Act and ends before the end of the target Act.

UsageNote:Inverse code isSCWSEAE

A relationship in which the source act starts within the target act's effective time (including end points, as defined in the act's effective times)

UsageNote:Inverse code isSBSEAS

An act relationship indicating that the source act follows the target act. The source act should in principle represent the same kind of act as the target. Source and target need not have the same mood code (mood will often differ). The target of a sequel is called antecedent. Examples for sequel relationships are: revision, transformation, derivation from a prototype (as a specialization is a derivation of a generalization), followup, realization, instantiation.

A relationship in which the source act's effective time starts near the end of the target act's effective time. Near is defined separately as a time interval.

Usage Note:Inverse code is SNS

A relationship in which the source act's effective time starts near the start of the target act's effective time. Near is defined separately as a time interval.

Usage Note:Inverse code is SNE

Used to indicate that an existing service is suggesting evidence for a new observation. The assumption of support is attributed to the same actor who asserts the observation. Source must be an observation, target may be any service (e.g., to indicate a status post).

A specialization of "has support" (SPRT), used to relate a secondary observation to a Region of Interest on a multidimensional observation, if the ROI specifies the true boundaries of the secondary observation as opposed to only marking the approximate area. For example, if the start and end of an ST elevation episode is visible in an EKG, this relation would indicate the ROI bounds the "ST elevation" observation -- the ROI defines the true beginning and ending of the episode. Conversely, if a ROI simply contains ST elevation, but it does not define the bounds (start and end) of the episode, the more general "has support" relation is used. Likewise, if a ROI on an image defines the true bounds of a "1st degree burn", the relation "has bounded support" is used; but if the ROI only points to the approximate area of the burn, the general "has support" relation is used.

A collection of sub-services as steps or subtasks performed for the source service. Services may be performed sequentially or concurrently.

UsageNotes:Sequence of steps may be indicated by use of \_ActRelationshipTemporallyPertains, as well as via ActRelationship.sequenceNumber, ActRelationship.pauseQuantity, Target.priorityCode.OpenIssue:Need Additional guidelines on when each approach should be used.
Sequence of steps may be indicated by use of _ActRelationshipTemporallyPertains, as well as via ActRelationship.sequenceNumber, ActRelationship.pauseQuantity, Target.priorityCode.

Relates an Act to its subject Act that the first Act is primarily concerned with.

Examples

  • The first Act may be a ControlAct manipulating the subject Act

  • The first act is a region of interest (ROI) that defines a region within the subject Act.

  • The first act is a reporting or notification Act, that echos the subject Act for a specific new purpose.

Constraints

An Act may have multiple subject acts.

Rationale

The ActRelationshipType "has subject" is similar to the ParticipationType "subject", Acts that primarily operate on physical subjects use the Participation, those Acts that primarily operate on other Acts (other information) use the ActRelationship.

Definition:A new act that carries forward the intention of the original act, but does not completely replace it. The status of the predecessor act must be 'completed'. The original act is the target act and the successor is the source act.

An act that contains summary values for a list or set of subordinate acts. For example, a summary of transactions for a particular accounting period.

Description:The source act is intented to provide symptomatic relief for the effects of the target act. Description:The source act is intended to improve a pre-existing adverse situation described by the target act. This is not limited to diseases but can apply to any adverse situation or condition of medical or technical nature.

A pre-condition that if true should result in the source Act being executed. The target is in typically in criterion mood. When reported after the fact (i.e. the criterion has been met) it may be in Event mood. A delay between the trigger and the triggered action can be specified.

Discussion:This includes the concept of a required act for a service or financial instrument such as an insurance plan or policy. In such cases, the trigger is the occurrence of a specific condition such as coverage limits being exceeded.

A condition thread relationship specifically links condition nodes together to form a condition thread. The source is the new condition node and the target links to the most recent node of the existing condition thread.

Indicates that the source act makes use of (or will make use of) the information content of the target act.

UsageNotes:A usage relationship only makes sense if the target act is authored and occurs independently of the source act. Otherwise a simpler relationship such as COMP would be appropriate.Rationale:There is a need when defining a clinical trial protocol to indicate that the protocol makes use of other protocol or treatment specifications. This is stronger than the assertion of "references". References may exist without usage, and in a clinical trial protocol is common to assert both: what other specifications does this trial use and what other specifications does it merely reference.
A usage relationship only makes sense if the target act is authored and occurs independently of the source act. Otherwise a simpler relationship such as COMP would be appropriate.

**Description:**Indicates that the target Act represents the result of the source observation Act.

FormalConstraint:Source Act must be an Observation or specialization there-of. Source Act must not have the value attribute specifiedUsageNote:This relationship allows the result of an observation to be fully expressed as RIM acts as opposed to being embedded in the value attribute. For example, sending a Document act as the result of an imaging observation, sending a list of Procedures and/or other acts as the result of a medical history observation.

The valueNegationInd attribute on the source Act has the same semantics of "negated finding" when it applies to the target of a VALUE ActRelationship as it does to the value attribute. On the other hand, if the ActRelationship.negationInd is true for a VALUE ActRelationship, that means the specified observation does not have the indicated value but does not imply a negated finding. Because the semantics are extremely close, it is recommended that Observation.valueNegationInd be used, not ActRelationship.negationInd.

OpenIssue:The implications of negationInd on ActRelationship and the valueNegationind on Observation.

The source is a direct quote from the target.

The source is an excerpt from the target.

Used when the target Act is a transformation of the source Act. (For instance, used to show that a CDA document is a transformation of a DICOM SR document.)

Codes that describe the relationship between an Act and a financial instrument such as a financial transaction, account or invoice element.

Specifies under what circumstances (target Act) the source-Act may, must, must not or has occurred

Expresses values for describing the relationship relationship between an InvoiceElement or InvoiceElementGroup and a billable act.

Expresses values for describing the relationship between a FinancialTransaction and an Account.

Abstract collector for ActRelationhsip types that relate two acts by their timing.

Abstract collector for ActRelationship types that relate two acts by their approximate timing.

A relationship that defines the relative time of the end source act based on the time of the target act.

A relationship that defines the relative time of the start source act based on the time of the target act.

The target act is a desired outcome of the source act. Source is any act (typically an intervention). Target must be an observation in criterion mood.

UPDATE:

An anatomical location on an organism which can be the focus of an act.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired..

An anatomical location on a non-human animal which can be the focus of an act.

An anatomical location on a human which can be the focus of an act.

The set of body locations to or through which a drug product may be administered.

An anatomical location on a human of an injury or disease which is the focus of an act.

UPDATE:

Codes representing the defined possible states of an Act, as defined by the Act class state machine.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

The Act has been terminated prior to the originally intended completion.

The Act can be performed or is being performed

The Act has been abandoned before activation.

An Act that has terminated normally after all of its constituents have been performed.

An Act that is still in the preparatory stages has been put aside. No action can occur until the Act is released.

An Act that is in the preparatory stages and may not yet be acted upon

Encompasses the expected states of an Act, but excludes "nullified" and "obsolete" which represent unusual terminal states for the life-cycle.

This Act instance was created in error and has been 'removed' and is treated as though it never existed. A record is retained for audit purposes only.

This Act instance has been replaced by a new instance.

An Act that has been activated (actions could or have been performed against it), but has been temporarily disabled. No further action should be taken against it until it is released

UPDATE: OpenIssue:Missing Description en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Specifies that the act statement is made without explicit tagging of uncertainty. This is the normal statement, meaning that it is not free of errors and uncertainty may still exist.

Specifies that the originator of the Act statement does not have full confidence in the applicability (i.e., in event mood: factual truth) of the statement.

UPDATE:

A jurisdictional mandate in the US relating to privacy.

Deprecation Comment:Content moved to ActCode under \_ActPrivacyLaw; use that instead.
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. A property that indicates the status of the concept. One of active, experimental, deprecated, or retired. An additional concept code that was also attributed to a concept

42 CFR Part 2 stipulates the right of an individual who has applied for or been given diagnosis or treatment for alcohol or drug abuse at a federally assisted program.

Definition:Non-disclosure of health information relating to health care paid for by a federally assisted substance abuse program without patient consent.Usage Note:May be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialityCode complies.

U.S. Federal regulations governing the protection of human subjects in research (codified at Subpart A of 45 CFR part 46) that has been adopted by 15 U.S. Federal departments and agencies in an effort to promote uniformity, understanding, and compliance with human subject protections. Existing regulations governing the protection of human subjects in Food and Drug Administration (FDA)-regulated research (21 CFR parts 50, 56, 312, and 812) are separate from the Common Rule but include similar requirements.

Definition:U.S. federal laws governing research-related privacy policies.Usage Note:May be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialtyCode complies.

The U.S. Public Law 104-191 Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule (45 CFR Part 164 Subpart E) permits access, use and disclosure of certain personal health information (PHI as defined under the law) for purposes of Treatment, Payment, and Operations, and requires that the provider ask that patients acknowledge the Provider's Notice of Privacy Practices as permitted conduct under the law.

Definition:Notification of HIPAA Privacy Practices.Usage Note:May be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialtyCode complies.

The U.S. Public Law 104-191 Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule (45 CFR Part 164 Section 164.508) requires authorization for certain uses and disclosure of psychotherapy notes.

Definition:Authorization that must be obtained for disclosure of psychotherapy notes.Usage Note:May be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialityCode complies.

Section 13405(a) of the Health Information Technology for Economic and Clinical Health Act (HITECH) stipulates the right of an individual to have disclosures regarding certain health care items or services for which the individual pays out of pocket in full restricted from a health plan.

Definition:Non-disclosure of health information to a health plan relating to health care items or services for which an individual pays out of pocket in full.Usage Note:May be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialityCode complies.

Title 38 Part 1-protected information may only be disclosed to a third party with the special written consent of the patient except where expressly authorized by 38 USC 7332. VA may disclose this information for specific purposes to: VA employees on a need to know basis - more restrictive than Privacy Act need to know; contractors who need the information in order to perform or fulfill the duties of the contract; and researchers who provide assurances that the information will not be identified in any report. This information may also be disclosed without consent where patient lacks decision-making capacity; in a medical emergency for the purpose of treating a condition which poses an immediate threat to the health of any individual and which requires immediate medical intervention; for eye, tissue, or organ donation purposes; and disclosure of HIV information for public health purposes.

Definition:Title 38 Part 1 - §1.462 Confidentiality restrictions.

(a) General. The patient records to which §§1.460 through 1.499 of this part apply may be disclosed or used only as permitted by these regulations and may not otherwise be disclosed or used in any civil, criminal, administrative, or legislative proceedings conducted by any Federal, State, or local authority. Any disclosure made under these regulations must be limited to that information which is necessary to carry out the purpose of the disclosure. SUBCHAPTER III--PROTECTION OF PATIENT RIGHTS Sec. 7332. Confidentiality of certain medical records (a)(1) Records of the identity, diagnosis, prognosis, or treatment of any patient or subject which are maintained in connection with the performance of any program or activity (including education, training, treatment, rehabilitation, or research) relating to drug abuse, alcoholism or alcohol abuse, infection with the human immunodeficiency virus, or sickle cell anemia which is carried out by or for the Department under this title shall, except as provided in subsections (e) and (f), be confidential, and (section 5701 of this title to the contrary notwithstanding) such records may be disclosed only for the purposes and under the circumstances expressly authorized under subsection (b).

Usage Note:May be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialityCode complies.
Definition:A jurisdictional mandate in the U.S. relating to privacy.Usage Note:ActPrivacyLaw codes may be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialtyCode complies. May be used to further specify rationale for assignment of other ActPrivacyPolicy codes in the US realm, e.g., ETH and 42CFRPart2 can be differentiated from ETH and Title38Part1.

Systematized Nomenclature of Dentistry (SNODENT) is owned, maintained and distributed by the American Dental Association (ADA). SNODENT is a vocabulary designed for use in the electronic environment - for electronic health and dental records. The intended purpose is to:

* Provide standardized terms for describing dental disease * Capture clinical detail and patient characteristics * Permit analysis of patient care services and outcomes * To be interoperable with Electronic Health Records (EHR) and Electronic Dental Records (EDR)

SNODENT licensing information can be found at: http://www.ada.org/8466.aspx

URL for Official Source: http://www.ada.org/snodent.aspx

en The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Tooth Absent

The lingual aspect of the tooth.

The buccal aspect of the tooth.

Impacted tooth

Bone structure of maxilla

Cleft palate with cleft lip

Supernumerary tooth

Tooth can be moved less than 1mm in the buccolingual or mesiodistal direction

Juvenile rheumatoid arthritis

Primary Dentition

Anterior open bite

Hemifacial microsomia

Ankylosis of tooth

Posterior crossbite

The mesial aspect of the tooth.

Cleft palate

Gingival Recession

Cleidocranial dysostosis

Tooth can be moved 1mm or more in the buccolingual or mesiodistal direction. No mobility in the occlusoapical direction (vertical mobility).

Anterior crossbite

Defective dental restoration

Permanent Dentition

The side of a tooth adjacent to the inside of the cheek or lips.

Ectopic tooth

Poor oral hygiene

Posterior open bite

Temporomandibular joint disorder

Bone structure of mandible

The distal aspect of the tooth.

Treacher Collins syndrome

Tooth can be moved 1mm or more in the buccolingual or mesiodistal direction. Mobility in the occlusoapical direction is also present (vertical mobility)

Cleft lip

Bimaxillary protrusion

Permanent mandibular left first premolar tooth; Universal designation 21; ISO designation 34

Permanent mandibular right second molar tooth; Universal designation 31; ISO designation 47

Permanent mandibular right first molar tooth; Universal designation 30; ISO designation 46

Permanent mandibular left canine tooth; Universal designation 22; ISO designation 33

Permanent maxillary right canine tooth; Universal designation 6; ISO designation 13

Permanent maxillary right central incisor tooth; Universal designation 8; ISO designation 11

Permanent maxillary left canine tooth; Universal designation 11; ISO designation 23

Permanent maxillary left central incisor tooth; Universal designation 9; ISO designation 21

Permanent maxillary right first molar tooth; Universal designation 3; ISO designation 16

Permanent mandibular left central incisor tooth; Universal designation 24; ISO designation 31

Permanent maxillary left lateral incisor tooth; Universal designation 10; ISO designation 22

Permanent mandibular right third molar tooth; Universal designation 32; ISO designation 48

Permanent maxillary left first molar tooth; Universal designation 14; ISO designation 26

Permanent mandibular left second premolar tooth; Universal designation 20; ISO designation 35

Permanent maxillary left second premolar tooth; Universal designation 13; ISO designation 25

Permanent mandibular right lateral incisor tooth; Universal designation 26; ISO designation 42

Permanent maxillary right third molar tooth; Universal designation 1; ISO designation 18

Permanent mandibular left third molar tooth; Universal designation 17; ISO designation 38

Permanent maxillary right second molar tooth; Universal designation 2; ISO designation 17

Permanent mandibular right central incisor tooth; Universal designation 25; ISO designation 41

Permanent maxillary left second molar tooth; Universal designation 15; ISO designation 27

Permanent maxillary left first premolar tooth; Universal designation 12; ISO designation 24

Permanent mandibular left second molar tooth; Universal designation 18; ISO designation 37

Permanent mandibular right second premolar tooth; Universal designation 29; ISO designation 45

Permanent maxillary left third molar tooth; Universal designation 16; ISO designation 28

Permanent mandibular left lateral incisor tooth; Universal designation 23; ISO designation 32

Permanent mandibular right first premolar tooth; Universal designation 28; ISO designation 44

Permanent mandibular right canine tooth; Universal designation 27; ISO designation 43

Permanent mandibular left first molar tooth; Universal designation 19; ISO designation 36

Permanent maxillary right second premolar tooth; Universal designation 4; ISO designation 15

Permanent maxillary right first premolar tooth; Universal designation 5; ISO designation 14

Deciduous mandibular right canine tooth; Universal designation R; ISO designation 83

Permanent maxillary right lateral incisor tooth; Universal designation 7; ISO designation 12

Deciduous mandibular right lateral incisor tooth; Universal designation Q; ISO designation 82

Deciduous maxillary left first molar tooth; Universal designation I; ISO designation 64

Deciduous mandibular right central incisor tooth; Universal designation P; ISO designation 81

Deciduous maxillary right second molar tooth; Universal designation A; ISO designation 55

Deciduous mandibular left lateral incisor tooth; Universal designation N; ISO designation 72

Deciduous mandibular right first molar tooth: Universal designation S; ISO designation 84

Deciduous maxillary right first molar tooth; Universal designation B; ISO designation 54

Deciduous maxillary right canine tooth; Universal designation C; ISO designation 53

Deciduous maxillary left canine tooth; Universal designation H; ISO designation 63

Deciduous mandibular left second molar tooth; Universal designation K; ISO designation 75

Deciduous mandibular left central incisor tooth: Universal designation O; ISO designation 71

Deciduous maxillary left lateral incisor tooth; Universal designation G; ISO designation 62

Deciduous maxillary left central incisor tooth; Universal designation F; ISO designation 61

Deciduous mandibular right second molar tooth; Universal designation T; ISO designation 85

Deciduous mandibular left canine tooth; Universal designation M; ISO designation 73

Deciduous maxillary right lateral incisor tooth; Universal designation D; ISO designation 52

Deciduous mandibular left first molar tooth; Universal designation L; ISO designation 74

Deciduous maxillary left second molar tooth; Universal designation J; ISO designation 65

Deciduous maxillary right central incisor tooth; Universal designation E; ISO designation 51

The mesial lingual aspect of the tooth.

The distal lingual aspect of the tooth.

The distal buccal aspect of the tooth.

The mesial buccal aspect of the tooth.

Supernumerary permanent maxillary right central incisor tooth; Universal designation 58

Supernumerary deciduous maxillary left lateral incisor tooth; Universal designation GS

Supernumerary permanent mandibular left lateral incisor tooth; Universal designation 73

Supernumerary permanent mandibular right central incisor tooth; Universal designation 75

Supernumerary deciduous mandibular left central incisor tooth; Universal designation OS

Supernumerary deciduous mandibular right second molar tooth; Universal designation TS

Supernumerary deciduous mandibular left lateral incisor tooth; Universal designation NS

Supernumerary permanent maxillary left second premolar tooth; Universal designation 63

Supernumerary permanent maxillary right canine tooth; Universal designation 56

Supernumerary permanent mandibular right canine tooth; Universal designation 77

Supernumerary permanent maxillary left canine tooth; Universal designation 61

Supernumerary deciduous maxillary right first molar tooth; Universal designation BS

Supernumerary permanent maxillary left second molar tooth; Universal designation 65

Supernumerary deciduous mandibular right canine tooth; Universal designation RS

Supernumerary permanent maxillary right third molar tooth; Universal designation 51

Supernumerary permanent mandibular right second premolar tooth; Universal designation 79

Supernumerary permanent mandibular right first molar tooth; Universal designation 80

Supernumerary deciduous mandibular left first molar tooth; Universal designation LS

Supernumerary permanent mandibular right second molar tooth; Universal designation 81

Supernumerary permanent maxillary left first premolar tooth; Universal designation 62

Supernumerary deciduous mandibular right central incisor tooth; Universal designation PS

Supernumerary deciduous mandibular right lateral incisor tooth; Universal designation QS

Supernumerary permanent mandibular left first molar tooth; Universal designation 69

Supernumerary permanent maxillary right lateral incisor tooth; Universal designation 57

Supernumerary deciduous maxillary left canine tooth; Universal designation HS

Supernumerary permanent mandibular right lateral incisor tooth; Universal designation 76

Supernumerary permanent mandibular left central incisor tooth; Universal designation 74

Supernumerary permanent mandibular left canine tooth; Universal designation 72

Supernumerary permanent maxillary right first molar tooth; Universal designation 53

Supernumerary permanent maxillary right second premolar tooth; Universal designation 54

Supernumerary deciduous mandibular left canine tooth; Universal designation MS

Supernumerary permanent maxillary left third molar tooth; Universal designation 66

Supernumerary deciduous maxillary right canine tooth; Universal designation CS

Supernumerary deciduous maxillary left second molar tooth; Universal designation JS

Supernumerary permanent mandibular right first premolar tooth; Universal designation 78

Supernumerary permanent mandibular right third molar tooth; Universal designation 82

Supernumerary permanent maxillary right first premolar tooth; Universal designation 55

Supernumerary deciduous maxillary right lateral incisor tooth; Universal designation DS

Supernumerary permanent mandibular left first premolar tooth ; Universal designation 71

Supernumerary permanent maxillary right second molar tooth; Universal designation 52

Supernumerary permanent maxillary left first molar tooth; Universal designation 64

Supernumerary deciduous maxillary right second molar tooth; Universal designation AS

Supernumerary permanent mandibular left second molar tooth; Universal designation 68

Supernumerary permanent maxillary left lateral incisor tooth; Universal designation 60

Supernumerary deciduous maxillary right central incisor tooth; Universal designation ES

Supernumerary deciduous mandibular left second molar tooth ; Universal designation KS

Supernumerary deciduous maxillary left first molar tooth; Universal designation IS

Supernumerary permanent mandibular left second premolar tooth; Universal designation 70

Supernumerary deciduous maxillary left central incisor tooth; Universal designation FS

Supernumerary permanent mandibular left third molar tooth; Universal designation 67

Supernumerary deciduous mandibular right first molar tooth; Universal designation SS

Supernumerary permanent maxillary left central incisor tooth; Universal designation 59

Overjet

Complete trisomy 21 syndrome

Marfan syndrome

The folds of mucous membrane extending from the gingiva to the midline of the lower lip.

The folds of mucous membrane extending from the gingiva to the midline of the upper lip.

A fold or band of mucous membrane connecting the upper alveolar ridge to the cheek and separating the labial vestibule from the buccal vestibule

A fold or band of mucous membrane connecting the lower alveolar ridge to the cheek and separating the labial vestibule from the buccal vestibule

Active dental caries

Deep impinging overbite with soft tissue destruction

Anterior crossbite with destruction of oral mucosa

Lip incompetence due to horizontal overbite

Posterior crossbite limited to left side

Posterior crossbite limited to right side

Articulatory defect secondary to dental defect

Cleft lip & alveolus

Craniosynostosis syndrome

Arthrogryposis

Mixed Dentition

Anterior segment of maxilla

Posterior segment of maxilla

Anterior part of lower alveolar ridge

Posterior part of lower alveolar ridge

Overbite

Anterior deviation of posterior interarch

Posterior deviation of posterior interarch

UPDATE: Description:Code that specifies whether an address part names the street, city, country, postal code, post box, etc.

Discussion: The hierarchical nature of these concepts shows composition. E.g. "Street Name" is part of "Street Address Line"

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. This relationship indicates that the source concept is a component of the target concept. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

This can be a unit designator, such as apartment number, suite number, or floor. There may be several unit designators in an address (e.g., "3rd floor, Appt. 342"). This can also be a designator pointing away from the location, rather than specifying a smaller location within some larger one (e.g., Dutch "t.o." means "opposite to" for house boats located across the street facing houses).

Description:An address line is for either an additional locator, a delivery address or a street address.

The numeric portion of a building number

The number of a building, house or lot alongside the street. Also known as "primary street number". This does not number the street but rather the building.

Any alphabetic character, fraction or other text that may appear after the numeric portion of a building number

The name of the party who will take receipt at the specified address, and will take on responsibility for ensuring delivery to the target recipient

A geographic sub-unit delineated for demographic purposes.

Country

A sub-unit of a state or province. (49 of the United States of America use the term "county;" Louisiana uses the term "parish".)

The name of the city, town, village, or other community or delivery center

A delivery address line is frequently used instead of breaking out delivery mode, delivery installation, etc. An address generally has only a delivery address line or a street address line, but not both.

Delimiters are printed without framing white space. If no value component is provided, the delimiter appears as a line break.

Indicates the type of delivery installation (the facility to which the mail will be delivered prior to final shipping via the delivery mode.) Example: post office, letter carrier depot, community mail center, station, etc.

The location of the delivery installation, usually a town or city, and is only required if the area is different from the municipality. Area to which mail delivery service is provided from any postal facility or service such as an individual letter carrier, rural route, or postal route.

A number, letter or name identifying a delivery installation. E.g., for Station A, the delivery installation qualifier would be 'A'.

Direction (e.g., N, S, W, E)

Indicates the type of service offered, method of delivery. For example: post office box, rural route, general delivery, etc.

Represents the routing information such as a letter carrier route number. It is the identifying number of the designator (the box number or rural route number).

A value that uniquely identifies the postal address.

**Description:**An intersection denotes that the actual address is located AT or CLOSE TO the intersection OF two or more streets.

A numbered box located in a post station.

A subsection of a municipality

Description:A street address line is frequently used instead of breaking out build number, street name, street type, etc. An address generally has only a delivery address line or a street address line, but not both.

A sub-unit of a country with limited sovereignty in a federally organized country.

The base name of a roadway or artery recognized by a municipality (excluding street type and direction)

The designation given to the street. (e.g. Street, Avenue, Crescent, etc.)

The number or name of a specific unit contained within a building or complex, as assigned by that building or complex.

Indicates the type of specific unit contained within a building or complex. E.g. Appartment, Floor

A postal code designating a region defined by the postal service.

UPDATE:

Codes that provide guidance around the circumstances in which a given address should be used.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. Description:An automated answering machine used for less urgent cases and if the main purpose of contact is to leave a message or access an automated announcement. Description:A flag indicating that the address is bad, in fact, useless. Description:Indicates that the address is considered sensitive and should only be shared or published in accordance with organizational controls governing patient demographic information with increased sensitivity. Uses of Addresses. Lloyd to supply more complete description. Description:Indicates a work place address or telecommunication address that reaches the individual or organization directly without intermediaries. For phones, often referred to as a 'private line'. Description:A contact specifically designated to be used for emergencies. This is the first choice in emergencies, independent of any other use codes. Description:A communication address at a home, attempted contacts for business purposes might intrude privacy and chances are one will contact family or other household members instead of the person one wishes to call. Typically used with urgent cases, or if no other contacts are available. Description:The primary home, to reach a person after business hours. Description:A vacation home, to reach a person while on vacation. Description:A telecommunication device that moves and stays with its owner. May have characteristics of all other use codes, suitable for urgent matters, not the first choice for routine business.

This address is no longer in use.

Usage Note:Address may also carry valid time ranges. This code is used to cover the situations where it is known that the address is no longer valid, but no particular time range for its use is known.
Description:A paging device suitable to solicit a callback or to leave a very short message. Description:Used primarily to visit an address. Description:Used to send mail. Description:Indicates a work place address or telecommunication address that is a 'standard' address which may reach a reception service, mail-room, or other intermediary prior to the target entity. Description:A temporary address, may be good for visit or mailing. Note that an address history can provide more detailed information. Description:An office address. First choice for business related contacts during business hours. Description:Address uses that can apply to both postal and telecommunication addresses. Description:Address uses that only apply to postal addresses, not telecommunication addresses. Description:Address uses that only apply to telecommunication addresses, not postal addresses.
UPDATE:

The gender of a person used for adminstrative purposes (as opposed to clinical gender)

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Female

Male

En: The gender of a person could not be uniquely defined as male or female, such as intersex. Nl: Het geslacht van een persoon kan niet uniek worden gedefinieerd als man of vrouw, zoals een intersekse-conditie.

Open Issue:This is a short-term stopgap solution to the definition issue, full solutions are being worked out by the Gender Harmony project launched in 2019.
Description:The AHFS Pharmacologic-Therapeutic Classification has been in use in hospitals in the United States since its inception in 1959. An integral part of the American Hospital Formulary Service, the AHFS classification allows the grouping of drugs with similar pharmacologic, therapeutic, and/or chemical characteristics. Today, the AHFS classification is used by many people outside of hospitals. UPDATE:

American Indian and Alaska Native languages currently being used in the United States.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

WHO Adverse Reaction Terms

ASTM E1238/ E1467 Universal

AS4 Neurophysiology Codes

SCPQUAL is used to encode the degree or educational rank of a healthcare provider credential as defined by the various Royal Canadian Professional Medical Collages. It is also supports the encoding “Expertise type” in the pan-Canadian version 3 messages

CPT-5

UPDATE:

Code system for specifying a type of calendar

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

The Gregorian calendar is the calendar in effect in most countries of Christian influence since approximately 1582. This calendar superceded the Julian calendar.

UPDATE:

Calendar cycle identifiers

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. A property that indicates the status of the concept. One of active, experimental, deprecated, or retired. An additional concept code that was also attributed to a concept

The week with the month's first Thursday in it (analagous to the ISO 8601 definition for week of the year).

UPDATE:

Code system for specifying a type of calendar

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

The Gregorian calendar is in effect in the most countries of Christian influence since approximately 1582. This calendar superceded the Julian calendar.

CAM & Nursing Coding Vocabulary Set

Chemical abstract codes

Clinical Care Classification System (formerly Home Health Care Classification system) codes. The Clinical Care Classification (CCC) consists of two taxonomies: CCC of Nursing Diagnoses and CCC of Nursing Interventions both of which are classified by 21 Care Components. Each of these are classified by Care Components which provide a standardized framework for documenting patient care in hospitals, home health agencies, ambulatory care clinics, and other health care settings.

American Dental Association's Current Dental Terminology 2 (CDT-2) codes.

Coding system intended for use in the Russian clinical documents

CDC Analyte Codes

CDC Methods/Instruments Codes

A set of healthcare surveillance vocabulary concepts and associated identifiers intended solely for data submissions to the National Healthcare Safety Network (NHSN). Other uses are not recommended.

The CDCNHSN code system is highly specialized to meet the needs of NHSN surveillance reporting, is undergoing changes, and is not recommended for creating value sets to be used outside of NHSN.

CDC Surveillance

CEN ECG diagnostic codes

UPDATE:

Internet Assigned Numbers Authority (IANA) Charset Types

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

HL7 is indifferent to the use of this Charset.

Deprecated for HL7 use.

Deprecated for HL7 use.

HL7 is indifferent to the use of this Charset.

HL7 is indifferent to the use of this Charset.

HL7 is indifferent to the use of this Charset.

HL7 is indifferent to the use of this Charset.

Required for HL7 use.

HL7 is indifferent to the use of this Charset.

Required for Unicode support.

CLIP

UPDATE:

Code systems used in HL7 standards.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. Property applies to concepts in the CodeSystem Code System. The property holds the OID that uniquely identifies the code system represented by this coded concept.

Five character alphabetic codes fit into current claims processing software or onto standard paper claim forms. ABC Codes give business parity to licensed CAM and nurse providers who file claims to insurance companies. .

Index for Radiological Diagnosis Revised, 3rd Edition 1986, American College of Radiology, Reston, VA.

Description:The AHFS Pharmacologic-Therapeutic Classification has been in use in hospitals in the United States since its inception in 1959. An integral part of the American Hospital Formulary Service, the AHFS classification allows the grouping of drugs with similar pharmacologic, therapeutic, and/or chemical characteristics. Today, the AHFS classification is used by many people outside of hospitals.

WHO Collaborating Centre for International Drug Monitoring, Box 26, S-751 03, Uppsala, Sweden.

American Society for Testing & Materials and CPT4 (see Appendix X1 of Specification E1238 and Appendix X2 of Specification E1467).

ASTM's diagnostic codes and test result coding/grading systems for clinical neurophysiology. See ASTM Specification E1467, Appendix 2.

A site specific problem code

Acknowledgement code as described in HL7 message processing rules.

The table that provides the detailed or rich codes for the Act classes.

A qualitative measure of the degree of exposure to the causative agent. This includes concepts such as "low", "medium" and "high". This quantifies how the quantity that was available to be administered to the target differs from typical or background levels of the substance.

Processing consideration and clarification codes.

Used to indicate that the target of the relationship will be a filtered subset of the total related set of targets.

Used when there is a need to limit the number of components to the first, the last, the next, the total, the average or some other filtered or calculated subset.

The source is an excerpt from the target.

An anatomical location on an organism which can be the focus of an act.

Contains the names (codes) for each of the states in the state-machine of the RIM Act class.

Description:A jurisdictional mandate in the US relating to privacy.

Discussion: The hierarchical nature of these concepts shows composition. E.g. "Street Name" is part of "Street Address Line"

Description:Uses of Addresses. Lloyd to supply more complete description.

The gender of a person used for adminstrative purposes (as opposed to clinical gender)

American Indian and Alaska Native languages currently being used in the United States.

Coded concepts representing the Binding Realms used for Context Binding of terminology in HL7 models. Where concepts align with nations, the country codes from ISO 3166-1 2-character alpha are used for the codes. For those realms where they do not,. codes are created for the concepts. These codes are generally carried in InfrastructureRoot.realmcode, and are used in Context Binding statements.

Description:HL7 version 2.x Body site used in chapter(s) 4; HL7 table 0163

American Medical Association, P.O. Box 10946, Chicago IL 60610.

American Medical Association, P.O. Box 10946, Chicago IL 60610.

CAM & Nursing Coding Vocabulary Set

These include unique codes for each unique chemical, including all generic drugs. The codes do not distinguish among different dosing forms. When multiple equivalent CAS numbers exist, use the first one listed in USAN. USAN 1990 and the USP dictionary of drug names, William M. Heller, Ph.D., Executive Editor, United States Pharmacopeial Convention, Inc., 12601 Twinbrook Parkway, Rockville, MD 20852.

CCI - Canadian Classification of Health Interventions, developed to accompany ICD-10-CA, maintained by CIHI (Canadian Institute for Health Information).

For example: sections 3.AA-3.BZ Diagnostic Imaging Interventions on the Nervous System 3.AN.^ ^.^ ^ Diagnostic Imaging Interventions on the Brain 3.AN.40. ^ ^ Magnetic Resonance Imaging, Brain Incudes: That for meninges, ventricles, cerebellum, brain stem, cisterna \[of brain\], posterior fossa MRI, brain 3.AN.40.VA without contrast 3.AN.40.VC following intravenous injection of contrast 3.AN.40.VZ following percutaneous injection of contrast

CIHI Toronto Attn: Director of Standards 90 Eglinton Avenue, Suite 300 Toronto, Ontario Canada M4P 2Y3

Phone: (416) 481.2002 Fax: (416) 481-2950

www.cihi.ca

American Dental Association's Current Dental Terminology (CDT-2) code. American Dental Association, 211 E. Chicago Avenue,. Chicago, Illinois 60611.

Public Health Practice Program Office, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA, 30421. Also available via FTP: ftp.cdc.gov/pub/laboratory \_info/CLIA and Gopher: gopher.cdc.gov:70/11/laboratory\_info/CLIA

Public Health Practice Program Office, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA, 30421. Also available via FTP: ftp.cdc.gov/pub/laboratory \_info/CLIA and Gopher: gopher.cdc.gov:70/11/laboratory\_info/CLIA

CDC Surveillance Codes. For data unique to specific public health surveillance requirements. Epidemiology Program Office, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA, 30333. (404) 639-3661.

CEN PT007. A quite comprehensive set of ECG diagnostic codes (abbreviations) and descriptions published as a pre-standard by CEN TC251. Available from CEN TC251 secretariat, c/o Georges DeMoor, State University Hospital Gent, De Pintelaan 185-5K3, 9000 Ge

Simon Leeming, Beth Israel Hospital, Boston MA. Codes for radiology reports.

CAN/CSA-Z795-96 (R2001) - This Standard provides a framework for consistent recording and classification of information on work-related injuries and diseases in Canada (injury coding).

It is constituted of Nature of injury, body part, side of body. For example: Cut or laceration of the Upper Arm, Left Injury = 03400; body part = 31100; side of body = L

Code set is maintained by the Canadian Standards Association (CSA).

The Canadian Standards Association 5060 Spectrum Way Mississauga, Ontario Canada L4W 5N6

Phone: (416) 747-4000 1-800-463-6727 Fax: (416) 747-2473

International coding system for adverse drug reactions. In the USA, maintained by the FDA, Rockville, MD.

National Immunization Program, Centers for Disease Control and Prevention, 1660 Clifton Road, Atlanta, GA, 30333

Internet Assigned Numbers Authority (IANA) Charset Types

Code systems used in HL7 standards.

Identifies how to interpret the instance of the code, codeSystem value in a set of translations. Since HL7 (or a government body) may mandate that codes from certain code systems be sent in conformant messages, other synonyms that are sent in the translation set need to be distinguished among the originally captured source, the HL7 specified code, or some future role. When this code is NULL, it indicates that the translation is an undefined type. When valued, this property must contain one of the following values:

SRC - Source (or original) code HL7 - HL7 Specified or Mandated SH - both HL7 mandated and the original code (precoordination)

There may be additional values added to this value set as we work through the use of codes in messages and determine other Use Cases requiring special interpretation of the translations.

Describes the type of communication function that the associated entity plays in the associated transmission.

Indicates whether the concept that is the target should be interpreted as itself, or whether it should be expanded to include its child concepts, or both when it is included in the source domain/valueset.

The type of cap associated with a container

A material in a blood collection container that facilites the separation of of blood cells from serum or plasma

**Description:**Identifies the order in which content should be processed.

The styles of context conduction usable by relationships within a static model derived from tyhe HL7 Reference Information Model.

This table contains the control codes that are used to manage the propagation and scope of a particular ActRelationship or Participation within a set of Acts.

The currency unit as defined in ISO 4217

From the Message Standards Classes table of the SNOMED-DICOM-Microglossary. College of American Pathologists, Skokie, IL, 60077-1034

Dean Bidgood, MD; Duke University Medical Center, Durham NC. Digital Imaging and Communications in Medicine (DICOM). From NEMA Publications PS-3.1 - PS 3.12: The ACR-NEMA DICOM Standard. National Electrical Manufacturers Association (NEMA). Rosslyn, VA,

HL7 Image Management Special Interest Group, Health Level Seven, Ann Arbor, MI.

Domain values for the Device.Alert\_levelCode

Identifies the current completion state of a clinical document.

Identifies the storage status of a document.

Available from Euclides Foundation International nv, Excelsiorlaan 4A, B-1930 Zaventem, Belgium; Phone: 32 2 720 90 60.

Available from Euclides Foundation International nv (see above)

Available from Euclides Foundation International nv, Excelsiorlaan 4A, B-1930 Zaventem, Belgium; Phone: 32 2 720 90 60.

Available from Euclides Foundation International nv (see above)

Enzyme Committee of the International Union of Biochemistry and Molecular Biology. Enzyme Nomenclature: Recommendations on the Nomenclature and Classification of Enzyme-Catalysed Reactions. London: Academic Press, 1992.

Description:The EPSG (European Petroleum Survey Group) dataset represents all Datums, coordinate references (projected and 2D geographic) and coordinate systems (including Cartesian coordinate systems) used in surveying worldwide. Each record includes a 4-8 digit unique identifier. The current version is available from http://www.epsg.org/. The database contains over 4000 records covering spatial data applications worldwide.

**Description:**The set of values found in the Coord Axis Code column of the Coordinate Axis table as maintained in the EPSG geodetic parameter dataset. These define the axis for coordinate systems for geographic coordinates.

Description:The set of values found in the Coord Axis Code column of the Coordinate Axis table as maintained in the EPSG geodetic parameter dataset. These define the axis for coordinate systems for geographic coordinates.

The status of an entry as it pertains to its review and incorporation into the HL7 domain specification database.

Years of education that a person has completed

The level of resource intensiveness of patient care.

This domain is defined in UB92 and applies to US realm only

Classifies the Entity class and all of its subclasses. The terminology is hierarchical. At the top is this HL7-defined domain of high-level categories (such as represented by the Entity subclasses). Each of these terms must be harmonized and is specializable. The value sets beneath are drawn from multiple, frequently external, domains that reflect much more fine-grained typing.

EntityDeterminer in natural language grammar is the class of words that comprises articles, demonstrative pronouns, and quantifiers. In the RIM, determiner is a structural code in the Entity class to distinguish whether any given Entity object stands for some, any one, or a specific thing.

**Description:**The qualifier is a set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type. For example, a given name may be flagged as a nickname, a family name may be a pseudonym or a name of public records.

**Description:**Indicates whether the name part is a given name, family name, prefix, suffix, etc.

**Description:**A set of codes advising a system or user which name in a set of names to select for a given purpose.

The vocabulary table for the Entity.riskCode attribute

The status of an instance of the RIM Entity class.

In the United States, federal standards for classifying data on ethnicity determine the categories used by federal agencies and exert a strong influence on categorization by state and local agencies and private sector organizations. The federal standards do not conceptually define ethnicity, and they recognize the absence of an anthropological or scientific basis for ethnicity classification. Instead, the federal standards acknowledge that ethnicity is a social-political construct in which an individual's own identification with a particular ethnicity is preferred to observer identification. The standards specify two minimum ethnicity categories: Hispanic or Latino, and Not Hispanic or Latino. The standards define a Hispanic or Latino as a person of "Mexican, Puerto Rican, Cuban, South or Central America, or other Spanish culture or origin, regardless of race." The standards stipulate that ethnicity data need not be limited to the two minimum categories, but any expansion must be collapsible to those categories. In addition, the standards stipulate that an individual can be Hispanic or Latino or can be Not Hispanic or Latino, but cannot be both.

Code for the mechanism by which the exposure agent was exchanged or potentially exchanged by the participants involved in the exposure.

National Drug Data File. Proprietary product of First DataBank, Inc. (800) 633-3453, or http://www.firstdatabank.com.

Used for drug-diagnosis interaction checking. Proprietary product of First DataBank, Inc. As above for FDDC.

Dept. of Health & Human Services, Food & Drug Administration, Rockville, MD 20857. (device & analyte process codes).

Health Industry Business Communications Council, 5110 N. 40th St., Ste 120, Phoenix, AZ 85018.

Description:

A code assigned to any component that has medicinal properties, and supplies pharmacological activity or other direct effect in the diagnosis, cure, mitigation, treatment or prevention of disease, or to affect the structure or any function of the body of man or other animals. http://www.hc-sc.gc.ca/dhp-mps/prodpharma/databasdon/index\_e.html

Description:Codes for particular grouping of active ingredients. This is the first 5 characters of active ingredient group number. http://www.hc-sc.gc.ca/dhp-mps/prodpharma/databasdon/index\_e.html Description:Codes for particular collections of active ingredients combined at specific strengths. http://www.hc-sc.gc.ca/dhp-mps/prodpharma/databasdon/index\_e.html Description:A Drug Identification Number (DIN) is a number assigned by Health Canada to a drug product prior to being marketed in Canada. It consists of eight digits (numbers) generated by a computer system in the Submission and Information Policy Division. http://www.hc-sc.gc.ca/dhp-mps/prodpharma/databasdon/index\_e.html

A unique identifier assigned to natural health products that have been issued a product licence by Health Canada. http://www.hc-sc.gc.ca/dhp-mps/prodnatur/applications/licen-prod/lnhpd-bdpsnh-eng.php

Home Health Care Classification System; Virginia Saba, EdD, RN; Georgetown University School of Nursing; Washington, DC.

Health Outcomes Institute codes for outcome variables available (with responses) from Stratis Health (formerly Foundation for Health Care Evaluation and Health Outcomes Institute), 2901 Metro Drive, Suite 400, Bloomington, MN, 55425-1525; (612) 854-3306 (voice); (612) 853-8503 (fax); dziegen@winternet.com. See examples in the Implementation Guide.

Holds the codes used to identify the committees and SIGS of HL7 in RIM repository tables.

These concepts represent theconformance requirments defined for including or valuing an element of an HL7 message. The concepts apply equally to conformance profiles defined for Version 2.x messgaes as defined by the Conformance SIG, and to the conformance columns for Version 3 messages as specified in the HMD.

The property Ids that HL7 has defined for customizing Rational Rose.

HL7 implementation technology specification versions. These codes will document the ITS type and version for message encoding. The code will appear in the instances based upon rules expressed in the ITS, and do not appear in the abstract message, either as it is presented to received from the ITS.

This code system holds version codes for the Version 3 standards. Values are to be determined by HL7 and added with each new version of the HL7 Standard.

The possible modes of updating that occur when an attribute is received by a system that already contains values for that attribute.

Health Care Financing Administration (HCFA) Common Procedure Coding System (HCPCS) modifiers.

A comprehensive classification of locations and settings where healthcare services are provided. This value set is based on the National Healthcare Safety Network (NHSN) location code system that has been developed over a number of years through CDC's interaction with a variety of healthcare facilities and is intended to serve a variety of reporting needs where coding of healthcare service locations is required.

HtmlLinkType values are drawn from HTML 4.0 and describe the relationship between the current document and the anchor that is the target of the link

World Health Publications, Albany, NY.

Procedure Coding System (ICD-10-PCS). See http://www/hcfa.gov/stats/icd10.icd10.htm for more information.

World Health Publications, Albany, NY.

Commission on Professional and Hospital Activities, 1968 Green Road, Ann Arbor, MI 48105 (includes all procedures and diagnostic tests).

International Society of Blood Transfusion. Blood Group Terminology 1990. VOX Sanquines 1990 58(2):152-169.

International Classification of Health Problems in Primary Care, Classification Committee of World Organization of National Colleges, Academies and Academic Associations of General Practitioners (WONCA), 3rd edition. An adaptation of ICD9 intended for use in General Medicine, Oxford University Press.

Canadian Coding Standards ICD-10 CA. These standards are a compilation of international rules of coding as established by the World Health Organization (International Classification of Diseases, 10th Revision, Volume 2) and the Diagnosis Typing Standard developed to denote case complexity for application in Canadian facilities.

For example:

* L40 Psoriasis * L40.0 Psoriasis vulgaris * Nummular psoriasis * Plaque psoriasis * L40.1 Generalized pustular psoriasis * Impetigo herpetiformis * Von ZumbuschaTMs disease * L40.2 Acrodermatitis continua * L40.3 Pustulosis palmaris et plantaris * L40.4 Guttate psoriasis * L40.5\* Arthropathic psoriasis (M07.0-M07.3\*)(M09.0\*) * L40.8 Other psoriasis * Erythroderma psoraticum * Erythrodermic psoriasis * Flexural psoriasis * L40.9 Psoriasis unspecified

They are maintained by CIHI (Canadian Institute for Health Information).

CIHI Toronto

Attn: Director of Standards

90 Eglinton Avenue, Suite 300

Toronto, Ontario

Canada

M4P 2Y3

Phone: (416) 481.2002

Fax: (416) 481-2950

www.cihi.ca

International Classification of Diseases for Oncology, 2nd Edition. World Health Organization: Geneva, Switzerland, 1990. Order from: College of American Pathologists, 325 Waukegan Road, Northfield, IL, 60093-2750. (847) 446-8800.

Commission on Professional and Hospital Activities, 1968 Green Road, Ann Arbor, MI 48105.

International Classification of Sleep Disorders Diagnostic and Coding Manual, 1990, available from American Sleep Disorders Association, 604 Second Street SW, Rochester, MN 55902

Language identifiers as defined by IETF RFC 1766: Tags for the Identification of Languages, or its successor on the IETF Standards Track. The biblio ref for RFC 1766 is: IETF (Internet Engineering Task Force), RFC 1766: Tag

from OID registry

Two character country codes

Three character country codes

Numeric country codes

ISO 4217 currency code

Codes used by IUPAC/IFF to identify the component (analyte) measured. Contact Henrik Olesen, as above for IUPP.

International Union of Pure and Applied Chemistry/International Federation of Clinical Chemistry. The Silver Book: Compendium of terminology and nomenclature of properties in clinical laboratory sciences. Oxford: Blackwell Scientific Publishers, 1995. Henrik Olesen, M.D., D.M.Sc., Chairperson, Department of Clinical Chemistry, KK76.4.2, Rigshospitalet, University Hospital of Copenhagen, DK-2200, Copenhagen. http://inet.uni-c.dk/~qukb7642/

Specifies the reliability with which the identifier is known. This attribute MAY be used to assist with identifier matching algorithms.

Description:Codes to specify the scope in which the identifier applies to the object with which it is associated, and used in the datatype property II.

Clinical examination classification code. Japan Association of Clinical Pathology. Version 8, 1990. A multiaxial code including a subject code (e.g., Rubella = 5f395, identification code (e.g., virus ab IGG), a specimen code (e.g., serum =023) and a method code (e.g., ELISA = 022)

Regenstrief Institute, c/o LOINC, 1050 Wishard Blvd., 5th floor, Indianapolis, IN 46202. 317/630-7433. Available from the Regenstrief Institute server at http://www.regenstrief.org/loinc/loinc.htm. Also available via HL7 file server: FTP/Gopher (www.mcis.duke.edu/standards/ termcode/loinclab and www.mcis.duke.edu/standards/termcode/loinclin) and World Wide Web (http:// www.mcis.duke.edu/ standards/termcode/loincl.htm). January 2000 version has identifiers, synonyms and cross-reference codes for reporting over 26,000 laboratory and related observations and 1,500 clinical measures.

A code depicting the living arrangements of a person

Tells a receiver to ignore just the local markup tags (local\_markup, local\_header, local\_attr) when value="markup", or to ignore the local markup tags and all contained content when value="all"

The nomenclature relates primarily to vital signs monitoring, but also includes semantics of other medical devices that are commonly used in acute care settings. There are multiple coding partitions each of which has a systematic name consisting of a set of base concepts and differentiating criteria.

Codes Used for drug-diagnosis interaction checking. Proprietary product. Hierarchical drug codes for identifying drugs down to manufacturer and pill size. MediSpan, Inc., 8425 Woodfield Crossing Boulevard, Indianapolis, IN 46240. Tel: (800) 428-4495. WWW: http://www.espan.com/medispan/pages/ medhome.html. As above for MGPI.

The standard prefixes used in Rose for RIM subject areas that determine the role or function of each subject area.

Proprietary Codes for identifying drugs. Proprietary product of Medical Economics Data, Inc. (800) 223-0581.

MEDCIN contains more than 175,000 clinical data elements arranged in a hierarchy, with each item having weighted links to relevant diagnoses. The clinical data elements are organized into six basic termtypes designed to accommodate information relevant to a clinical encounter. The basic termtypes in MEDCIN's terminological hierarchy are as follows:

Symptoms History Physical Examination Tests Diagnoses Therapy

Within this basic structure, MEDCIN terms are further organized in a ten level terminological hierarchy, supplemented by an optional, multi-hierarchical diagnostic index. For example, the symptom of "difficulty breathing" is placed in the terminological hierarchy as a subsidiary (or "child") finding of "pulmonary symptoms" although the presence (or absence) of difficulty breathing can related to conditions as diverse as myocardial infarction, bronchitis, pharyngeal foreign bodies, asthma, pulmonary embolism, etc. MEDCIN's diagnostic index provides more than 800 such links for difficulty breathing.

Dr. Louise Wood, Medicines Control Agency, Market Towers, 1 Nine Elms Lane, London SW85NQ, UK Tel: (44)0 171-273-0000 WWW: http://www.open.gov.uk/mca/mcahome.htm

Used for drug-diagnosis interaction checking. Proprietary product of Medical Economics Data, Inc. (800) 223-0581.

Medispan hierarchical drug codes for identifying drugs down to manufacturer and pill size. Proprietary product of MediSpan, Inc., 8425 Woodfield Crossing Boulevard, Indianapolis, IN 46240. Tel: (800) 428-4495.

IETF MIME media types

Medical Subject Headings (MeSH). Bethesda (MD): National Library of Medicine, 2004

Broadly, the fields and values in the Multum Lexicon and the VantageRx Database are intended to be available for use in any HL7 message that includes a reference to non-veterinary drug products or active ingredients that are either approved for sale by the FDA or readily available in the United States. The following inter-related definitions recently circulated by us to the HL7 Vocabulary Technical Committee explain the scope of what we mean by "drug product" and "active ingredient." (A definition for "drug ingredient" is also provided here because the definition of "active ingredient" is reliant on this term.)

Drug Product A drug product is a manufactured or extemporaneously-compounded physiologically-active material intended by the preparer to achieve therapeutic, diagnostic, or preventative effects via biochemical mechanisms when applied to an epithelial surface or placed in an internal body space of a targeted organism.

Drug Ingredient A drug ingredient is a chemical compound or biologic agent that occurs in a drug product.

Active Ingredient An active ingredient is a drug ingredient that mediates one or more of the intended therapeutic, diagnostic, or preventative effects of a drug product and is present in sufficient quantities to achieve such effects according to the allopathic tradition of healthcare practice.

National Immunization Program, Centers for Disease Control and Prevention, 1660 Clifton Road, Atlanta, GA, 30333

The status of an instance of the RIM Participation class.

The closeness or quality of the mapping between the HL7 concept (as represented by the HL7 concept identifier) and the source coding system. The values are patterned after the similar relationships used in the UMLS Metathesaurus. Because the HL7 coding sy

Code to identify the source of a Message Element Type represented in the 'of MET' column of an HMD.

The row type codes for the tabular representation of a Hierarchical Message Description.

The row types for the tabular representation of an R-MIM.

Internet Assigned Numbers Authority (IANA) Mime Media Types

Indicates that the receiver has messages for the sender

NAACCR Cancer Registry

North American Industry Classification System(NAICS) for the United States, a new economic classification system that replaces the 1987 Standard Industrial Classification (SIC) for statistical purposes. NAICS is a system for classifying establishments by type of economic activity. Its purposes are: (1) to facilitate the collection, tabulation, presentation, and analysis of data relating to establishments, and (2) to promote uniformity and comparability in the presentation of statistical data describing the economy. NAICS will be used by Federal statistical agencies that collect or publish data by industry.

North American Nursing Diagnosis Association, Philadelphia, PA.

These provide unique codes for each distinct drug, dosing form, manufacturer, and packaging. (Available from the National Drug Code Directory, FDA, Rockville, MD, and other sources.)

Iowa Intervention Project, College of Nursing, University of Iowa, Iowa City, Iowa

The NMMDS is the minimum set of items of information with uniform definitions and categories concerning the specific dimension of the context of patient care delivery. It represents the minimum data used to support the management and administration of patient/nursing care delivery across all types of settings. The NMMDS is composed of seventeen (17) data elements organized into three categories: environment, nurse resources, and financial resources. See Tables 1-3 for the elements and related definitions organized by each categories. The NMMDS most appropriately focuses at the first level of accountability for patient/client/family/community nursing care: this may be the delivery unit, service, or center of excellence level. The NMMDS supports numerous constructed variables as well as aggregation of data at the unit, institution, network, and system, etc levels. This minimum data set provides the structure for the collection of uniform information that influences quality of patient care, directly and indirectly.

NOC - Nursing Outcome Codes

The UB-92 data element specifications are developed and maintained by the NUBC. The data element specifications are for use in EDI billing and payment transactions and related business applications. There is a proprietary fee. Available from the National Uniform Billing Committee of the American Hospital Association, One North Franklin, Chicago, IL 60606. "UB-92 National Uniform Billing Data Element Specifications as developed by the National Uniform Billing Committee as of August 13, 1999". url: http://www.nubc.org

The Provider Taxonomy Code List is published (released) twice a year on July 1st and January 1st. The July publication is effective for use on October 1st and the January publication is effective for use on April 1st. The time between the publication release and the effective date is considered an implementation period to allow providers, payers and vendors an opportunity to incorporate any changes into their systems. This listing includes Active codes approved for use effective April 1st, 2003, version 3.0; and codes that are New and approved for use effective October 1st, 2003, version 3.1.

Omaha Visiting Nurse Association, Omaha, NB.

Description:Codes to identify products and services that do not have DIN's and which need to be billed. http://www.atlanticpharmaceutical.ca/default.asp?mn=5.23

High level observation categories for the general type of observation being made.

URL: http://hl7-fhir.github.io/valueset-observation-category.html

This is an inline code system http://hl7.org/fhir/observation-category.

This domain is the root domain to which all HL7-recognized value sets for the Observation.value attribute will be linked when Observation.value has a coded data type.

2010 Industry coding system used by CDC (NIOSH and NCHS) for coding industry text. Industry describes an economic/business sector comprised of businesses/ enterprises concerned with the output of a specified category of products or services.

2010 Occupation coding system used by CDC (NIOSH and NCHS) for coding occupation text. Occupation describes a set of activities or tasks that individuals are paid to perform or, if unpaid, define a person's contribution to a household/family business/community.

The concepts representing the values supporting Occupational Data for Health, including Job Supervisory Level or Pay Grade (ODH) code system consists of data elements that describe a person's work information, structured to facilitate individual, population, and public health use; not intended to support billing.).

The PNDS provides standardized terms and codes for patient problems/nursing diagnoses, nursing interventions including actual or expected (goal) outcomes. The PNDS provides standardized terms and codes for nursing diagnoses (a subset of NANDA), nursing interventions and outcomes. The outcomes and interventions are in a relational database. The PNDS intervention and outcome statements are attached in an Access Database. The NANDA diagnoses in the PNDS have already been registered by HL7.

HCFA Place of Service Codes for Professional Claims (see http://www.hcfa.gov/medicare/poscode.htm).

This code is used to specify the exact function an actor had in a service in all necessary detail. This domain may include local extensions (CWE).

Identifies the primary means by which an Entity participates in an Act.

Patient VIP code

Describes payment terms for a financial transaction, used in an invoice.

This is typically expressed as a responsibility of the acceptor or payor of an invoice.

A code identifying a person's disability.

Identifies the technique used to perform a procedure.

The domain of coded values used as parameters within QueryByParameter queries.

Values in this domain specify the units of a query quantity limited request.

Definition:Defines the units associated with the magnitude of the maximum size limit of a query response that can be accepted by the requesting application.

Values in this domain allow a query response system to return a precise response status.

State attributes for Query event

The Read Clinical Classification of Medicine, Park View Surgery, 26 Leicester Rd., Loughborough LE11 2AG (includes drug procedure and other codes, as well as diagnostic codes).

The Read Codes Four Byte Set consists of 4 alphanumeric characters. This version contains approximately 40,000 codes arranged in a hierarchical structure.

Top level hierarchy sections: Disorders Findings Surgical procedures Investigations Occupations Drugs

The Read Codes Version 2 contains over 70,000 coded concepts arranged in a hierarchical structure.

Top level hierarchy sections: Disorders Findings Surgical procedures Investigations Occupations Drugs

In the United States, federal standards for classifying data on race determine the categories used by federal agencies and exert a strong influence on categorization by state and local agencies and private sector organizations. The federal standards do not conceptually define race, and they recognize the absence of an anthropological or scientific basis for racial classification. Instead, the federal standards acknowledge that race is a social-political construct in which an individual's own identification with one more race categories is preferred to observer identification. The standards use a variety of features to define five minimum race categories. Among these features are descent from "the original peoples" of a specified region or nation. The minimum race categories are American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander, and White. The federal standards stipulate that race data need not be limited to the five minimum categories, but any expansion must be collapsible to those categories.

Assigment of spiritual faith affiliation

Specifies whether a response is expected from the addressee of this interaction and what level of detail that response should include

Specifies the mode, immediate versus deferred or queued, by which a receiver should communicate its receiver responsibilities.

Specific classification codes for further qualifying RoleClass codes.

Description:Codes representing possible states of a RoleLink, as defined by the RoleLink class state machine.

The status of an instance of the RIM Role class.

Description:The South Carolina Department of Health and Environmental Control GIS Spatial Data Accuracy Tiers have been derived from the National Standard for Spatial Data Accuracy as a means to categorize the accuracy of spatial data assignment utilizing a variety of tools for capturing coordinates including digitizers, geocoding software and global positioning system devices.

College of American Pathologists, Skokie, IL, 60077-1034. (formerly designated as 99SDM).

Systemized Nomenclature of Medicine, 2nd Edition 1984 Vols 1, 2, College of American Pathologists, Skokie, IL.

SNOMED International, 1993 Vols 1-4, College of American Pathologists, Skokie, IL, 60077-1034..

College of American Pathologists, 5202 Old Orchard Road, Skokie, IL 60077-1034.

A code indicating the type of special arrangements provided for a patient encounter (e.g., wheelchair, stretcher, interpreter, attendant, seeing eye dog). For encounters in intention moods, this information can be used to identify special arrangements that will need to be made for the incoming patient.

The style code is used within the CDA/SPL narrative block to give the instance author some control over various aspects of style

Identifies what sort of change is permitted or has occurred between the therapy that was ordered and the therapy that was/will be provided.

Identifies what sort of change is permitted or has occurred between the item that was ordered/requested and the one that was/will be provided.

These values are defined within the XHTML 4.0 Table Model

These values are defined within the XHTML 4.0 Table Model

These values are defined within the XHTML 4.0 Table Model

These values are defined within the XHTML 4.0 Table Model

These values are defined within the XHTML 4.0 Table Model

Description:Concepts that define the telecommunication capabilities of a particular device. Used to identify the expected capabilities to be found at a particular telecommunication address.

**Description:**A code specifying the meaning and purpose of every TransmissionRelationship instance. Each of its values implies specific constraints to what kinds of Transmission objects can be related and in which way.

INDIAN ENTITIES RECOGNIZED AND ELIGIBLE TO RECEIVE SERVICES FROM THE UNITED STATES BUREAU OF INDIAN AFFAIRS

**Description:**Trigger Event ID as published in the standard.

Uniform Clinical Data Systems. Ms. Michael McMullan, Office of Peer Review Health Care Finance Administration, The Meadows East Bldg., 6325 Security Blvd., Baltimore, MD 21207; (301) 966 6851.

Unified Code for Units of Measure

Universal Medical Device Nomenclature System. ECRI, 5200 Butler Pike, Plymouth Meeting, PA 19462 USA. Phone: 215-825-6000, Fax: 215-834-1275.

National Library of Medicine, 8600 Rockville Pike, Bethesda, MD 20894.

The Uniform Code Council. 8163 Old Yankee Road, Suite J, Dayton, OH 45458; (513) 435 3070

A Universal Resource Locator (URL) is a type of telecommunications address specified as Internet standard RFC 1738 \[http://www.ietf.org/rfc/rfc1738.txt\]. The URL specifies the protocol and the contact point defined by that protocol for the resource.

The manufacturer of a vaccine.

The kind of vaccine.

Vocabulary domain qualifiers are concepts that are used in domain constraints to specify behavior of the new domain.

World Health organization record number code. A unique sequential number is assigned to each unique single component drug and to each multi-component drug. Eight digits are allotted to each such code, six to identify the active agent, and 2 to identify the salt, of single content drugs. Six digits are assigned to each unique combination of drugs in a dispensing unit. The six digit code is identified by W1, the 8 digit code by W2.

With ASTM extensions (see Implementation Guide), the WHO codes can be used to report serum (and other) levels, patient compliance with drug usage instructions, average daily doses and more (see Appendix X1 the Implementation Guide).

WHO's ATC codes provide a hierarchical classification of drugs by therapeutic class. They are linked to the record number codes listed above.

Code system of concepts representing a person's job type as defined by compensation and sector (e.g. paid vs. unpaid, self-employed vs. not self-employed, government vs. private, etc.).

Systematized Nomenclature of Dentistry (SNODENT) is owned, maintained and distributed by the American Dental Association (ADA). SNODENT is a vocabulary designed for use in the electronic environment - for electronic health and dental records. The intended purpose is to:

* Provide standardized terms for describing dental disease * Capture clinical detail and patient characteristics * Permit analysis of patient care services and outcomes * To be interoperable with Electronic Health Records (EHR) and Electronic Dental Records (EDR)

SNODENT licensing information can be found at: http://www.ada.org/8466.aspx

URL for Official Source: http://www.ada.org/snodent.aspx

Reference cultures (microorganisms, tissue cultures, etc.), related biological materials and associated data. American Type Culture Collection, 12301 Parklawn Dr, Rockville MD, 20852. (301) 881-2600. http://www.atcc.org

Description:Codes for concepts describing the approval level of HL7 artifacts. This code system reflects the concepts expressed in HL7's Governance & Operations Manual (GOM) past and present. Description:Codes identifying types of HL7 Implementation Technology Specifications Description:Codes for HL7 publishing 'domain's (specific content area) Description:Codes for HL7 publishing 'section's (major business categories) Description:Codes for HL7 publishing 'sub-section's (business sub-categories) Description:Identifies allowed codes for HL7aTMs v3 conformance property. Description:Based on concepts for resolutions from HL7 ballot spreadsheet according to HL7's Governance & Operations Manual (GOM).

ISO/IEC 21000-6:2004 describes a Rights Data Dictionary which comprises a set of clear, consistent, structured, integrated and uniquely identified terms to support the MPEG-21 Rights Expression Language (REL), ISO/IEC 21000-5. Annex A specifies the methodology for and structure of the RDD Dictionary, and specifies how further Terms may be defined under the governance of a Registration Authority, requirements for which are described in Annex C.

Taken together, these specifications and the RDD Dictionary and Database make up the RDD System. Use of the RDD System will facilitate the accurate exchange and processing of information between interested parties involved in the administration of rights in, and use of, Digital Items, and in particular it is intended to support ISO/IEC 21000-5 (REL). Clause 6 describes how ISO/IEC 21000-6:2004 relates to ISO/IEC 21000-5.

As well as providing definitions of terms for use in ISO/IEC 21000-5, the RDD System is designed to support the mapping of terms from different namespaces. Such mapping will enable the transformation of metadata from the terminology of one namespace (or Authority) into that of another namespace. Mapping, to ensure minimum ambiguity or loss of semantic integrity, will be the responsibility of the Registration Authority. Provision of automated trm look-up is also a requirement.

The RDD Dictionary is a prescriptive dctionary, in the sense that it defines a single meaning for a trm represented by a particular RddAuthorized TermName, but it is also inclusive in that it can recognize the prescription of other Headwords and definitions by other Authorities and incorporates them through mappings. The RDD Dictionary also supports the circumstance that the same name may have different meanings under different Authorities. ISO/IEC 21000-6:2004describes audit provisions so that additions, amendments and deletions to Terms and their attributes can be tracked.

ISO/IEC 21000-6:2004 recognizes legal definitions as and only as Terms from other Authorities that can be mapped into the RDD Dictionary. Therefore Terms that are directly authorized by the RDD Registration Authority neither define nor prescribe intellectual property rights or other legal entities.

UPDATE:

Retired code system for HL7 Code System Types. This description added to conform to shareable codesystem profile

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Code system is created and maintained by an organization outside of HL7

Code system is created and updated by an organization outside of HL7, but an internal copy is mainted by HL7 for convenience

Code system is created and maintained by HL7

UPDATE:

Identifies how to interpret the instance of the code, codeSystem value in a set of translations. Since HL7 (or a government body) may mandate that codes from certain code systems be sent in conformant messages, other synonyms that are sent in the translation set need to be distinguished among the originally captured source, the HL7 specified code, or some future role. When this code is NULL, it indicates that the translation is an undefined type. When valued, this property must contain one of the following values:

SRC - Source (or original) code HL7 - HL7 Specified or Mandated SH - both HL7 mandated and the original code (precoordination)

There may be additional values added to this value set as we work through the use of codes in messages and determine other Use Cases requiring special interpretation of the translations.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired..

HL7 Specified or Mandated

Description:Originally produced code.

Originally produced code, required by the specification describing the use of the coded concept.

Description:Post-coded from free text source</description>

Post-coded from free text source, required by the specification describing the use of the coded concept.

Description:Required standard code for HL7.

Both HL7 mandated and the original code (precoordination)

Source (or original) code

UPDATE:

Describes the type of communication function that the associated entity plays in the associated transmission.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

The entity is the receiver of the transmission.

The entity is the one to which the response or reply to the transmission should be sent.

The entity is the sender of the transmission.

UPDATE:

Type of compression algorithm used

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Haven't a clue! Designation of a concept's state. Normally is not populated unless the state is retired.

bzip-2 compression format. See \[http://www.bzip.org/\] for more information.

The deflate compressed data format as specified in RFC 1951 \[http://www.ietf.org/rfc/rfc1951.txt\].

A compressed data format that is compatible with the widely used GZIP utility as specified in RFC 1952 \[http://www.ietf.org/rfc/rfc1952.txt\] (uses the deflate algorithm).

Original UNIX compress algorithm and file format using the LZC algorithm (a variant of LZW). Patent encumbered and less efficient than deflate.

7z compression file format. See \[http://www.7-zip.org/7z.html\] for more information.

A compressed data format that also uses the deflate algorithm. Specified as RFC 1950 \[http://www.ietf.org/rfc/rfc1952.txt\]

UPDATE: Deprecation Comment:Deprecated as per 11/2008 Harmonization cleanup; internal and obsolete HL7 usage, no longer used. en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Property applies to the ConceptCodeRelationship code system. For each concept, it identifies the name of the inverse relationship. Designation of a concept's state. Normally is not populated unless the state is retired.

The target concept is a part or portion of the source concept.

Target concept is a subtype / subclass or the source (or the target concept implies the source

The source concept code is "less than" the target concept in a strictly ordinal sense.

UPDATE:

Indicates whether the concept that is the target should be interpreted as itself, or whether it should be expanded to include its child concepts, or both when it is included in the source domain/valueset.

Deprecation Comment:Deprecated as per 11/2008 Harmonization cleanup; internal and obsolete HL7 usage, no longer used.
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Include only the descendents of this concept in the domain or value set, not the concept itself.

Include only the concept itself in the domain or value set. Do not include descendents of the concept.

Include both the concept and its descendents as possible values in the domain or value set.

UPDATE: Deprecation Comment:Deprecated as per 11/2008 Harmonization cleanup; internal and obsolete HL7 usage, no longer used. en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Object identifier assigned to a concept

Property identifiers for a value sets

Entity to which a given value set or concept code applies

Description:Qualifier value for concept status.

Description of how set or code applies

Name that should be used when the relationship is used in the reverse (target to source) direction. Example: The inverse relationship of hasPart is isPartOf

Outstanding issue that still needs resolution

**Description:**specialized by domain

UPDATE: Deprecation Comment:Deprecated as per 11/2008 Harmonization cleanup; internal and obsolete HL7 usage, no longer used. en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Concept code is active and in use

Concept code is not longer in use anywhere.

Proposed but not yet in general use

Concept code has been used previously, but is no longer value for new use.

UPDATE:

A set of codes specifying the security classification of acts and roles in accordance with the definition for concept domain "Confidentiality".

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. A property that indicates the status of the concept. One of active, experimental, deprecated, or retired. Description:Since the service class can represent knowledge structures that may be considered a trade or business secret, there is sometimes (though rarely) the need to flag those items as of business level confidentiality. However, no patient related information may ever be of this confidentiality level.Deprecation Comment:Replced by ActCode.B Description:Celebrities are people of public interest (VIP) including employees, whose information require special protection.

*Deprecation Comment:*Replced by ActCode.CEL

Description:Only clinicians may see this item, billing and administration persons can not access this item without special permission.

*Deprecation Comment:*Deprecated due to updated confidentiality codes under ActCode

Description:Alcohol/drug-abuse related item

*Deprecation Comment:*Replced by ActCode.ETH

Description:HIV and AIDS related item

*Deprecation Comment:*Replced by ActCode.HIV

Description:Access only to individual persons who are mentioned explicitly as actors of this service and whose actor type warrants that access (cf. to actor type code).

*Deprecation Comment:*Deprecated due to updated confidentiality codes under ActCode

Privacy metadata indicating that a low level of protection is required to safeguard personal and healthcare information, which has been altered in such a way as to minimize the need for confidentiality protections with some residual risks associated with re-linking. The risk of harm to an individual's reputation and sense of privacy if disclosed without authorization is considered negligible, and mitigations are in place to address reidentification risk.

Usage Note:

The level of protection afforded anonymized and pseudonymized, and non-personally identifiable information (e.g., a limited data set) is dictated by privacy policies and data use agreements intended to engender trust that health information can be used and disclosed with little or no risk of re-identification.

Example:Personal and healthcare information, which excludes 16 designated categories of direct identifiers in a HIPAA Limited Data Set. This information may be disclosed by HIPAA Covered Entities without patient authorization for a research, public health, and operations purposes if conditions are met, which includes obtaining a signed data use agreement from the recipient. See 45 CFR Section 164.514.

This metadata indicates that the receiver may have an obligation to comply with a data use agreement with the discloser. The discloser may have obligations to comply with policies dictating the methods for de-identification.

Confidentiality code total order hierarchy: Low (L) is less protective thanV, R, N,and *M*, and subsumes *U*.

Privacy metadata indicating the level of protection required to safeguard personal and healthcare information, which if disclosed without authorization, would present a moderate risk of harm to an individual's reputation and sense of privacy.

Usage Note:The level of protection afforded moderately confidential information is dictated by privacy policies intended to engender trust in a service provider. May include publicly available information in jurisdictions that restrict uses of that information without the consent of the data subject.

Privacy policies mandating moderate levels of protection, which preempt less protective privacy policies. "Moderate" confidentiality policies differ from and would be preempted by the prevailing privacy policies mandating the normative level of protection for information used in the delivery and management of healthcare.

Confidentiality code total order hierarchy: Moderate (M) is less protective thanV, R, and N*, and subsumes all other protection levels (i.e., *Land *U*).Examples:Includes personal and health information that an individual authorizes to be collected, accessed, used or disclosed to a bank for a health credit card or savings account; to health oversight authorities; to a hospital patient directory; to worker compensation, disability, property and casualty or life insurers; and to personal health record systems, consumer-controlled devices, social media accounts and online Apps; or for marketing purposes

Privacy metadata indicating the level of protection required to safeguard personal and healthcare information, which if disclosed without authorization, would present a considerable risk of harm to an individual's reputation and sense of privacy.

Usage Note:The level of protection afforded normatively confidential information is dictated by the prevailing normative privacy policies, which are intended to engender patient trust in their healthcare providers.

Privacy policies mandating normative levels of protection, which preempt less protective privacy policies when the information is used in the delivery and management of healthcare. May be pre-empted by jurisdictional law (e.g., for public health reporting or emergency treatment).

Confidentiality code total order hierarchy: Normal (N) is less protective than *V* and *R*, and subsumes all other protection levels (i.e., *M, L, and U*).

**Map:**Partial Map to ISO 13606-4 Sensitivity Level (3) Clinical Care when purpose of use is treatment: Default for normal clinical care access (i.e., most clinical staff directly caring for the patient should be able to access nearly all of the EHR). Maps to normal confidentiality for treatment information but not to ancillary care, payment and operations.

Examples:

n the US, this includes what HIPAA identifies as protected health information (PHI) under 45 CFR Section 160.103.

Description:Psychiatry related item

*Deprecation Comment:*Replced by ActCode.PSY

Privacy metadata indicating the level of protection required to safeguard potentially stigmatizing information, which if disclosed without authorization, would present a high risk of harm to an individual's reputation and sense of privacy.

Usage Note:The level of protection afforded restricted confidential information is dictated by specially protective organizational or jurisdictional privacy policies, including at an authorized individual's request, intended to engender patient trust in providers of sensitive services.

Privacy policies mandating additional levels of protection by restricting information access preempt less protective privacy policies when the information is used in the delivery and management of healthcare. May be pre-empted by jurisdictional law (e.g., for public health reporting or emergency treatment).

Confidentiality code total order hierarchy: Restricted (R) is less protective than *V*, and subsumes all other protection levels (i.e., *N, M, L, and U*).

Examples:

Includes information that is additionally protected such as sensitive conditions mental health, HIV, substance abuse, domestic violence, child abuse, genetic disease, and reproductive health; or sensitive demographic information such as a patient's standing as an employee or a celebrity. May be used to indicate proprietary or classified information that is not related to an individual (e.g., secret ingredients in a therapeutic substance; or the name of a manufacturer).

Description:

Information for which the patient seeks heightened confidentiality. Sensitive information is not to be shared with family members. Information reported by the patient about family members is sensitive by default. Flag can be set or cleared on patient's request.

*Deprecation Comment:*Deprecated due to updated confidentiality codes under ActCode

Description:Sexual assault / domestic violence related item

*Deprecation Comment:*Replced by ActCode.SDV

Description:Information not to be disclosed or discussed with patient except through physician assigned to patient in this case. This is usually a temporary constraint only, example use is a new fatal diagnosis or finding, such as malignancy or HIV.

*Deprecation Note:*Replced by ActCode.TBOO

Privacy metadata indicating that no level of protection is required to safeguard personal and healthcare information that has been disclosed by an authorized individual without restrictions on its use.

Examples:Includes publicly available information e.g., business name, phone, email and physical address.Usage Note:The authorization to collect, access, use, and disclose this information may be stipulated in a contract of adhesion by a data user (e.g., via terms of service or data user privacy policies) in exchange for the data subject's use of a service.

This metadata indicates that the receiver has no obligation to consider privacy policies other than its own when making access control decisions.

This metadata indicates that the receiver has no obligation to consider privacy policies other than its own when making access control decisions.

Confidentiality code total order hierarchy: Unrestricted (U) is less protective thanV, R, N, M,and *L*, and is the lowest protection levels.

Privacy metadata indicating the level of protection required under atypical cicumstances to safeguard potentially damaging or harmful information, which if disclosed without authorization, would (1) present an extremely high risk of harm to an individual's reputation, sense of privacy, and possibly safety; or (2) impact an individual's or organization's legal matters.

Usage Note:The level of protection afforded very restricted confidential information is dictated by specially protective privacy or legal policies intended to ensure that under atypical circumstances additional protections limit access to only those with a high 'need to know' and the information is kept in highest confidence..

Privacy and legal policies mandating the highest level of protection by stringently restricting information access, preempt less protective privacy policies when the information is used in the delivery and management of healthcare including legal proceedings related to healthcare. May be pre-empted by jurisdictional law (e.g., for public health reporting or emergency treatment but only under limited circumstances).

Confidentiality code total order hierarchy: Very Restricted (V) is the highest protection level and subsumes all other protection levels s (i.e., *R, N, M, L, and UI*).

Examples:

Includes information about a victim of abuse, patient requested information sensitivity, and taboo subjects relating to health status that must be discussed with the patient by an attending provider before sharing with the patient. May also include information held under a legal hold or attorney-client privilege.

A specializable code and its leaf codes used in Confidentiality value sets to value the Act.Confidentiality and Role.Confidentiality attribute in accordance with the definition for concept domain "Confidentiality".

Description:By accessing subject / role and relationship based rights (These concepts are mutually exclusive, one and only one is required for a valid confidentiality coding.)

*Deprecation Comment:*Deprecated due to updated confidentiality codes under ActCode

Description:By information type, only for service catalog entries (multiples allowed). Not to be used with actual patient data!

*Deprecation Comment:*Deprecated due to updated confidentiality codes under ActCode

Description:Modifiers of role based access rights (multiple allowed)

*Deprecation Comment:*Deprecated due to updated confidentiality codes under ActCode

UPDATE:

The type of cap associated with a container

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

A cap designed to be difficult to open for children. Generally requires multiple simultaneous actions (e.g. squeeze and twist) to open. Used for products that may be dangerous if ingested or overdosed by children.

A cap designed to be easily removed. For products intended to be opened by persons with limited strength or dexterity.

A non-reactive plastic film covering over the opening of a container.

A foil covering (type of foil not specified) over the opening of a container

A non-threaded cap that forms a tight-fitting closure on a container by pushing the fitted end into the conatiner opening

A threaded cap that is screwed onto the opening of a container

Cap types for medication containers

UPDATE:

A material in a blood collection container that facilites the separation of of blood cells from serum or plasma

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

A gelatinous type of separator material.

No separator material is present in the container.

UPDATE:

**Description:**Identifies the order in which content should be processed.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

**Description:**The content should be processed in a sequential fashion.

**Description:**The content may be processed in any order.

UPDATE:

A code that specifies how an ActRelationship or Participation contributes to the context of an Act, and whether it may be propagated to descendent Acts whose association allows such propagation (see also attributes Participation.contextControlCode, ActRelationship.contextControlCode, ActRelationship.contextConductionInd).

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

The association adds to the existing context associated with the Act, but will not propagate to any descendant Acts reached by conducting ActRelationships (see contextControlCode). Examples: If an 'Author' Participation were marked as "Additive, Non-Propagating" it means that the author will be added to the set of author participations that have propagated from ancestor Acts for the purpose of this Act. However only the previously propagated authors will propagate to any child Acts that allow context to be propagated.

The association adds to the existing context associated with the Act, and will propagate to any descendant Acts reached by conducting ActRelationships (see contextControlCode). Examples: If an 'Author' Participation were marked as "Additive, Propagating" it means that the author will be added to the set of author participations that have propagated from ancestor Acts, and will itself propagate with the other authors to any child Acts that allow context to be propagated.

The association is added to the existing context associated with the Act, but overrides an association with the same typeCode. However, this overriding association will not propagate to any descendant Acts reached by conducting ActRelationships (see contextControlCode). Examples: If an 'Author' Participation were marked as "Overriding, Non-Propagating" it means that the author will replace the set of author participations that have propagated from ancestor Acts. Furthermore, no author participations whatsoever will propagate to any child Acts that allow context to be propagated.

The association is added to the existing context associated with the Act, but overrides an association with the same typeCode. This overriding association will propagate to any descendant Acts reached by conducting ActRelationships (see contextControlCode). Examples: If an 'Author' Participation were marked as "Overriding, Propagating" it means that the author will replace the set of author participations that have propagated from ancestor Acts, and will itself be the only author to propagate to any child Acts that allow context to be propagated.

The association adds to the existing context associated with the Act. Both this association and any associations propagated from ancestor Acts are interpreted as being related to this Act.

The association applies only to the current Act and will not propagate to any child Acts that are related via a conducting ActRelationship (refer to contextConductionInd).

The association adds to the existing context associated with the Act, but replaces associations propagated from ancestor Acts whose typeCodes are the same or more specific.

The association propagates to any child Acts that are related via a conducting ActRelationship (refer to contextConductionInd).

Gold Standard's Clinical Pharmacology Monograph Number

The Current Procedural Terminology (CPT) code set, created and maintained by the American Medical Association, is the language of medicine today and the code to its future. This system of terminology is the most widely accepted medical nomenclature used to report medical procedures and services under public and private health insurance programs. CPT coding is also used for administrative management purposes such as claims processing and developing guidelines for medical care review. Each year, via a rigorous, evidence-based and transparent process, the independent CPT Editorial Panel revises, creates or deletes hundreds of codes in order to reflect current medical practice.

Designated by the U.S. Department of Health and Human Services under the Health Insurance Portability and Accountability Act (HIPAA) as a national coding set for physician and other health care professional services and procedures, CPT’s evidence-based codes accurately encompass the full range of health care services.

All CPT codes are five-digits and can be either numeric or alphanumeric, depending on the category. CPT code descriptors are clinically focused and utilize common standards so that a diverse set of users can have common understanding across the clinical health care paradigm.

There are various types of CPT codes:

Category I: These codes have descriptors that correspond to a procedure or service. Codes range from 00100–99499 and are generally ordered into sub-categories based on procedure/service type and anatomy.

Category II: These alphanumeric tracking codes are supplemental codes used for performance measurement. Using them is optional and not required for correct coding.

Category III: These are temporary alphanumeric codes for new and developing technology, procedures and services. They were created for data collection, assessment and in some instances, payment of new services and procedures that currently don’t meet the criteria for a Category I code.

Proprietary Laboratory Analyses (PLA) codes: These codes describe proprietary clinical laboratory analyses and can be either provided by a single (“solesource”) laboratory or licensed or marketed to multiple providing laboratories that are cleared or approved by the Food and Drug Administration (FDA)). This category includes but is not limited to Advanced Diagnostic Laboratory Tests (ADLTs) and Clinical Diagnostic Laboratory Tests (CDLTs), as defined under the Protecting Access to Medicare Act of 2014 (PAMA).

Inactive since 2015. Nature of injury (NOI) codes, which are part of the Work Injury or Disease Information coding system (CAN/CSA-Z795-96 - R2003).

The CSA code set includes 3 parts: Nature of injury (NOI), body part (BP), side of body (SB).

For example:

* NOI - Cut or laceration Injury = 03400 * BP - Upper Arm body part = 31100 * SOB - Left Side of Body = L

The Body Part codes are qualified by the Side of Body codes code system, to be more precise in specifying the location of the injury being coded.

Code set is maintained by the Canadian Standards Association (CSA).

set is maintained by the Canadian Standards Association (CSA).

The Canadian Standards Association 5060 Spectrum Way Mississauga, Ontario Canada L4W 5N6

Phone: (416) 747-4000 1-800-463-6727 Fax: (416) 747-2473

COSTART

The CDC's National Center of Immunization and Respiratory Diseases (NCIRD - seehttps://www.cdc.gov/ncird/https://www.cdc.gov/ncird/)) developed and maintains the CVX (vaccine administered) code set. It includes both active and inactive vaccines available in the US. CVX codes for inactive vaccines allow transmission of historical immunization records. When a MVX (manufacturer) code is paired with a CVX (vaccine administered) code, the specific trade named vaccine may be indicated. These codes should be used for immunization messages using either HL7 Version 2.3.1 or HL7 Version 2.5.1. CVX is the underlying Master Code System for V2 table 0292 (Vaccines Administered. The machine readable name for CVX in PHIN VADS is PH_VaccinesAdministeredCVX_CDC_NIP. The version of the CVX code set for certification can be found on the archive page:https://www2a.cdc.gov/vaccines/iis/iisstandards/mu3versioned_codes.asphttps://www2a.cdc.gov/vaccines/iis/iisstandards/mu3versioned_codes.asp

The Status column indicates if the vaccine is currently available in the United States.

  • Active: A currently available administrable vaccine

  • Inactive: An administrable vaccine formulation that is no longer available for patient administration, but can be found in historical patient records OR A historical record of a vaccine administered where the exact formulation is unknown

  • Pending: A vaccine that is expected to become active in the future

  • Non-US: A vaccine that available outside the US only

  • Never Active: A vaccine that was never available and is not in the pipeline of new vaccines

The Last Updated column indicates the last time this particular vaccine code was updated in this table.

Questions regarding this table should be directed to the IIS Technical Assistance Team via iisinfo@cdc.gov (or use mailing address viahttps://www2a.cdc.gov/vaccines/iis/iisstandards/vaccines.asp?rpt=cvx#addrhttps://www2a.cdc.gov/vaccines/iis/iisstandards/vaccines.asp?rpt=cvx#addr)

HL7 Implementers should note that 'Status' IS NOT CONCEPT STATUS as all codes are ACTIVE in this code system.

The current code system is available viahttps://www2a.cdc.gov/vaccines/iis/iisstandards/vaccines.asp?rpt=cvxhttps://www2a.cdc.gov/vaccines/iis/iisstandards/vaccines.asp?rpt=cvx
UPDATE:

**** MISSING DESCRIPTION ****

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Change the status of an object representing an Act to "aborted", i.e., terminated prior to the originally intended completion. For an HL7 Act, the state transitions per the HL7 Reference Information Model.

Change the status of an object representing an Act to "active", i.e., so it can be performed or is being performed, for the first time. (Contrast with REACTIVATE.) For an HL7 Act, the state transitions per the HL7 Reference Information Model.

Fundamental operation in an Information System (IS) that results only in the addition of information to an object already in existence. Note: The preceding definition is taken from the HL7 RBAC specification. There is no restriction on how the operation is invoked, e.g., via a user interface.

Change the status of an object representing an Act to "cancelled", i.e., abandoned before activation. For an HL7 Act, the state transitions per the HL7 Reference Information Model.

Change the status of an object representing an Act to "completed", i.e., terminated normally after all of its constituents have been performed. For an HL7 Act, the state transitions per the HL7 Reference Information Model.

Fundamental operation in an Information System (IS) that results only in the act of bringing an object into existence. Note: The preceding definition is taken from the HL7 RBAC specification. There is no restriction on how the operation is invoked, e.g., via a user interface. For an HL7 Act, the state transitions per the HL7 Reference Information Model.

Fundamental operation in an Information System (IS) that results only in the removal of information about an object from memory or storage. Note: The preceding definition is taken from the HL7 RBAC specification. There is no restriction on how the operation is invoked, e.g., via a user interface.

Fundamental operation in HL7 Standards Governance that results only in the addition of deprecation information to an object already in existence without changing the status of the object. Operation used internally in the maintenance and recordkeeping of HL7 terminology and standards artifacts.

Fundamental operation in an IS that results only in initiating performance of a single or set of programs (i.e., software objects). Note: The preceding definition is taken from the HL7 RBAC specification. There is no restriction on how the operation is invoked, e.g., via a user interface.

Change the status of an object representing an Act to "held", i.e., put aside an Act that is still in preparatory stages. No action can occur until the Act is released. For an HL7 Act, the state transitions per the HL7 Reference Information Model.

Change the status of an object representing an Act to a normal state. For an HL7 Act, the state transitions per the HL7 Reference Information Model.

Change the status of an object representing an Act.

Change the status of an object representing an Act to "nullified", i.e., treat as though it never existed. For an HL7 Act, the state transitions per the HL7 Reference Information Model.

Change the status of an object representing an Act to "obsolete" when it has been replaced by a new instance. For an HL7 Act, the state transitions per the HL7 Reference Information Model.

Act on an object or objects.

Change the status of a formerly active object representing an Act to "active", i.e., so it can again be performed or is being performed. (Contrast with ACTIVATE.) For an HL7 Act, the state transitions per the HL7 Reference Information Model.

Fundamental operation in an Information System (IS) that results only in the flow of information about an object to a subject. Note: The preceding definition is taken from the HL7 RBAC specification. There is no restriction on how the operation is invoked, e.g., via a user interface.

Change the status of an object representing an Act so it is no longer "held", i.e., allow action to occur. For an HL7 Act, the state transitions per the HL7 Reference Information Model.

Change the status of a suspended object representing an Act to "active", i.e., so it can be performed or is being performed. For an HL7 Act, the state transitions per the HL7 Reference Information Model.

Change the status of an object representing an Act to **suspended**, i.e., so it is temporarily not in service.

Fundamental operation in an Information System (IS) that results only in the revision or alteration of an object. Note: The preceding definition is taken from the HL7 RBAC specification. There is no restriction on how the operation is invoked, e.g., via a user interface.

In collaboration with the National Human Genome Research Institute, The National Center for Biotechnology Information has established the dbSNP database to serve as a central repository for both single base nucleotide substitutions and short deletion and insertion polymorphisms.

The entries in the dbSNP database can be used with the HL7 coded data type. For example, in the HL7 messages specified according to the HL7 V2 Clinical Genomics Fully LOINC-Qualified Genetic Variation Model, dbSNP entries can be used to as the observation values for DNA sequence variation identifiers. For example, OBX|1|CWE|48004-6^DNA Sequence Variation Identifier^LN||rs55538123^^dbSNP

Versioning is identified by the build id. A new build is released approximately every six months or every year. The latest build id is 130, and the dbSNP web query for built 130 was available on Apr 30, 2009.

dbSNP is a database that can be used freely by the public.

More information may be fouond at: http://www.ncbi.nlm.nih.gov/projects/SNP/

DICOM Class Label

Coded concepts defined in PS 3.16 Digital Imaging and Communications in Medicine (DICOM): Part 16: Content Mapping Resource, Annex D: DICOM Controlled Terminology Definition

root for the DEEDS code sets

retired root for DEEDs from earlier work. Superceded.

Code for ED Practitioner Role

Mode of transport to ED

ED Source of Referral

Code for Initial Healthcare Encounter for Chief Complaint

Code for Acuity Assessment

ED Responsiveness Assessment

Glasgow eye opening assessment

Glasgow verbal component assessment

Glasgow motor component assessment

Systolic blood pressure special situation

Heart rate method

Respiratory rate special circumstances codes

Patient temperature route

Injury Activity

Safety Equipment Use

Clinical Finding Data Source

UPDATE:

**** MISSING DESCRIPTION ****

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired..

Artificial dentition, artificial subsitutes for the natural dentition

Permanent dentition, the natural teeth of adulthood that replace or are added to the deciduous teeth

Primary dentition, the first teeth to errupt and usually replaced with permanent dentition

Supernumerary tooth, any tooth in addition to the normal permanent and primary dentition

Maxillary right third molar

Maxillary left lateral incisor

Maxillary left lateral incisor abutment

Maxillary left lateral incisor implant

Maxillary left lateral incisor prosthesis

Maxillary left lateral incisor distal prosthesis

Maxillary left lateral incisor mesial prosthesis

Supernumerary maxillary left lateral incisor

Maxillary left canine

Maxillary left canine abutment

Maxillary left canine implant

Maxillary left canine prosthesis

Maxillary left canine distal prosthesis

Maxillary left canine mesial prosthesis

Supernumerary maxillary left canine

Maxillary left first premolar

Maxillary left first premolar abutment

Maxillary left first premolar implant

Maxillary left first premolar prosthesis

Maxillary left first premolar distal prosthesis

Maxillary left first premolar mesial prosthesis

Supernumerary maxillary left first premolar

Maxillary left second premolar

Maxillary left second premolar abutment

Maxillary left second premolar implant

Maxillary left second premolar prosthesis

Maxillary left second premolar distal prosthesis

Maxillary left second premolar mesial prosthesis

Supernumerary maxillary left second premolar

Maxillary left first molar

Maxillary left first molar abutment

Maxillary left first molar implant

Maxillary left first molar prosthesis

Maxillary left first molar distal prosthesis

Maxillary left first molar mesial prosthesis

Supernumerary maxillary left first molar

Maxillary left second molar

Maxillary left second molar abutment

Maxillary left second molar implant

Maxillary left second molar prosthesis

Maxillary left second molar distal prosthesis

Maxillary left second molar mesial prosthesis

Supernumerary maxillary left second molar

Maxillary left third molar

Maxillary left third molar abutment

Maxillary left third molar implant

Maxillary left third molar prosthesis

Maxillary left third molar distal prosthesis

Maxillary left third molar mesial prosthesis

Supernumerary maxillary left third molar

Mandibular left third molar

Mandibular left third molar abutment

Mandibular left third molar abutment distal hemisection

Mandibular left third molar abutment mesial hemisection

Mandibular left third molar distal hemisection

Mandibular left third molar implant

Mandibular left third molar implant distal hemisection

Mandibular left third molar implant mesial hemisection

Mandibular left third molar mesial hemisection

Mandibular left third molar prosthesis

Mandibular left third molar distal prosthesis

Mandibular left third molar mesial prosthesis

Supernumerary mandibular left third molar

Mandibular left second molar

Mandibular left second molar abutment

Mandibular left second molar abutment distal hemisection

Mandibular left second molar abutment mesial hemisection

Mandibular left second molar distal hemisection

Mandibular left second molar implant

Mandibular left second molar implant distal hemisection

Mandibular left second molar implant mesial hemisection

Mandibular left second molar mesial hemisection

Mandibular left second molar prosthesis

Mandibular left second molar distal prosthesis

Mandibular left second molar mesial prosthesis

Supernumerary mandibular left second molar

Mandibular left first molar

Mandibular left first molar abutment

Mandibular left first molar abutment distal hemisection

Mandibular left first molar abutment mesial hemisection

Mandibular left first molar distal hemisection

Mandibular left first molar implant

Mandibular left first molar implant distal hemisection

Mandibular left first molar implant mesial hemisection

Mandibular left first molar mesial hemisection

Mandibular left first molar prosthesis

Mandibular left first molar distal prosthesis

Mandibular left first molar mesial prosthesis

Supernumerary mandibular left first molar

Maxillary right third molar abutment

Maxillary right third molar implant

Maxillary right third molar prosthesis

Maxillary right third molar distal prosthesis

Maxillary right third molar mesial prosthesis

Supernumerary maxillary right third molar

Maxillary right second molar

Mandibular left second premolar

Mandibular left second premolar abutment

Mandibular left second premolar implant

Mandibular left second premolar prosthesis

Mandibular left second premolar distal prosthesis

Mandibular left second premolar mesial prosthesis

Supernumerary mandibular left second premolar

Mandibular left first premolar

Mandibular left first premolar abutment

Mandibular left first premolar implant

Mandibular left first premolar prosthesis

Mandibular left first premolar distal prosthesis

Mandibular left first premolar mesial prosthesis

Supernumerary mandibular left first premolar

Mandibular left canine

Mandibular left canine abutment

Mandibular left canine implant

Mandibular left canine prosthesis

Mandibular left canine distal prosthesis

Mandibular left canine mesial prosthesis

Supernumerary mandibular left canine

Mandibular left lateral incisor

Mandibular left lateral incisor abutment

Mandibular left lateral incisor implant

Mandibular left lateral incisor prosthesis

Mandibular left lateral incisor distal prosthesis

Mandibular left lateral incisor mesial prosthesis

Supernumerary mandibular left lateral incisor

Mandibular left central incisor

Mandibular left central incisor abutment

Mandibular left central incisor implant

Mandibular left central incisor prosthesis

Mandibular left central incisor distal prosthesis

Mandibular left central incisor mesial prosthesis

Supernumerary mandibular left central incisor

Mandibular right central incisor

Mandibular right central incisor abutment

Mandibular right central incisor implant

Mandibular right central incisor prosthesis

Mandibular right central incisor distal prosthesis

Mandibular right central incisor mesial prosthesis

Supernumerary mandibular right central incisor

Mandibular right lateral incisor

Mandibular right lateral incisor abutment

Mandibular right lateral incisor implant

Mandibular right lateral incisor prosthesis

Mandibular right lateral incisor distal prosthesis

Mandibular right lateral incisor mesial prosthesis

Supernumerary mandibular right lateral incisor

Mandibular right canine

Mandibular right canine abutment

Mandibular right canine implant

Mandibular right canine prosthesis

Mandibular right canine distal prosthesis

Mandibular right canine mesial prosthesis

Supernumerary mandibular right canine

Mandibular right first premolar

Mandibular right first premolar abutment

Mandibular right first premolar implant

Mandibular right first premolar prosthesis

Mandibular right first premolar distal prosthesis

Mandibular right first premolar mesial prosthesis

Supernumerary mandibular right first premolar

Mandibular right second premolar

Mandibular right second premolar abutment

Mandibular right second premolar implant

Mandibular right second premolar prosthesis

Mandibular right second premolar distal prosthesis

Mandibular right second premolar mesial prosthesis

Supernumerary mandibular right second premolar

Maxillary right second molar abutment

Maxillary right second molar implant

Maxillary right second molar prosthesis

Maxillary right second molar distal prosthesis

Maxillary right second molar mesial prosthesis

Supernumerary maxillary right second molar

Maxillary right first molar

Mandibular right first molar

Mandibular right first molar abutment

Mandibular right first molar abutment distal hemisection

Mandibular right first molar abutment mesial hemisection

Mandibular right first molar distal hemisection

Mandibular right first molar implant

Mandibular right first molar implant distal hemisection

Mandibular right first molar implant mesial hemisection

Mandibular right first molar mesial hemisection

Mandibular right first molar prosthesis

Mandibular right first molar distal prosthesis

Mandibular right first molar mesial prosthesis

Supernumerary mandibular right first molar

Mandibular right second molar

Mandibular right second molar abutment

Mandibular right second molar abutment distal hemisection

Mandibular right second molar abutment mesial hemisection

Mandibular right second molar distal hemisection

Mandibular right second molar implant

Mandibular right second molar implant distal hemisection

Mandibular right second molar implant mesial hemisection

Mandibular right second molar mesial hemisection

Mandibular right second molar prosthesis

Mandibular right second molar distal prosthesis

Mandibular right second molar mesial prosthesis

Supernumerary mandibular right second molar

Mandibular right third molar

Mandibular right third molar abutment

Mandibular right third molar abutment distal hemisection

Mandibular right third molar abutment mesial hemisection

Mandibular right third molar distal hemisection

Mandibular right third molar implant

Mandibular right third molar implant distal hemisection

Mandibular right third molar implant mesial hemisection

Mandibular right third molar mesial hemisection

Mandibular right third molar prosthesis

Mandibular right third molar distal prosthesis

Mandibular right third molar mesial prosthesis

Supernumerary mandibular right third molar

Maxillary right first molar abutment

Maxillary right first molar implant

Maxillary right first molar prosthesis

Maxillary right first molar distal prosthesis

Maxillary right first molar mesial prosthesis

Supernumerary maxillary right first molar

Maxillary right second premolar

Maxillary right second premolar abutment

Maxillary right second premolar implant

Maxillary right second premolar prosthesis

Maxillary right second premolar distal prosthesis

Maxillary right second premolar mesial prosthesis

Supernumerary maxillary right second premolar

Maxillary right first premolar

Maxillary right first premolar abutment

Maxillary right first premolar implant

Maxillary right first premolar prosthesis

Maxillary right first premolar distal prosthesis

Maxillary right first premolar mesial prosthesis

Supernumerary maxillary right first premolar

Maxillary right canine

Maxillary right canine abutment

Maxillary right canine implant

Maxillary right canine prosthesis

Maxillary right canine distal prosthesis

Maxillary right canine mesial prosthesis

Supernumerary maxillary right canine

Maxillary right lateral incisor

Maxillary right lateral incisor abutment

Maxillary right lateral incisor implant

Maxillary right lateral incisor prosthesis

Maxillary right lateral incisor distal prosthesis

Maxillary right lateral incisor mesial prosthesis

Supernumerary maxillary right lateral incisor

Maxillary right central incisor

Maxillary right central incisor abutment

Maxillary right central incisor implant

Maxillary right central incisor prosthesis

Maxillary right central incisor distal prosthesis

Maxillary right central incisor mesial prosthesis

Supernumerary maxillary right central incisor

Maxillary left central incisor

Maxillary left central incisor abutment

Maxillary left central incisor implant

Maxillary left central incisor prosthesis

Maxillary left central incisor distal prosthesis

Maxillary left central incisor mesial prosthesis

Supernumerary maxillary left central incisor

Maxillary right second primary molar

Supernumerary maxillary right second primary molar

Maxillary right first primary molar

Supernumerary maxillary right first primary molar

Maxillary right primary canine

Supernumerary maxillary right primary canine

Maxillary right lateral primary incisor

Supernumerary maxillary right lateral primary incisor

Maxillary right central primary incisor

Supernumerary maxillary right central primary incisor

Maxillary left central primary incisor

Supernumerary maxillary left central primary incisor

Maxillary left lateral primary incisor

Supernumerary maxillary left lateral primary incisor

Maxillary left primary canine

Supernumerary maxillary left primary canine

Maxillary left first primary molar

Supernumerary maxillary left first primary molar

Maxillary left second primary molar

Supernumerary maxillary left second primary molar

Mandibular left second primary molar

Supernumerary mandibular left second primary molar

Mandibular left first primary molar

Supernumerary mandibular left first primary molar

Mandibular left primary canine

Supernumerary mandibular left primary canine

Mandibular left lateral primary incisor

Supernumerary mandibular left lateral primary incisor

Mandibular left central primary incisor

Supernumerary mandibular left central primary incisor

Mandibular right central primary incisor

Supernumerary mandibular right central primary incisor

Mandibular right lateral primary incisor

Supernumerary mandibular right lateral primary incisor

Mandibular right primary canine

Supernumerary mandibular right primary canine

Mandibular right first primary molar

Supernumerary mandibular right first primary molar

Mandibular right second primary molar

Supernumerary mandibular right second primary molar

UPDATE:

Domain values for the Device.Alert\_levelCode

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Shut Down, Fix Problem and Re-initialize

No Corrective Action Needed

Corrective Action Required

Corrective Action Anticipated

DICOM modality codes

DICOM Query Label

Internationale Klassifikation der Krankheiten 10 \[German translation of ICD10\]. Germany: Deutsches Institut fuer Medizinische Dokumentation und Information, 1998.

UPDATE:

Identifies the current completion state of a clinical document.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

A completion status in which a document has been signed manually or electronically by one or more individuals who attest to its accuracy. No explicit determination is made that the assigned individual has performed the authentication. While the standard allows multiple instances of authentication, it would be typical to have a single instance of authentication, usually by the assigned individual.

A completion status in which information has been orally recorded but not yet transcribed.

A completion status in which document content, other than dictation, has been received but has not been translated into the final electronic format. Examples include paper documents, whether hand-written or typewritten, and intermediate electronic forms, such as voice to text.

A completion status in which information is known to be missing from a transcribed document.

A workflow status where the material has been assigned to personnel to perform the task of transcription. The document remains in this state until the document is transcribed.

A completion status in which a document has been signed manually or electronically by the individual who is legally responsible for that document. This is the most mature state in the workflow progression.

A completion status in which a document was created in error or was placed in the wrong chart. The document is no longer available.

A completion status in which a document is transcribed but not authenticated.

A completion status where the document is complete and there is no expectation that the document will be signed.

UPDATE:

Identifies the storage status of a document.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

A storage status in which a document is available on-line and is also stored off-line for long-term access.

A storage status in which a document is available on-line.

A storage status in which a document has been stored off-line for long-term access.

A storage status in which a document is no longer available in this system.

Euclides quantity codes

Euclides Lab method codes

Euclides Lab equipment codes

UPDATE:

The status of an entry as it pertains to its review and incorporation into the HL7 domain specification database.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

The item has been reviewed and approved and is now valid for use in HL7 standards and messages.

A previously active item has been retired from use. The item may exist as previously stored data in a database, but no current or new HL7 standards or messges should use this item. The code for an inactive item will not be reused by HL7.

A previously active item that is scheduled to be retired from use, but for practical reasons can not be immediately inactivated. It is still legal to use an obsolete item in HL7 standards or messages, but those creating new messages should make every effort to use an active concept instead.

The item has been suggested for incorporation but has not been officially approved. The item is not yet legal for use in HL7 standards and messages.

The item has been reviewed and rejected. The item is not legal for use in HL7 standards and messages.

UPDATE:

Years of education that a person has completed

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Associate's or technical degree complete

College or baccalaureate degree complete

Elementary School

Graduate or professional Degree complete

High School or secondary school degree complete

Some post-baccalaureate education

Doctoral or post graduate education

Some College education

Some secondary or high school education

UPDATE:

A code qualifying the employment in various ways, such as, full-time vs. part time, etc.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired..

Employment in which the employee is expected to work at least a standard work week (defined by the US Bureau of Labor Statistics as 35-44 hours per week)

Employment in which the employee is expected to work less than a standard work week (defined by the US Bureau of Labor Statistics as 35-44 hours per week)

Industry and/or jurisdictional classification system for kind-of-work performed by an employee.

Occupation codes are intended primarily as work descriptions that are suitable for a multitude of public uses e.g., job matching, employment counseling, occupational and career guidance, and labor market information services.

UPDATE:

**** MISSING DESCRIPTION ****

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.
UPDATE:

This domain is defined in UB92 and applies to US realm only

Deprecation Comment:Deprecated as per 11/2008 Harmonization cleanup; internal and obsolete HL7 usage, no longer used. We've deprecated all of the codes.
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired..
UPDATE:

**** MISSING DESCRIPTION ****

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Courtesies extended to the staff of the entity providing service.

UPDATE:

Classifies the Entity class and all of its subclasses. The terminology is hierarchical. At the top is this HL7-defined domain of high-level categories (such as represented by the Entity subclasses). Each of these terms must be harmonized and is specializable. The value sets beneath are drawn from multiple, frequently external, domains that reflect much more fine-grained typing.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. The formal name for the class clone under this code Haven't a clue! Designation of a concept's state. Normally is not populated unless the state is retired.

A living subject from the animal kingdom.

A physical artifact that stores information about the granting of authorization.

A substance that is fully defined by an organic or inorganic chemical formula, includes mixtures of other chemical substances. Refine using, e.g., IUPAC codes.

The territory of a city, town or other municipality.

A container of other entities.

The territory of a sovereign nation.

The territory of a county, parish or other division of a state or province.

A subtype of ManufacturedMaterial used in an activity, without being substantially changed through that activity. The kind of device is identified by the code attribute inherited from Entity.

Usage:This includes durable (reusable) medical equipment as well as disposable equipment.

Corresponds to the Entity class

Naturally occurring, processed or manufactured entities that are primarily used as food for humans and animals.

A health chart included to serve as a document receiving entity in the management of medical records.

A type of container that can hold other containers or other holders.

Anything that essentially has the property of life, independent of current state (a dead human corpse is still essentially a living subject).

Any thing that has extension in space and mass, may be of living or non-living origin.

All single celled living organisms including protozoa, bacteria, yeast, viruses, etc.

Corresponds to the ManufacturedMaterial class

Class to contain unique attributes of diagnostic imaging equipment.

A politically organized body of people bonded by territory and known as a nation.

A subtype of living subject that includes all living things except the species Homo Sapiens.

A social or legal structure formed by human beings.

A physical place or site with its containing structure. May be natural or man-made. The geographic position of a place may or may not be constant.

A living subject from the order of plants.

The territory of a state, province, department or other division of a sovereign country.

A living subject of the species homo sapiens.

An agency of the people of a state often assuming some authority over a certain matter. Includes government, governmental agencies, associations.

A grouping of resources (personnel, material, or places) to be used for scheduling purposes. May be a pool of like-type resources, a team, or combination of personnel, material and places.

A politically organized body of people bonded by territory, culture, or ethnicity, having sovereignty (to a certain extent) granted by other states (enclosing or neighboring states). This includes countries (nations), provinces (e.g., one of the United States of America or a French departement), counties or municipalities. Refine using, e.g., ISO country codes, FIPS-PUB state codes, etc.

UPDATE: OpenIssue:Missing description. en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The child code is a classification of the particular class group identified by the 'classCode' in a RIM class as the parent code. Used only in RIM backbone classes to link the code and classCode values. The internal identifier for the concept in the HL7 Access database repository. A property that indicates the status of the concept. One of active, experimental, deprecated, or retired.

ACD Solution A of trisodium citrate, 22.0g/L; citric acid, 8.0 g/L; and dextrose 24.5 g/L. Used in Blood banking and histocompatibilty testing

ACD Solution B of trisodium citrate, 13.2g/L; citric acid, 4.8 g/L; and dextrose 14.7 g/L. Used in Blood banking and histocompatibilty testing.

50% V/V acetic acid in water. Used as a urine preservative

Automatically injects medication.

Sodium Chloride 3.0g, Potassium Chloride 0.2g, Calcium Chloride 0.1g, Magnesium Chloride 0.1g, Monopotassium Phosphate 0.2g, Disodium Phosphate 1.15g, Sodium Thiogly collate 1.0g, Distilled Water 1 liter

A small sealed glass container that holds a measured amount of a medicinal substance.

A device used to apply a liquid or powder to a surface.

Any medium used to maintain bacterial viability (e.g. Stuart's, Cary-Blair, Amies)

A pouched or pendulous container.

The location of a bed

Formaldehyde 4% w/v; methyl alcohol 1% w/v; phosphate buffering salts. Tissue preservative

The location of a building

A manufactured product that is produced from the raw blood oi a donor with the intention of using it in a recipient transfusion.

A bubblepack. Medications sealed individually, separated into doses.

Powdered boric acid (usually 10 g) added to 24-hour urine collections as a preservative.

A container, typically rounded, either glass or plastic with a narrow neck and capable of storing liquid.

A bottle of yellow to brown color. Used to store light-sensitive materials

A bottle with a cap designed to release the contained liquid in droplets of a specific size.

A bottle made of glass

A bottle made of plastic

A bottle made of polyethylene

Picric acid, saturated aqueous solution (750.0 ml), 37-40% formalin (250.0 ml), glacial acetic acid (50.0 ml). Tissue preservative.

A 6-sided container commonly made from paper or cardboard used for solid forms.

50% skim milk in 0.01 M phosphate-buffered saline. Maintain virus viability

A 3.2% solution of Sodium Citrate in water. Used as a blood preservative

A 3.8% solution of Sodium Citrate in water. Used as a blood preservative

A metal container in which a material is hermetically sealed to enable storage over long periods.

A bubble pack card. Multiple individual/separated doses.

A modification of buffered 10% formalin used as a general tissue preservative.

A sealed container of liquid or powder intended to be loaded into a device.

Sodium Thioglycollate 1.5 g, Disodium Hydrogen Phosphate 1.1 g, Sodium Chloride 5.0 g, Calcium Chloride 0.09 g, Agar 5.0 g, per Liter of Water

Any of a number of non-nutritive buffered media used to maintain Chlamydia viability during transportation to the laboratory

A pressurized metal container holding a substance released as a spray or aerosol.

A container intended to contain sufficient material for more than one use, but grouped or organized to provide individual access to sufficient material for a single use. Often used to ensure that the proper type and amount of material is consumed/expended for each use.

Buffered tri-sodium citrate solution with theophylline, adenosine and dipyridamole

Rotatable dispenser. Eg. Birth control package.

Object that is thin, flat, and circular. Doses of medication often contained in bubbles on the disk.

Special packaging that will help patients take their medications on a regular basis.

The device used to inhale the doses of medication contained in the disk form.

The device used to inhale the doses of medication contained in the disk form.

Potassium EDTA 15% solution in water

Potassium EDTA 7.5% solution in water

Sodium fluoride and Disodium EDTA

Any of a number of non-nutritive buffered media used to maintain enteric bacterial viability during transportation to the laboratory

A 10% v/v solution in water of formalin( a 37% solution of formaldehyde and water). Used for tissue preservation.

Thrombin plus soybean trypsin inhibitor. For use in identifying fibrn degredation products.

Sodium fluoride, 10mg added as a urine preservative.

Sodium fluoride, 100mg added as a urine preservative.

The location of a floor of a building

A solution of HCl containing 6moles of hydrogen ion/L. Used as a Urine Preservative.

Ammonium heparin

Lithium heparin salt

Sodium heparin salt

The group of persons who occupy a single housing unit.

6N Nitric acid used to preserve urine for heavy metal analysis.

A line used to administer a substance into an artery

A small device used for inhaling medicine in the form of a vapour or gas in order to ease a respiratory condition such as asthma or to relieve nasal congestion.

A line used to administer a substance into a vein

A container of glass, earthenware, plastic, etc. Top of the container has a diameter of similar size to the diameter of the container as a whole

A transport medium formulated to maintain Bordetella pertussis viability.

A deep vessel for holding liquids, with a handle and often with a spout or lip shape for pouring.

5% Glutaraldehyde, 4% Formaldehyde in 0.08M buffer. Tissue preservation

A container for a diverse collection of products intended to be used together for some purpose (e.g. Medicinal kits often contain a syringe, a needle and the injectable medication).

Potassium oxalate and sodium fluoride in a 1.25:1 ratio

Iodoacetate lithium salt

A hollow tube used to administer a substance into a vein, artery or body cavity

Modified Hank's balanced salt solution supplemented with bovine serum albumin, gelatin, sucrose and glutamic acid. It is buffered to pH 7.3+ or - 0.2 with HEPES buffer. Phenol red is used to indicate pH. Vancomycin, Amphotericin B and Colistin are used to

Modified Hank's balanced salt solution supplemented with bovine serum albumin, gelatin, sucrose and glutamic acid. It is buffered to pH 7.3+ or - 0.2 with Hepes buffer. Phenol red is used to indicate pH. Gentamicin and amphotericin B are used to inhibit c

Modified Hank's balanced salt solution supplemented with protein stabilizers, sucrose and glutamic acid. It is buffered to pH 7.3+ or - 0.2 with Hepes buffer. Phenol red is used to indicate pH. Vancomycin, Amphotericin B and Colistin are used to inhibit c

1M potassium citrate, pH 7.0 2.5 ml, 0.1M magnesium sulfate 5.0 ml, 0.1M N-ethyl malemide 5.0 ml, dH2O 87.5 ml, ammonium sulfate 55gm. Preserve antigens for Immunofluorescence procedures

Individually dosed ophthalmic solution. One time eye dropper dispenser.

A buffered medium with ammonium sulfate added to preserve antigens for Immunofluorescence procedures

Sodium fluoride

Codes identifying nation states. Allows for finer grained specification of Entity with classcode <= NAT

*Example:*ISO3166 country codes.

Individually dosed inhalation solution.

No additive. Specifically identifes the specimen as having no additives.

A container either glass or plastic and a narrow neck, for storing liquid.

A paper

0.12 g NaCl, 0.004 g MgSO, 0.004 g, CaCl, 0.142 g Na2HPO4 and 0.136 g KH2PO4 per liter of distilled water. Maintain Acanthaoemba viability.

A small bag or container made of a soft material.

A device which can contain a cartridge for injection purposes. Eg. Insulin pen.

Phenol. Urine preservative

A material intended to hold other materials for purposes of storage or transportation

A device that is used to raise, compress, or transfer liquids or gases and is operated by a piston or similar mechanism.

Polyvinyl alcohol

An organization that provides religious rites of worship.

A transport medium formulated to maintain Bordetella pertussis viability.

The location of a room

A small bag or packet containing a small portion of a substance.

Diatomaceous earth. For glucose determination blood samples

Sodium polyanethol sulfonate in saline. Anticomplementary and antiphagocytic properties. Used in blood culture collection.

Polymer separator gel with clot activator

A continuous strip of plastic sectioned into individual pouches, each one containing the quantity of 1 or more medications intended to be administered at a specific time

Sodium Glycerophosphate 10.0g, Calcium Chloride 0.1g, Mercaptoacetic Acid 1.0ml, Distilled Water 1 liter

A barrel with a plunger.

A kit in which the components are interconnected.

Thrombin. Accelerates clotting.

2-Isopropyl-5-methyl phenol. A preservative for 24 Hr Urine samples

A nutritive medium with a reducing agent (sodium thioglycolate) which, due to a chemical reaction, removes oxygen from the broth.

A lidded container made of thin sheet metal.

Also known as Methylbenzene; Toluol; Phenylmethane. A preservative for 24 Hr Urine samples

Asthma medication delivery device.

An open flat bottomed round container.

A long hollow rigid or flexible cylinder. Material is extruded by squeezing the container.

A buffered salt solution with antifungal agents added for the collection and transport of Ureaplasma specimens.

A Type of medicine that creates an immune protection without the recipient experiencing the disease.

A small cylindrical glass for holding liquid medicines.

Sucrose 74.6g, Potassium hydrogenphosphate 0.52g, L-glutamic acid 0.72g, Bovine serum albumin 5.0g, Gentamicin 50mg, Potassium dihydrogenphosphate 1.25g, L-15 medium 9.9L, Water to 10L. Maintain Virus viability.

3.8% Citrate buffered to a pH of 5.5 for Westergren Sedimentation Rate

The location of a wing of a building (e.g. East Wing). The same room number for the same floor number can be distinguished by wing number in some situations

A device used to allow access to a part of a body

Any substance which, when combined with other ingredients, delivers all or part of the therapeutic benefit associated with a medication.

A device intended to administer a substance to a subject

Any substance or mixture of substances manufactured, sold or represented for use in: (a) the diagnosis, treatment, mitigation or prevention of a disease, disorder, abnormal physical state, or its symptoms, in human beings or animals; (b) restoring, correcting or modifying organic functions in human beings or animals.

Material intended to hold another material for purpose of storage or transport.

Includes the set of codes used to identify a device that may be referred to in an ICSR report. Example code set reference is the FDA Center for Devices and Radiological Health product code list.

Example product codes include: FOZ = Catheter, Intravascular, Therapeutic, short-term less than 30 days, MOP = Rotator, Prosthetic Heart Valve.

A substance whose therapeutic effect is produced by chemical action within the body.

Indicates the material to which the patient was exposed which is believed to be related to the adverse reaction

A code that is used to indicate the type of organization which is originating and sending the ICSR. The current code example reference is from the International Conference on Harmonisation (ICH) Expert Workgroup guideline on Clinical Safety Data Management: Data Elements for Transmission of Individual Case Safety Reports.

Example concepts are: Pharmaceutical Company, Regulatory Authority, Health Professional, Regional Pharmacovigilence Center, World Health Organization Collaborating Center for International Drug Monitoring.

Container intended to contain sufficient material for only one use.

A device intended to administer liquid into a subject via a

Identifies a drug or the use of a drug as produced by a specific manufacturer

Types of Material for EntityClass "MAT"

A device with direct or indirect therapeutic purpose. Values for EntityCode when EntityClass = "DEV"

A container intended to contain sufficient material for more than one use. (I.e. Material is intended to be removed from the container at more than one discrete time period.)

Indicates types of allergy and intolerance agents which are non-drugs. (E.g. foods, latex, etc.)

**Description:**Types of NonPersonLivingSubjects for the EntityClass 'NLIV'

A container having dimensions that adjust somewhat based on the amount and shape of the material placed within it.

Further classifies entities of classCode ORG.

Types of places for EntityClass "PLC"

Codes to characterize a Resource Group using categories that typify its membership and/or function

.

Example:PractitionerGroup

A container having a fixed and inflexible dimensions and volume

Set of codes related to specimen additives

**Description:**The billable codes selected for Clinical Product Invoices. Steward is Financial Management.

UPDATE:

EntityDeterminer in natural language grammar is the class of words that comprises articles, demonstrative pronouns, and quantifiers. In the RIM, determiner is a structural code in the Entity class to distinguish whether any given Entity object stands for some, any one, or a specific thing.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. A property that indicates the status of the concept. One of active, experimental, deprecated, or retired. The formal name for the class clone under this code

A determiner that specifies that the Entity object represents a particular collection of physical things (as opposed to a universal, kind, or class of physical thing). While the collection may resolve to having only a single individual (or even no individuals), the potential should exist for it to cover multiple individuals.

A determiner that specifies that the Entity object represents a universal, kind or class of collections physical things. While the collection may resolve to having only a single individual (or even no individuals), the potential should exist for it to cover multiple individuals.

**Description:**A determiner that specifies that the Entity object represents a particular physical thing (as opposed to a universal, kind, or class of physical thing).

Discussion:It does not matter whether an INSTANCE still exists as a whole at the point in time (or process) when we mention it, for example, a drug product lot is an INSTANCE even though it has been portioned out for retail purpose.

**Description:**A determiner that specifies that the Entity object represents a universal, kind or class of physical thing (as opposed to a particular thing).

The described quantified determiner indicates that the given Entity is taken as a general description of a specific amount of a thing. For example, QUANTIFIED\_KIND of syringe (quantity = 3,) stands for exactly three syringes.

UPDATE:

Special handling requirements for an Entity.

*Example:*Keep at room temperature; Keep frozen below 0 C; Keep in a dry environment; Keep upright, do not turn upside down.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Keep at ambient temperature, 22 +/- 2C

Critical to keep at body temperature 36-38C

Critical ambient - must not be refrigerated or frozen.

Critical. Do not expose to atmosphere. Do not uncap.

Critical frozen. Specimen must not be allowed to thaw until immediately prior to testing.

Critical refrigerated - must not be allowed to freeze or warm until imediately prior to testing.

Deep Frozen -16 to -20C.

Keep in a dry environment

Keep frozen below 0 ?C

Container is free of heavy metals, including lead.

Keep in liquid nitrogen

Protect from light (eg. Wrap in aluminum foil).

Do not shake

Protect against shock

Keep at refrigerated temperature:4-8C Accidental warming or freezing is of little consequence.

Shake thoroughly before using

Ultra cold frozen -75 to -85C. Ultra cold freezer is typically at temperature of dry ice.

Keep upright, do not turn upside down

UPDATE: OpenIssue:Needs description en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired..

Indicates that a prefix like "Dr." or a suffix like "M.D." or "Ph.D." is an academic title.

The name the person was given at the time of adoption.

A name that a person had shortly after being born. Usually for family names but may be used to mark given names at birth that may have changed later.

A callme name is (usually a given name) that is preferred when a person is directly addressed.

Description:This refers to the container if present in the medicinal product name.

EXAMPLES:

* For Optaflu suspension for injection in pre-filled syringe Influenza vaccine (surface antigen, inactivated, prepared in cell culture) (2007/2008 season): pre-filled syringe

Description:This refers to the qualifiers in the name for devices and is at the moment mainly applicable to insulins and inhalation products.

EXAMPLES:

* For the medicinal product Actrapid FlexPen 100 IU/ml Solution for injection Subcutaneous use: FlexPen.

Description:This refers to a flavor of the medicinal product if present in the medicinal product name.Examples:

* For 'CoughCure Linctus Orange Flavor', the flavor part is "Orange" * For 'Wonderdrug Syrup Cherry Flavor', the flavor part is "Cherry"

Description:This refers to the formulation of the medicinal product if present in the medicinal product name.Examples:

* For 'SpecialMed Sugar Free Cough Syrup', the formulation name part is "Sugar Free" * For 'QuickCure Gluten-free Bulk Fibre', the formulation name part is "gluten-free"

Description:This refers to the pharmaceutical form/ if present in the medicinal product name.

EXAMPLES:

* For Agenerase 50 mg soft capsules: Soft Capsules * For Ludiomil 25mg-Filmtabletten: Filmtabletten * For Optaflu suspension for injection in pre-filled syringe Influenza vaccine (surface antigen, inactivated, prepared in cell culture) (2007/2008 season): suspension for injection

Indicates that a name part is just an initial. Initials do not imply a trailing period since this would not work with non-Latin scripts. Initials may consist of more than one letter, e.g., "Ph." could stand for "Philippe" or "Th." for "Thomas".

Description:This refers to the product name without the trademark or the name of the marketing authorization holder or any other descriptor reflected in the product name and, if appropriate, whether it is intended e.g. for babies, children or adults.

EXAMPLES:

* Agenerase * Optaflu * Ludiomil

For organizations a suffix indicating the legal status, e.g., "Inc.", "Co.", "AG", "GmbH", "B.V." "S.A.", "Ltd." etc.

In Europe and Asia, there are still people with nobility titles (aristocrats). German "von" is generally a nobility title, not a mere voorvoegsel. Others are "Earl of" or "His Majesty King of..." etc. Rarely used nowadays, but some systems do keep track of this.

Description:This refers to the target population for the medicinal product if present in the medicinal product nameExamples:

* For 'Broncho-Drug 3.5 mg-capsules for children', the target population part is "children" * For 'Adult Chesty Cough Syrup', the target population part is "adult"

Primarily in the British Imperial culture people tend to have an abbreviation of their professional organization as part of their credential suffices.

Description:Medication Name Parts are a means of specifying a range of acceptable "official" forms of the name of a product. They are used as patterns against which input name strings may be matched for automatic identification of products from input text reports. While they cover the concepts held under "doseForm" or "route" or "strength" the name parts are not the same and do not fit into a controlled vocabulary in the same way. By specifying up to 8 name parts a much larger range of possible names can be generated. Description:This refers to the product common or scientific name without the trademark or the name of the marketing authorization holder or any other descriptor reflected in the product name.

EXAMPLES:

* For Agenerase: N/A * For Optaflu: Influenza vaccine (surface antigen, inactivated, prepared in cell culture) (2007/2008 season) * For Ludiomil: N/A

The name assumed from the partner in a marital relationship (hence the "SP"). Usually the spouse's family name. Note that no inference about gender can be made from the existence of spouse names.

Description:This refers to the strength if present in the medicinal product name. The use of decimal points should be accommodated if required.

EXAMPLES:

* For Agenerase 50 mg soft capsules: 50mg * For Ludiomil 25mg-Filmtabletten: 25 mg * For Optaflu suspension for injection in pre-filled syringe Influenza vaccine (surface antigen, inactivated, prepared in cell culture) (2007/2008 season): N/A

Description:This refers to a time or time period that may be specified in the text of the medicinal product nameExample:

* For an influenza vaccine 'Drug-FLU season 2008/2009', the time/period part is "2008/2009 season"

Indicates that a prefix or a suffix is a title that applies to the whole name, not just the adjacent name part.

Description:This refers to trademark/company element if present in the medicinal product name.

EXAMPLES:

* for Insulin Human Winthrop Comb 15: Winthrop

Description:This refers to the intended use if present in the medicinal product name without the trademark or the name of the marketing authorization holder or any other descriptor reflected in the product name.Examples:

* For 'Drug-BI Caplets - Heartburn Relief', the intended use part is: "Heartburn Relief" * For 'Medicine Honey Syrup for Soothing Coughs' the intended use part is "Soothing Coughs"

A Dutch "voorvoegsel" is something like "van" or "de" that might have indicated nobility in the past but no longer so. Similar prefixes exist in other languages such as Spanish, French or Portugese.

UPDATE:

**Description:**The qualifier is a set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type. For example, a given name may be flagged as a nickname, a family name may be a pseudonym or a name of public records.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. An additional concept code that was also attributed to a concept

**Description:**Indicates that a title like "Dr.", "M.D." or "Ph.D." is an academic title.

**Description:**A name part a person acquired. The name part may be acquired by adoption, or the person may have chosen to use the name part for some other reason.

Note:this differs from an Other/Psuedonym/Alias in that an acquired name part is acquired on a formal basis rather than an informal one (e.g. registered as part of the official name).

**Description:**A name that a person was given at birth or established as a consequence of adoption.

Note:This is not used for temporary names assigned at birth such as "Baby of Smith" a" which is just a name with a use code of "TEMP".

**Description:**Used to indicate which of the various name parts is used when interacting with the person.

Description:This refers to the container if present in the medicinal product name.

EXAMPLES:

* For Optaflu suspension for injection in pre-filled syringe Influenza vaccine (surface antigen, inactivated, prepared in cell culture) (2007/2008 season): pre-filled syringe

Description:This refers to the qualifiers in the name for devices and is at the moment mainly applicable to insulins and inhalation products.

EXAMPLES:

* For the medicinal product Actrapid FlexPen 100 IU/ml Solution for injection Subcutaneous use: FlexPen.

Description:This refers to a flavor of the medicinal product if present in the medicinal product name.Examples:

* For 'CoughCure Linctus Orange Flavor', the flavor part is "Orange" * For 'Wonderdrug Syrup Cherry Flavor', the flavor part is "Cherry"

Description:This refers to the formulation of the medicinal product if present in the medicinal product name.Examples:

* For 'SpecialMed Sugar Free Cough Syrup', the formulation name part is "Sugar Free" * For 'QuickCure Gluten-free Bulk Fibre', the formulation name part is "gluten-free"

Description:This refers to the pharmaceutical form/ if present in the medicinal product name.

EXAMPLES:

* For Agenerase 50 mg soft capsules: Soft Capsules * For Ludiomil 25mg-Filmtabletten: Filmtabletten * For Optaflu suspension for injection in pre-filled syringe Influenza vaccine (surface antigen, inactivated, prepared in cell culture) (2007/2008 season): suspension for injection

**Description:**A honorific such as "The Right Honourable" or "Weledelgeleerde Heer".

**Description:**Indicates that a name part is just an initial. Initials do not imply a trailing period since this would not work with non-Latin scripts. In some languages, initials may consist of more than one letter, e.g., "Ph" could stand for "Philippe" or "Th" For "Thomas".

Description:This refers to the product name without the trademark or the name of the marketing authorization holder or any other descriptor reflected in the product name and, if appropriate, whether it is intended e.g. for babies, children or adults.

EXAMPLES:

* Agenerase * Optaflu * Ludiomil

**Description:**For organizations a suffix indicating the legal status, e.g., "Inc.", "Co.", "AG", "GmbH", "B.V." "S.A.", "Ltd." etc.

**Description:**Indicates that the name part is a middle name.

Usage Notes:In general, the english "middle name" concept is all of the given names after the first. This qualifier may be used to explicitly indicate which given names are considered to be middle names. The middle name qualifier may also be used with family names. This is a Scandinavian use case, matching the concept of "mellomnavn","mellannamn". Note that there are specific rules that indicate what names may be taken as a mellannamn in different Scandinavian countries.
In general, the english "middle name" concept is all of the given names after the first. This qualifier may be used to explicitly indicate which given names are considered to be middle names. The middle name qualifier may also be used with family names. This is a Scandinavian use case, matching the concept of "mellomnavn","mellannamn". Note that there are specific rules that indicate what names may be taken as a mellannamn in different Scandinavian countries.

**Description:**A nobility title such as Sir, Count, Grafin.

**Description:**A prefix has a strong association to the immediately following name part. A prefix has no implicit trailing white space (it has implicit leading white space though).

Description:This refers to the target population for the medicinal product if present in the medicinal product nameExamples:

* For 'Broncho-Drug 3.5 mg-capsules for children', the target population part is "children" * For 'Adult Chesty Cough Syrup', the target population part is "adult"

**Description:**Primarily in the British Imperial culture people tend to have an abbreviation of their professional organization as part of their credential titles.

Description:Medication Name Parts are a means of specifying a range of acceptable "official" forms of the name of a product. They are used as patterns against which input name strings may be matched for automatic identification of products from input text reports. While they cover the concepts held under "doseForm" or "route" or "strength" the name parts are not the same and do not fit into a controlled vocabulary in the same way. By specifying up to 8 name parts a much larger range of possible names can be generated. Description:This refers to the product common or scientific name without the trademark or the name of the marketing authorization holder or any other descriptor reflected in the product name.

EXAMPLES:

* For Agenerase: N/A * For Optaflu: Influenza vaccine (surface antigen, inactivated, prepared in cell culture) (2007/2008 season) * For Ludiomil: N/A

**Description:**A suffix has a strong association to the immediately preceding name part. A suffix has no implicit leading white space (it has implicit trailing white space though).

**Description:**The name assumed from the partner in a marital relationship. Usually the spouse's family name. Note that no inference about gender can be made from the existence of spouse names.

Description:This refers to the strength if present in the medicinal product name. The use of decimal points should be accommodated if required.

EXAMPLES:

* For Agenerase 50 mg soft capsules: 50mg * For Ludiomil 25mg-Filmtabletten: 25 mg * For Optaflu suspension for injection in pre-filled syringe Influenza vaccine (surface antigen, inactivated, prepared in cell culture) (2007/2008 season): N/A

Description:This refers to a time or time period that may be specified in the text of the medicinal product nameExample:

* For an influenza vaccine 'Drug-FLU season 2008/2009', the time/period part is "2008/2009 season"

Description:This refers to trademark/company element if present in the medicinal product name.

EXAMPLES:

* for Insulin Human Winthrop Comb 15: Winthrop

**Description:**Extra information about the style of a title

Description:This refers to the intended use if present in the medicinal product name without the trademark or the name of the marketing authorization holder or any other descriptor reflected in the product name.Examples:

* For 'Drug-BI Caplets - Heartburn Relief', the intended use part is: "Heartburn Relief" * For 'Medicine Honey Syrup for Soothing Coughs' the intended use part is "Soothing Coughs"

UPDATE:

**** MISSING DESCRIPTION ****

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

A delimiter has no meaning other than being literally printed in this name representation. A delimiter has no implicit leading and trailing white space.

Family name, this is the name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

Given name (don't call it "first name" since this given names do not always come first)

A prefix has a strong association to the immediately following name part. A prefix has no implicit trailing white space (it has implicit leading white space though). Note that prefixes can be inverted.

**Description:**A suffix has a strong association to the immediately preceding name part. A suffix has no implicit leading white space (it has implicit trailing white space though). Suffices cannot be inverted.

UPDATE:

**Description:**Indicates whether the name part is a given name, family name, prefix, suffix, etc.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. Relationship points from a concept in EntityNamePartType to a concept in EntityNamePartQualifier and indicates that the former concept may be qualified by the latter. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

**Description:**A delimiter has no meaning other than being literally printed in this name representation. A delimiter has no implicit leading and trailing white space.

**Description:**Family name, this is the name that links to the genealogy. In some cultures (e.g. Eritrea) the family name of a son is the first name of his father.

**Description:**Given name. Note: don't call it "first name" since the given names do not always come first.

**Description:**Part of the name that is acquired as a title due to academic, legal, employment or nobility status etc.

**Note:**Title name parts include name parts that come after the name such as qualifications, even if they are not always considered to be titles.

UPDATE:

**** MISSING DESCRIPTION ****

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired..

Includes writer's pseudonym, stage name, etc

Alphabetic transcription of name (Japanese: romaji)

A name assigned to a person. Reasons some organizations assign alternate names may include not knowing the person's name, or to maintain anonymity. Some, but not necessarily all, of the name types that people call "alias" may fit into this category.

As recorded on a license, record, certificate, etc. (only if different from legal name)

e.g. Chief Red Cloud

Ideographic representation of name (e.g., Japanese kanji, Chinese characters)

Known as/conventional/the one you use

**Definition:**The formal name as registered in an official (government) registry, but which name might not be commonly used. Particularly used in countries with a law system based on Napoleonic law.

A self asserted name that the person is using or has used.

A name spelled phonetically.

There are a variety of phonetic spelling algorithms. This code value does not distinguish between these.*Discussion:*

e.g. Sister Mary Francis, Brother John

A name spelled according to the SoundEx algorithm.

A name intended for use in searching or matching.

Syllabic transcription of name (e.g., Japanese kana, Korean hangul)

Description:A name intended for use in searching or matching.

Identifies the different representations of a name. The representation may affect how the name is used. (E.g. use of Ideographic for formal communications.)

A code indicating the type of name (e.g. nickname, alias, maiden name, legal, adopted)

UPDATE:

**Description:**A set of codes advising a system or user which name in a set of names to select for a given purpose.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. An additional concept code that was also attributed to a concept

**Description:**A name used in a Professional or Business context . Examples: Continuing to use a maiden name in a professional context, or using a stage performing name (some of these names are also pseudonyms)

**Description:**Alphabetic transcription of name in latin alphabet (Japanese: romaji)

**Description:**Anonymous assigned name (used to protect a persons identity for privacy reasons)

**Description:**A name that a person has assumed or has been assumed to them.

**Description:**Known as/conventional/the one you normally use

**Description:**This name should no longer be used when interacting with the person (i.e . in addition to no longer being used, the name should not be even mentioned when interacting with the person)Note: applications are not required to compare names labeled "Do Not Use" and other names in order to eliminate name parts that are common between the other name and a name labeled "Do Not Use".

**Description:**e.g . Chief Red Cloud

**Description:**Ideographic representation of name (e.g., Japanese kanji, Chinese characters)

**Description:**A name used prior to marriage.Note that marriage naming customs vary greatly around the world. This name use is for use by applications that collect and store maiden names. Though the concept of maiden name is often gender specific, the use of this term is not gender specific. The use of this term does not imply any particular history for a person's name, nor should the maiden name be determined algorithmically

**Description:**Identifies the different representations of a name . The representation may affect how the name is used . (E.g . use of Ideographic for formal communications.)

**Description:**This name is no longer in use (note: Names may also carry valid time ranges . This code is used to cover the situations where it is known that the name is no longer valid, but no particular time range for its use is known)

**Description:**The formal name as registered in an official (government) registry, but which name might not be commonly used . May correspond to the concept of legal name

**Description:**A non-official name by which the person is sometimes known. (This may also be used to record informal names such as a nickname)

**Description:**The name as understood by the data enterer, i.e. a close approximation of a phonetic spelling of the name, not based on a phonetic algorithm.

**Description:**A name assumed as part of a religious vocation . e.g . Sister Mary Francis, Brother John

**Description:**A name intended for use in searching or matching. This is used when the name is incomplete and contains enough details for search matching, but not enough for other uses.

**Description:**Syllabic transcription of name (e.g., Japanese kana, Korean hangul)

**Description:**A temporary name. Note that a name valid time can provide more detailed information. This may also be used for temporary names assigned at birth or in emergency situations.

UPDATE:

Kinds of risks associated with the handling of the material..

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

A danger that can be associated with certain living subjects, including humans.

Material contains microorganisms that is an environmental hazard. Must be handled with special care.

The dangers associated with normal biological materials. I.e. potential risk of unknown infections. Routine biological materials from living subjects.

Material is corrosive and may cause severe injury to skin, mucous membranes and eyes. Avoid any unprotected contact.

The entity is at risk for escaping from containment or control.

Material is an explosive mixture. Keep away from fire, sparks, and heat.

Material is highly inflammable and in certain mixtures (with air) may lead to explosions. Keep away from fire, sparks and excessive heat.

Material known to be infectious with human pathogenic microorganisms. Those who handle this material must take precautions for their protection.

Material is solid and sharp (e.g., cannulas). Dispose in hard container.

Material is poisonous to humans and/or animals. Special care must be taken to avoid incorporation, even of small amounts.

Material is a source for ionizing radiation and must be handled with special care to avoid injury of those who handle it and to avoid environmental hazards.

UPDATE:

Codes representing the defined possible states of an Entity, as defined by the Entity class state machine.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired..

The state representing the fact that the Entity record is currently active.

Definition:The state representing the fact that the entity is inactive.

The 'typical' state. Excludes "nullified" which represents the termination state of an Entity record instance that was created in error.

The state representing the termination of an Entity record instance that was created in error.

The state representing the normal termination of an Entity record.

Enzyme Codes

**Description:**The set of values found in the Coord Axis Code column of the Coordinate Axis table as maintained in the EPSG geodetic parameter dataset. These define the axis for coordinate systems for geographic coordinates.

Description:The set of values found in the Coord Axis Code column of the Coordinate Axis table as maintained in the EPSG geodetic parameter dataset. These define the axis for coordinate systems for geographic coordinates. Description:The EPSG (European Petroleum Survey Group) dataset represents all Datums, coordinate references (projected and 2D geographic) and coordinate systems (including Cartesian coordinate systems) used in surveying worldwide. Each record includes a 4-8 digit unique identifier. The current version is available from http://www.epsg.org/. The database contains over 4000 records covering spatial data applications worldwide.Deprecation Comment:This has been superceded by the two code systems EPSG-CRS and EPSG-CA UPDATE:

**** MISSING DESCRIPTION ****

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Shut Down, Fix Problem and Re-init

No Corrective Action Needed

Corrective Action Required

Corrective Action Anticipated

UPDATE: Deprecation Information:Deprecated due to UP-265. This code system in NOT the acknowledged source of truth for Ethnicity concepts and codes. It should no longer be used. https://terminology.hl7.org/CodeSystem-CDCREC.html should be used in its place. In the United States, federal standards for classifying data on ethnicity determine the categories used by federal agencies and exert a strong influence on categorization by state and local agencies and private sector organizations. The federal standards do not conceptually define ethnicity, and they recognize the absence of an anthropological or scientific basis for ethnicity classification. Instead, the federal standards acknowledge that ethnicity is a social-political construct in which an individual's own identification with a particular ethnicity is preferred to observer identification. The standards specify two minimum ethnicity categories: Hispanic or Latino, and Not Hispanic or Latino. The standards define a Hispanic or Latino as a person of "Mexican, Puerto Rican, Cuban, South or Central America, or other Spanish culture or origin, regardless of race." The standards stipulate that ethnicity data need not be limited to the two minimum categories, but any expansion must be collapsible to those categories. In addition, the standards stipulate that an individual can be Hispanic or Latino or can be Not Hispanic or Latino, but cannot be both. en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Note that this term remains in the table for completeness, even though within HL7, the notion of "not otherwise coded" term is deprecated.

EUCLIDES

UPDATE:

Code for the mechanism by which the exposure agent was exchanged or potentially exchanged by the participants involved in the exposure.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. Description:Communication of an agent from a living subject or environmental source to a living subject through indirect contact via oral or nasal inhalation. Description:Communication of an agent from a living subject or environmental source to a living subject through direct physical contact. Description:Communication of an agent from a food source to a living subject via oral consumption. Description:Communication of an agent to a living subject by contact and/or consumption via an aqueous medium

Code for the mechanism by which the exposure agent was exchanged or potentially exchanged by the participants involved in the exposure.

External coding systems registered in HL7 with an HL7 OID

The FDB Hierarchical Ingredient Code is a six character identifier that represents an active ingredient and its specific therapeutic classification.

First DataBank Drug Codes

First DataBank Diagnostic Codes

FDA K10

FIPSPUB92 - GUIDELINE FOR STANDARD OCCUPATIONAL CLASSIFICATION (SOC) CODES, version 1983 February 24. This entry is now obsolete, as FIPS92 was withdrawn from use in February 2005 by the US Government. It has been replaced by 2.16.840.1.113883.6.243; please use that OID instead.

GCDF

Dosage Form Code (2-character)

a two-character alphanumeric column that represents a dosage form. The dosage form of a generic drug formulation describes the physical presentation of a drug, such as tablet, capsule, or liquid. It may also incorporate the delivery and release mechanism of the drug. A GCDF is associated to each GCN\_SEQNO to identify that component of the generic drug formulation.

GCRT

Route of Administration Code (1-character)

a one-character alphanumeric column that provides the normal site or method by which a drug is administered, such as oral, injection, or topical. A GCRT is associated to each GCN\_SEQNO to identify that component of the generic drug formulation.

UPDATE:

A value representing whether the primary reproductive organs of NonPersonLivingSubject are present.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Reproductively intact

Reproductively neutered

http://www.gmdnagency.com/

UPDATE: Open Issue:It appears that the printnames are suboptimal and should be improved for many of the existing codes. en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Haven't a clue! Designation of a concept's state. Normally is not populated unless the state is retired.

Every morning at institution specified times.

At bedtime (institution specified time).

Two times a day at institution specified time

Regular business days (Monday to Friday excluding holidays)

Regular weekends (Saturday and Sunday excluding holidays)

Holidays

Easter Sunday. The Easter date is a rather complex calculation based on Astronomical tables describing full moon dates. Details can be found at \[http://www.assa.org.au/edm.html, and http://aa.usno.navy.mil/AA/faq/docs/easter.html\]. Note that the Christian Orthodox Holidays are based on the Julian calendar.

Good Friday, is the Friday right before Easter Sunday.

New Year's Day (January 1)

Pentecost Sunday, is seven weeks after Easter (the 50th day of Easter).

Christmas Eve (December 24)

Christmas Day (December 25)

**Description:**The Netherlands National Holidays.

**Description:**Liberation day (May 5 every five years)

**Description:**Queen's day (April 30)

**Description:**Sinterklaas (December 5)

United States National Holidays (public holidays for federal employees established by U.S. Federal law 5 U.S.C. 6103).

Columbus Day, the second Monday in October.

Independence Day (4th of July)

Alternative Monday after 4th of July Weekend \[5 U.S.C. 6103(b)\].

Alternative Friday before 4th of July Weekend \[5 U.S.C. 6103(b)\].

Labor Day, the first Monday in September.

Memorial Day, the last Monday in May.

Friday before Memorial Day Weekend

Saturday of Memorial Day Weekend

Dr. Martin Luther King, Jr. Day, the third Monday in January.

Washington's Birthday (Presidential Day) the third Monday in February.

Thanksgiving Day, the fourth Thursday in November.

Friday after Thanksgiving.

Veteran's Day, November 11.

Monthly at institution specified time.

Every afternoon at institution specified times.

Every hour at institution specified times.

Every 2 hours at institution specified times.

Every 3 hours at institution specified times.

Every 4 hours at institution specified time

Every 6 hours at institution specified time

Every 8 hours at institution specified times.

Every day at institution specified times.

Four times a day at institution specified time

Every other day at institution specified times.

Three times a day at institution specified time

Weekly at institution specified time.

Christian Holidays (Roman/Gregorian \[Western\] Tradition.)

Foreign key for the Active Ingredient Table that relates active ingredients to specific products.

Further information about this Code System can be found at https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database/read-file-drug-product-database-data-extract.html

Part of the active ingredient code number starting at position 3 and ending at position 7.

Further information about this Code System can be found at https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database/terminology.html

A Drug Identification Number (DIN) is a computer-generated eight digit number assigned by Health Canada to a drug product prior to being marketed in Canada. It uniquely identifies all drug products sold in a dosage form in Canada and is located on the label of prescription and over-the-counter drug products that have been evaluated and authorized for sale in Canada. A DIN uniquely identifies the following product characteristics:

* manufacturer * product name * active ingredient(s) * strength(s) of active ingredient(s) * pharmaceutical form, and * route of administration.

Note: The number has a leading zero.

Further information about this Code System can be found at https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/applications-submissions/guidance-documents/regulatory-requirements-drug-identification-numbers/document.html

The AIG number is a 10 digit number that identifies products that have the same active ingredient(s) and ingredient strength(s). The AIG is comprised of three portions:

* the first portion (2 digits) identifies the number of active ingredients * the second portion(5 digits) identifies the unique groups of active ingredients(s); * the last portion (3 digits) identifies the active ingredient group strength. The strength group has a tolerance of -2% to +10%.

Further information about this Code System can be found at https://www.canada.ca/en/health-canada/services/drugs-health-products/drug-products/drug-product-database/terminology.html

Natural Product Number (NPN) is an eight (8) digit numerical code assigned to each natural health product approved to be marketed under the Natural Health Products Regulations. A Homeopathic Medicine Number (DIN-HM) is an eight (8) digit numerical code assigned to each homeopathic medicine approved to be marketed under the Natural Health Products Regulations.

Further information about this Code System can be found at https://www.canada.ca/en/health-canada/services/drugs-health-products/natural-non-prescription/applications-submissions/product-licensing/licensed-natural-health-products-database.html

The HGNC is responsible for approving unique symbols and names for human loci, including protein coding genes, ncRNA genes and pseudogenes, to allow unambiguous scientific communication.

For each known human gene we approve a gene name and symbol (short-form abbreviation). All approved symbols are stored in the HGNC database,www.genenames.orghttps://www.genenames.org/tools/search, a curated online repository of HGNC-approved gene nomenclature, gene groups and associated resources including links to genomic, proteomic and phenotypic information. Each symbol is unique and we ensure that each gene is only given one approved gene symbol. It is necessary to provide a unique symbol for each gene so that we and others can talk about them, and this also facilitates electronic data retrieval from publications and databases.

HGNC gene symbols can be used with the HL7 coded data type. For example, in the HL7 messages specified according to the HL7 V2 Clinical Genomics Fully LOINC-Qualified Genetic Variation Model Implementation Guide, HGNC gene symbols can be used to as the observation values for gene identifiers. For example, OBX|1|CWE|48018-6^Gene identifier^||BRCA1^HGNC|

Versioning Information: The version of the HGNC database is reported using the last updated date and timestamp. The last updated date and timestamp is posted on the main HGNC Search screen in the format like "Monday March 30 23:00:56 2009".

HGNC is updated daily.

HGNC is a free database for the public.

Please see https://www.genenames.org/ for more info.

HGVS nomenclatures are the guidelines for mutation nomenclature made by the Human Genome Variation Society.

HGVS nomenclature can be used with the HL7 coded data type (code data type that accepts expression data, or a coded expression data type). This coded data type should be able to distinguish expressions in HGVS nomenclature from coded concepts. For example, in the HL7 messages specified according to the HL7 V2 Clinical Genomics Fully LOINC-Qualified Genetic Variation Model, HGVS nomenclature can be used to as the observation values for DNA sequence variations. For example, OBX|1|CWE|48004-6^DNA Sequence Variation^LN||c.1129C>T^^HGVS|

Versioning information: The HGVS nomenclature for the description of sequence variants was last modified Feb 20, 2008. The HGVS nomenclature for the description of protein sequence variants was last modified May 12, 2007. The HGVS nomenclature for the description of DNA sequence variants was last modified June 15, 2007 The HGVS nomenclature for the description of RNA sequence variants was last modified May 12, 2007

HGVS nomenclatures can be used freely by the public.

HHCC - Home Health Codes

Health Outcomes

HIBCC

UPDATE: Description:Codes for concepts describing the approval level of HL7 artifacts. This code system reflects the concepts expressed in HL7's Governance & Operations Manual (GOM) past and present. en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. A property that indicates the status of the concept. One of active, experimental, deprecated, or retired. Description:Content that is being presented to an international affiliate for consideration as a realm-specific draft standard for trial use. Description:Content that is being presented to an international affiliate for consideration as a realm-specific informative standard. Description:Content that is being presented to an international affiliate for consideration as a realm-specific normative standard. Description:Content that has passed ballot as a realm-specific draft standard for trial use. Description:Content that has passed ballot as a realm-specific informative standard. Description:Content that has passed ballot as a realm-specific normative standard Description:Content that has passed ballot as a draft standard for trial use. Description:Content that has passed ballot as a normative standard. Description:Content that has passed ballot as a normative standard. Description:Content prepared by a committee and submitted for internal consideration as an informative standard.Deprecation CommentNo longer supported as ballot statuses within the HL7 Governance and Operations Manual. Use normative or informative variants instead. Description:Content prepared by a committee and submitted for internal consideration as an informative standard.Deprecation CommentNo longer supported as ballot statuses within the HL7 Governance and Operations Manual. Use normative or informative variants instead. Description:Content that is under development and is not intended to be used. Description:Content that represents an adaption of a implementable balloted material to represent the needs or capabilities of a particular installation. Description:Content prepared by a committee and submitted for membership consideration as a draft standard for trial use. Description:Content prepared by a committee and submitted for membership consideration as an informative standard. Description:Content prepared by a committee and submitted for membership consideration as a normative standard. Description:Content developed independently by an organization or individual that is declared to be 'usable' but for which there is no present intention to submit through the standards submission and review process. Description:Content submitted to a committee for consideration for future inclusion in the standard. Description:Content intended to support other content that is subject to approval, but which is not itself subject to formal approval. Description:Content that represents an item that was at one point a normative or informative standard, but was subsequently withdrawn. UPDATE:

**** MISSING DEFINITIONS ****

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. Description:Provides sufficient information to allow the object identified to be contacted. This is likely to have the content of identified and confirmable plus telephone number. Description:This variant is a proper subset of universal and is intended to provide sufficient information to identify the object(s) modeled by the CMET. This variant is only suitable for use within TIGHTLY COUPLED SYSTEMS ONLY. This variant provides ONLY the ID (and code where applicable) and Name. Other variants may not be substituted at runtime. Description:This extends the identified variant by adding just sufficient additional information to allow the identity of object modeled to be confirmed by a number of corroborating items of data; for instance a patient's date of birth and current address. However, specific contact information, such as telephone number, are not viewed as confirming information. Description:Generally the same information content as "contactable" but using new "informational" CMETs as dependant CMETs. This flavor allows expression of the CMET when non-focal class information is not known. Description:Generally the same information content as "contactable", but with required (not mandatory) ids on entry point class. This flavor allows expression of the CMET even when mandatory information is not known. Description:Provides more than identified, but not as much as universal. There are not expected to be many of these. Description:This variant includes all attributes and associations present in the R-MIM. Any of non-mandatory and non-required attributes and/or associations may be present or absent, as permitted in the cardinality constraints.
UPDATE:

Holds the codes used to identify the committees and SIGS of HL7 in RIM repository tables.

Deprecation Comment:Deprecated as per 11/2008 Harmonization cleanup; internal and obsolete HL7 usage, no longer used.
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Modeling and Methodology

Technical Steering Committee

Control/Query/MasterFiles

Patient Administration

Orders/Observation

Financial Management

Information Management (Medical Records)

Scheduling & Referral

Patient Care

PRA Technical Committee

PRA Technical Committee

UPDATE:

These concepts represent theconformance requirments defined for including or valuing an element of an HL7 message. The concepts apply equally to conformance profiles defined for Version 2.x messgaes as defined by the Conformance SIG, and to the conformance columns for Version 3 messages as specified in the HMD.

Deprecation Comment:Deprecated as per 11/2008 Harmonization cleanup; internal and obsolete HL7 usage, no longer used.
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. An additional concept code that was also attributed to a concept

The message element must appear every time the message is communicated and its value must not be null. This condition is subject to the rules of multiplicity and conditionality. If a non-null default value is defined for the element, a null value may be communicated.

This message element may not appear when the message is communicated.

The message element may be populated or used by one system sponsor (or profile), but not by another. Each system sponsor or profile is required to state the ability to accept or send the message element as part of a conformance claim.

Pursuant to a profile or vendor conformance claim, the message element must appear every time the message is communicated, but the value may be communicated as null.

The message element must appear every time the message is communicated, but the value may be communicated as null.

Pursuant to a profile or vendor conformance claim, this message element may not appear when the message is communicated.

The message element is not mandatory, but its appearance may be constrained by one of the non-mandatory concepts.

UPDATE:

The styles of context conduction usable by relationships within a static model derived from tyhe HL7 Reference Information Model.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. Definition:Context conduction is defined using the contextConductionCode and contextConductionInd attributes on ActRelationship and Participation.UsageNotes:This approach is deprecated as of March, 2010. This approach is deprecated as of March, 2010. Definition:Context conduction is not explicitly defined. The recipient of an instance must infer conduction based on the semantics of the model and what is deemed "reasonable".UsageNotes:Because this approach can lead to variation in instance interpretation, its use is discouraged. Because this approach can lead to variation in instance interpretation, its use is discouraged. Definition:Context conduction is defined using the ActRelationship.blockedContextActRelationshipType and blockedContextParticipationType attributes and the "conductible" property on the ActRelationshipType and ParticipationType code systems.
UPDATE:

The property Ids that HL7 has defined for customizing Rational Rose.

Deprecation Comment:Deprecated as per 11/2008 Harmonization cleanup; internal and obsolete HL7 usage, no longer used.
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Holds the unique identifier of an Application Role (stereotype of class).

Records the constraints on the cardinality of attributes as documented in the RIM and in MIMs.

Holds the symbol for a defined data type (stereotype of class).

Used in constructing a Message Information Model to indicate which attributes to omit from the MIM.

Holds the id of the HL7 committee developing the model like "C00."

The HL7 MDF says that leaf level use cases should be connected to a state transition of the subject class. The use case diagram provides the link to the subject class. The modeler must use three properties to identify the state transition -- this property and the two following ones named StartState and StateTransition. The first two are, as their names imply, the names of the starting state and ending state of the transition, and the third is the name of the transition.

The identifier of the HMD from which the message structure for the message transferred by an interaction is drawn.

Holds the unique identifier of use cases, interactions and storyboards.

Holds the data type assigned to the generic type parameter when an instantiation of generic type is recorded.

Indicates that a data type definition is for a primitive data type (stereotype of class).

Indicates that the type for a data type component (attribute of a data type stereotype of class) is found by reference.

Set true for classes that are subject classes.

Used in a subject area category that holds a MIM. It provides the unique identifier for the MIM. The first portion of this identifier should be the ModelID of the RIM from which the MIM is derived.

Indicates with a value of "True" whether the inclusion of an attribute in an HMD and in the messages derived from that HMD is mandatory. The default is not mandatory, and use of mandatory inclusion in the RIM is deprecated.

Indicates with values of "True" or "False" whether an attribute may repeat in an HMD. The default is non-repeating.

A text version of the last modified date formatted like "19970606"

Contains the textual description of the model.

Holds the unique identifier assigned to this model.

Holds the formal name for the model

A text version of the version number like "V 30-08"

The identifier of the message structure within the HMD (above) that defines the message transferred by an interaction.

This is the organization defining the model, "Health\_Level\_Seven"

This property holds the identifier of the follow-on interaction, when the receiving application role for an interaction has the responsibility to initiate a follow-on interaction.

Captures the identifier of the responsible committee for all subject areas and categories.

(See description of EndState above).

For classes that are subject classes, this component provides the name of the state attribute for the class. Only one state attribute component may appear for a given class.

(See description of EndState above.)

This component can document the Version 2.3 datatype for an attribute that is related to or derived from data fields in HL7 Version 2.3.

This component provides a reference to the source Version 2.x field for an attribute that is related to or derived from data fields in HL7 Version 2.3 standard. Concatenate multiple values with commas, if multiple references to Version 2.x exist for an attribute.

Captures the identifier (name) of the vocabulary domain that constrains the values of coded attributes. This property is captured both for RIM attributes and in MIMs.

Captures the strength of encoding for the elements of a coded attribute. This property is captured both for RIM attributes and in MIMs.

This component tracks the version history of each element of the model. It contains the unique element identifier assigned to each model element. The repository assigns values for this element. Modelers should not change these values or assign new ones, but they may copy them to indicate an element's historic predecessor.

UPDATE: Description:Codes identifying types of HL7 Implementation Technology Specifications en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. Description:ITS based on the Universal Modeling Language. Description:ITS based on the Extensible Markup Language. UPDATE:

HL7 implementation technology specification versions. These codes will document the ITS type and version for message encoding. The code will appear in the instances based upon rules expressed in the ITS, and do not appear in the abstract message, either as it is presented to received from the ITS.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

XML ITS version 1 pre-release 1.

UPDATE: Description:Codes for HL7 publishing domains (specific content area) en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. Identifies the sub-section (target concept) of which this domain (source concept) is a part. ConceptRelationshipProperites: [isNavigable: false; functionalism: functional; reflexivity: irreflexive; symmetry: antisymetric; connected: false; transitivity: antitransitive; allowedForTargets: all codes from the hl7PublishingSubSection code system; requiredForSources: all codes from hl7PublishingDomain code system;] The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. Description:Represents the HL7 content "domain" that supports accounting and billing functions - and "provides support for the creation and management of patient billing accounts and the post of financial transactions against patient billing accounts for the purpose of aggregating financial transactions that will be submitted as claims or invoices for reimbursemen"UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports trigger event control act infrastructure - and "covers the alternate structures of the message Trigger Event Control Acts in the HL7 Composite Message."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that was defined as an "artificial listing" domain to support publication testing. Description:Represents the HL7 content "domain" that supports blood tissue and organ domain - and "comprises the models, messages, and other artIfacts that are needed to support messaging related to the process of blood, tissue, and organ banking operations such as donations, eligibility, storage, dispense, administration/transfusion, explantation, and implantation. "UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports the clinical document architecture.UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports clinical genomics - and includes " standards to enable the exchange of interrelated clinical and personalized genomic data between interested parties."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports transmission infrastructure - and " is primarily concerned with the data content of exchanges between healthcare applications, the sequence or interrelationships in the flow of messages and the communication of significant application level exceptions or error conditions."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports Coverage - and provides support for managing health care coverage in the reimbursement system(s).UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports the common product model - which "is used to improve the alignment between the different representations of products used within the body of HL7 Version 3 models."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports Claims and Reimbursement - and "provides support for Generic, Pharmacy, Preferred Accommodation, Physician, Oral Health Vision Care and Hospital claims for eligibility, authorization, coverage extension, pre-determination, invoice adjudication, payment advice and Statement of Financial Activity (SOFA) Release 3 of this document adds claims messaging support for Physician, Oral Health Vision Care and Hospital claims."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports a common clinical statement pattern - and "is a 'pattern' designed to be used within multiple HL7 Version 3 domain models. This pattern is intended to facilitate the consistent design of communications that convey clinical information to meet specific use cases."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports common model types - and "are a work product produced by a particular committee for expressing a common, useful and reusable concept."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that was created to support testing and initial set-up functions. Description:This domain has been retired in favor of "imaging integration" (II). Description:Represents the HL7 content "domain" that provides decision support.UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports Emergency Medical Services.UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports imaging integration - and is "comprises the models, implementation guides, sample documents and images that are needed to illustrate the transformation of DICOM structured reports to CDA Release 2 as well as the creation of CDA diagnostic imaging reports."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports immunization - and "describes communication of information about immunization: the administration of vaccines (and/or antisera) to individuals to prevent infectious disease."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports clinical laboratory functions - and is "comprises the models, messages, and other artifacts that are needed to support messaging related to laboratory tests or observations. "UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports medication - and "deals with the description of a medicine for the purposes of messaging information about medicines" and the applications of these descriptions.UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports master file infrastructure - and is "comprises the classes and attributes needed to support Master Files and Registries."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports Materials Management - and is "supports the simple scenario of a Materials Management application sending requests, notifications and queries to an auxiliary application. The intent is to establish a standard for the minimum functionality that is useful and comprehensive enough to explore the important concepts relative to inventory management."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports medical records - and is "supports clinical document management, and document querying."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports shared messages - and "are a work product produced for expressing common, useful and reusable message types."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports observations - and is "comprises the models, messages, and other artifacts that are needed to support messaging related to resulting basic healthcare diagnostic services. "UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports orders and observations - and will provide over-arching support information for the "Orders" (OR) and "Observations" (OB) domains.UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports orders - and "comprises the models, messages, and other artifacts that are needed to support messaging related to ordering basic healthcare services."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports Patient Administration - and "defines person and patient demographics and visit information about patients"UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports Care Provision - and "addresses the information that is needed for the ongoing care of individuals, populations, and other targets of care."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports public health - and is "the source of a number of Common Model Element Types (CMET) designed to meet the needs of public health data exchange."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports Personnel Management - and "spans a variety of clinical-administrative information functions associated with the organizations, individuals, animals and devices involved in the delivery and support of healthcare services."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports query infrastructure - and "specifies the formation of information queries and the responses to these queries to meet the needs of healthcare applications using the HL7 version 3 messaging standard."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports Quality Measures - and "is a standard for representing a health quality measure as an electronic document."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports Registries - and "collects HL7 artifacts for administrative registries."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports Informative Public Health.UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports Regulated Products - and "includes standards developed as part of the family of messages targeted for the exchange of information about regulated products and the exchange of the data needed to provide approval for such products."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports Public Health Reporting - and "includes messages and documents that are specifically designed to support managment, reporting and investigation in the public health context."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports Regulated Studies - and is "includes standards developed as part of the family of messages targeted for the exchange of information about the conduct of regulated studies, and the exchange of the data collected during those studies."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports pharmacy - and is a "model used to derive message patterns to describe and communicate processes related to medication."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports Scheduling - and "offers a generic set of messages and behavior to implement any number of Scheduling scenarios."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports Specimen - and "comprises the models and artifacts that are needed to support the creation of messaging related to specimen."UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. Description:Represents the HL7 content "domain" that supports Therapeutic Devices - and is "comprises the models, messages, and other artifacts that are needed to support messaging related to therapy delivery and observations made by a medical device. "UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications. UPDATE: Description:Codes for HL7 publishing sections (major business categories) en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. Description:Represents the HL7 V3 publishing section that deals with the administration and management of health care activities and organizations.UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications.

For publishing purposes, these domains are aggregated into sub-sections of related health care areas and these sub-sections are further aggregated into three major sets.

Description:Represents the HL7 V3 publishing section that deals with the health care provision and clinical management.UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications.

For publishing purposes, these domains are aggregated into sub-sections of related health care areas and these sub-sections are further aggregated into three major sets.

Description:Represents the HL7 V3 publishing section that deals with the definition and management of the computing and communication infrastructure necessary to support health care.UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications.

For publishing purposes, these domains are aggregated into sub-sections of related health care areas and these sub-sections are further aggregated into three major sets.

Description:Represents the HL7 V3 publishing section that holds specifications that are unassigned - that have not yet been assigned to one of the formal publishing sections.UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications.

For publishing purposes, these domains are aggregated into sub-sections of related health care areas and these sub-sections are further aggregated into three major sets.

UPDATE: Description:Codes for HL7 publishing sub-sections (business sub-categories) en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. Identifies the section (target concept) of which this subsection (source concept) is a part. ConceptRelationshipProperites: [isNavigable: false; functionalism: functional; reflexivity: irreflexive; symmetry: antisymetric; connected: false; transitivity: antitransitive; allowedForTargets: all codes from the hl7PublishingSection code system; requiredForSources: all codes from hl7PublishingSubSection code system;] The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. Description:Represents the HL7 V3 publishing sub-section that holds common or shared specifications within the Infrastructure Management (IM) section.UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications.

For publishing purposes, these domains are aggregated into sub-sections of related health care areas and these sub-sections are further aggregated into three major sets.

Description:Represents the HL7 V3 publishing sub-section that holds specifications related to the management of financial information within the Administrative Management (AM) section.UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications.

For publishing purposes, these domains are aggregated into sub-sections of related health care areas and these sub-sections are further aggregated into three major sets.

Description:Represents the HL7 V3 publishing sub-section that holds specifications related to the definition and control of interoperability messages within the Infrastructure Management (IM) section.UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications.

For publishing purposes, these domains are aggregated into sub-sections of related health care areas and these sub-sections are further aggregated into three major sets.

Description:Represents the HL7 V3 publishing sub-section that holds specifications related to master file and registry management activities within the Infrastructure Management (IM) section.UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications.

For publishing purposes, these domains are aggregated into sub-sections of related health care areas and these sub-sections are further aggregated into three major sets.

Description:Represents the HL7 V3 publishing sub-section that holds specifications related to managing clinical operations within the Health and Clinical Management (HM) section.UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications.

For publishing purposes, these domains are aggregated into sub-sections of related health care areas and these sub-sections are further aggregated into three major sets.

Description:Represents the HL7 V3 publishing sub-section that holds specifications related to the management of practice settings within the Administrative Management (AM) section.UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications.

For publishing purposes, these domains are aggregated into sub-sections of related health care areas and these sub-sections are further aggregated into three major sets.

Description:Represents the HL7 V3 publishing sub-section that holds specifications related to query/response activities within the Infrastructure Management (IM) section.UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications.

For publishing purposes, these domains are aggregated into sub-sections of related health care areas and these sub-sections are further aggregated into three major sets.

Description:Represents the HL7 V3 publishing sub-section that holds specifications related to the definition and communication of records of clinical care within the Health and Clinical Management (HM) section.UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications.

For publishing purposes, these domains are aggregated into sub-sections of related health care areas and these sub-sections are further aggregated into three major sets.

Description:Represents the HL7 V3 publishing sub-section that holds specifications related to the definition and communication of reasoning (knowledge) within the Health and Clinical Management (HM) section.UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications.

For publishing purposes, these domains are aggregated into sub-sections of related health care areas and these sub-sections are further aggregated into three major sets.

Description:Represents the HL7 V3 publishing sub-section that holds specifications that are unassigned - that have not yet been assigned to one of the formal publishing sections.UsageNote:V3 Specifications are published in a set of "domains", which contain interactions and related specifications for a single area of health care within which can be supported by a single, coherent set of interoperability specifications.

For publishing purposes, these domains are aggregated into sub-sections of related health care areas and these sub-sections are further aggregated into three major sets.

UPDATE: Description:Coded concepts representing Binding Realms (used for Context Binding of terminology in HL7 models) and/or Namespace Realms (used to help ensure unique identification of HL7 artifacts). This code system is partitioned into three sections: Affiliate realms, Binding realms and Namespace realms. All affiliate realm codes may automatically be used as both binding realms and namespace realms. Furthermore, affiliate realms are the only realms that have authority over the creation of binding realms. (Note that 'affiliate' includes the idea of both international affiliates and the HL7 International organization.) All other codes must be associated with an owning affiliate realm and must appear as a specialization of \_BindingRealm or \_NamespaceRealm. For affiliates whose concepts align with nations, the country codes from ISO 3166-1 2-character alpha are used for the code when possible so these codes should not be used for other realm types. It is recommended that binding realm and namespace codes submitted by affiliates use the realm code as a prefix to avoid possible collisions with ISO codes. However, tooling does not currently support namepace realm codes greater than 2 characters.Open Issue:The name of the concept property "owningAffiliate" should be changed to better reflect that the property value is the human readable name of the organizational entity that manages the Realm identified by the Realm Code.Open Issue:In spite of the inability of tooling to process codes longer than 2 characters, there is at least one realm codes ('SOA') that was added that is 3 characters in length. en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. Identifies the affiliate responsible for a binding realm or namespace realm code. Must be specified for all codes that are not specializations of AffiliateRealms. ConceptRelationshipProperties: [relationshipKind: other; isNavigable: false; functionalism: functional; reflexivity: irreflexive; symmetry: antisymetric; connected: false; transitivity: antitransitive; allowedForTargets: all codes from the hl7PublishingSection code system; requiredForSources: all codes which are not equal to ZZ and are not specializations of the abstract code AffiliateRealms; allowedForTargets: all codes which are specializations of the abstract code AffiliateRealms;] The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.. Description:Realm code for use of Argentina Description:Realm code for use of Austria Description:Realm code for use of Australia Description:Realm codes for official HL7 organizational bodies. This includes both the HL7 International organization as well as all recognized international affiliates (past and present). These groups have the ability to bind vocabulary and develop artifacts. As well, they have the ability to have "ownership" over other binding realms and namespace realms via the owningAffiliate property of those other realm codes. Description:Realm code for use of Brazil Description:Concepts that can be used as Binding Realms when creating Binding Statements. These codes are permitted to appear in the InfrastructureRoot.realmCode attribute. Description:Realm code for use of Unclassified Realm Description:Realm code for use of Canada Description:Realm code for use of Switzerland Description:Realm code for use of Chile Description:Realm code for use of China Description:Realm code for use of Localized Version Description:Realm code for use of Czech Republic Description:Realm code for use of Germany Description:Realm code for use of Denmark Description:Realm code for use of Spain Description:Realm code for use of Finland Description:Realm code for use of France Description:Realm code for use of Great Britain Description:Realm code for use of Greece Description:Realm code for use of Croatia Description:Realm code for use of Ireland Description:Realm code for use of India Description:Realm code for use of Italy Description:Realm code for use of Japan Description:Realm code for use of Korea Description:Realm code for use of Lithuania Description:Realm code for use of Mexico Description:Realm code for use of The Netherlands Description:Realm code for use of New Zealand Description:Codes that can be used in the "realm" portion of HL7 v3 artifact identifiers. Description:Realm code for use of Representative Realm Description:Realm code for use of Romania Description:Realm code for use of Russian Federation Description:Realm code for use of Sweden Description:Realm code for use of Localized Version Description:Realm code for use of Southern Africa Description:Realm code for use of Special Realms Description:Realm code for use of Turkey Description:Realm code for use of Taiwan Description:Realm code for use of United Kingdom Description:Realm code for use of United States of America Description:Realm code for use of Universal realm or context, used in every instance Description:Realm code for use of Uruguay Description:Realm code for use of Example Realm Description:An artifact created for local use only. This realm namespace has no owning affiliate. Its use is uncontrolled, i.e. anyone can create artifacts using this realm namespace. Because of this, there is a significant likelihood of artifact identifier collisions. Implementers are encouraged to register their artifacts under an affiliate owned and controlled namespace to avoid such collision problems where possible. UPDATE:

This code system holds version codes for the Version 3 standards. Values are to be determined by HL7 and added with each new version of the HL7 Standard.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired..

The complete set of normative, DSTU, proposed (under ballot) and draft artifacts as published in the ballot whose ballot cycle ended in January 2008.

The complete set of normative, DSTU, proposed (under ballot) and draft artifacts as published in the ballot whose ballot cycle ended in May 2008.

The complete set of normative, DSTU, proposed (under ballot) and draft artifacts as published in the ballot whose ballot cycle ended in September 2008.

The complete set of normative, DSTU, proposed (under ballot) and draft artifacts as published in the ballot whose ballot cycle ended in January 2009.

The complete set of normative, DSTU, proposed (under ballot) and draft artifacts as published in the ballot whose ballot cycle ended in May 2009.

The complete set of normative, DSTU, proposed (under ballot) and draft artifacts as published in the ballot whose ballot cycle ended in September 2009.

Definition:The complete set of normative, DSTU, proposed (under ballot) and draft artifacts as published in the ballot whose ballot cycle ended in January 2010. Definition:The complete set of normative, DSTU, proposed (under ballot) and draft artifacts as published in the ballot whose ballot cycle ended in May 2010. Definition:The complete set of normative, DSTU, proposed (under ballot) and draft artifacts as published in the ballot whose ballot cycle ended in September 2010. Definition:The complete set of normative, DSTU, proposed (under ballot) and draft artifacts as published in the ballot whose ballot cycle ended in January 2011. Definition:The complete set of normative, DSTU, proposed (under ballot) and draft artifacts as published in the ballot whose ballot cycle ended in May 2011. Definition:The complete set of normative, DSTU, proposed (under ballot) and draft artifacts as published in the ballot whose ballot cycle ended in September 2011. Definition:The complete set of normative, DSTU, proposed (under ballot) and draft artifacts as published in the ballot whose ballot cycle ended in January 2012. Definition:The complete set of normative, DSTU, proposed (under ballot) and draft artifacts as published in the ballot whose ballot cycle ended in May 2012. Definition:The complete set of normative, DSTU, proposed (under ballot) and draft artifacts as published in the ballot whose ballot cycle ended in September 2012.

The consistent set of messaging artefacts as published or contained in repositories in December of 2003, based on the latest version of any V3 models or artefacts (RIM, Datatypes, CMETS, Common Messages, Vocabularies) as available in December of 2003. Note: This versioncode does not cover the version of the XML ITS.

**Description:**The consistent set of normative and DSTU messaging artifacts as published or contained in repositories in December of 2004, based on the latest version of any V3 models or artifacts (RIM, Datatypes, CMETS, Common Messages, Vocabularies) as published under the title of Normative Edition 2005. Note: This versioncode does not cover the version of the XML ITS.

**Description:**The consistent set of normative and DSTU messaging artifacts as published or contained in repositories in December of 2005, based on the latest version of any V3 models or artifacts (RIM, Datatypes, CMETS, Common Messages, Vocabularies) as published under the title of Normative Edition 2006. Note: This versioncode does not cover the version of the XML ITS.

**Description:**The consistent set of normative and DSTU messaging artifacts as published or contained in repositories in December of 2006, based on the latest version of any V3 models or artifacts (RIM, Datatypes, CMETS, Common Messages, Vocabularies) published under the title of Normative Edition 2007. Note: This versioncode does not cover the version of the XML ITS.

Definition:The consistent set of normative and DSTU messaging artifacts as published or contained in repositories in December of 2007, based on the latest version of any V3 models or artifacts (RIM, Data Types, CMETS, Common Messages, Vocabularies) published under the title of Normative Edition 2008. Note: This version code does not cover the version of the XML ITS. Description:The consistent set of normative and DSTU messaging artifacts as published or contained in repositories in December of 2008, based on the latest version of any V3 models or artifacts (RIM, Data Types, CMETS, Common Messages, Vocabularies) published under the title of Normative Edition 2009. Note: This version code does not cover the version of the XML ITS. Definition:The consistent set of normative and DSTU messaging artifacts as published or contained in repositories in December of 2009, based on the latest version of any V3 models or artifacts (RIM, Data Types, CMETS, Common Messages, Vocabularies) published under the title of Normative Edition 2010. Note: This version code does not cover the version of the XML ITS. Definition:The consistent set of normative and DSTU messaging artifacts as published or contained in repositories in December of 2010, based on the latest version of any V3 models or artifacts (RIM, Data Types, CMETS, Common Messages, Vocabularies) published under the title of Normative Edition 2011. Note: This version code does not cover the version of the XML ITS. Definition:The consistent set of normative and DSTU messaging artifacts as published or contained in repositories in December of 2011, based on the latest version of any V3 models or artifacts (RIM, Data Types, CMETS, Common Messages, Vocabularies) published under the title of Normative Edition 2012. Note: This version code does not cover the version of the XML ITS.

Includes all material published as part of the ballot package released for vote in July-August 2003.

UPDATE:

The possible modes of updating that occur when an attribute is received by a system that already contains values for that attribute.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired..

**Description:**The item was (or is to be) added, having not been present immediately before. (If it is already present, this may be treated as an error condition.)

**Description:**The item was (or is to be) either added or replaced.

Description:AU: If this item exists, update it with these values. If it does not exist, create it with these values. If the item is part of the collection, update each item that matches this item, and if no items match, add a new item to the collection.

**Description:**The item was (or is to be) removed (sometimes referred to as deleted). If the item is part of a collection, delete any matching items.

Add the message element to the collection of items on the receiving system that correspond to the message element.

Change the item on the receiving system that corresponds to this message element; if a matching element does not exist, add a new one created with the values in the message.

Change the item on the receiving system that corresponds to this message element; do not process if a matching element does not exist.

Delete the item on the receiving system that corresponds to this message element.

Ignore this role, it is not relevant to the update.

**Description:**This item is part of the identifying information for this object.

**Description:**There was (or is to be) no change to the item. This is primarily used when this element has not changed, but other attributes in the instance have changed.

**Description:**The item existed previously and has (or is to be) revised. (If an item does not already exist, this may be treated as an error condition.)

**Description:**This item provides enough information to allow a processing system to locate the full applicable record by identifying the object.

**Description:**Description:</b>It is not specified whether or what kind of change has occurred to the item, or whether the item is present as a reference or identifying property.

Verify - this message element must match a value already in the receiving systems database in order to process the message.

These concepts apply when the element and/or message is updating a set of items.

UPDATE: Description:Identifies allowed codes for HL7aTMs v3 conformance property. en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. Description:Implementers receiving this property must not raise an error if the data is received, but will not perform any useful function with the data. This conformance level is not used in profiles or other artifacts that are specific to the "sender" or "initiator" of a communication. Description:All implementers are prohibited from transmitting this content, and may raise an error if they receive it. Description:All implementers must support this property. I.e. they must be able to transmit, or to receive and usefully handle the concept. Description:The element is considered "required" (i.e. must be supported) from the perspective of systems that consume instances, but is "undetermined" for systems that generate instances. Used only as part of specifications that define both initiator and consumer expectations. Description:The element is considered "required" (i.e. must be supported) from the perspective of systems that generate instances, but is "undetermined" for systems that consume instances. Used only as part of specifications that define both initiator and consumer expectations. Description:The conformance expectations for this element have not yet been determined. UPDATE: Description:Based on concepts for resolutions from HL7 ballot spreadsheet according to HL7's Governance & Operations Manual (GOM). en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. Description:The recommended change has been deferred to consideration for a future release. Description:The recommended change has been incorporated or identified issue has been answered. Description:An abstract concept grouping resolutions that can be applied to affirmative ballot comments. Description:The recommended change has been refused and is not expected to be incorporated. Description:An abstract concept grouping resolutions that can be applied to negative ballot comments. Description:Responsible group has recommended that the negative vote be considered non-substantive. (Issue raised does not provide sufficiently convincing reason to make changes to the item under ballot, or otherwise impede its adoption.) Description:Ballot group has voted and declared the negative vote non-substantive. Description:Responsible group has recommended that the negative vote be considered not-related. (Issue raised is not related to the current scope of the item under ballot, or does not prevent the item under ballot for being used for its defined intent. Recommended changes may be considered as part of future versions.) (Perhaps after further reading or explanation). Description:Ballot group has voted and declared the negative vote non-related. Description:Committee identifies that the same issue has been raised as part of a previous ballot on the same element version and was found by the ballot group to be non-substantive or not related.) Description:Voter has formally withdrawn their vote or comment as having been in error. (Perhaps after further reading or explanation). Description:Vote has not yet gone through resolution. Description:Voter has formally withdrawn their vote or comment on the basis of agreed changes or proposed future changes.

A classification of patient care locations within healthcare facilities for public health purposes.

UPDATE:

HtmlLinkType values are drawn from HTML 4.0 and describe the relationship between the current document and the anchor that is the target of the link

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Designates substitute versions for the document in which the link occurs. When used together with the lang attribute, it implies a translated version of the document. When used together with the media attribute, it implies a version designed for a different medium (or media).

Refers to a document serving as an appendix in a collection of documents.

Refers to a bookmark. A bookmark is a link to a key entry point within an extended document. The title attribute may be used, for example, to label the bookmark. Note that several bookmarks may be defined in each document.

Refers to a document serving as a chapter in a collection of documents.

Refers to a document serving as a table of contents. Some user agents also support the synonym ToC (from "Table of Contents").

Refers to a copyright statement for the current document.

Refers to a document providing a glossary of terms that pertain to the current document.

Refers to a document offering help (more information, links to other sources of information, etc.).

Refers to a document providing an index for the current document.

Refers to the next document in a linear sequence of documents. User agents may choose to preload the "next" document, to reduce the perceived load time.

Refers to the previous document in an ordered series of documents. Some user agents also support the synonym "Previous".

Refers to a document serving as a section in a collection of documents.

Refers to the first document in a collection of documents. This link type tells search engines which document is considered by the author to be the starting point of the collection.

Refers to an external style sheet. See the section on external style sheets for details. This is used together with the link type "Alternate" for user-selectable alternate style sheets.

Refers to a document serving as a subsection in a collection of documents.

ISBT 128 is a coding system for blood components, hematopoietic progenitor cells and other tissues. It is comprised of an overall Application Specification, and labeling and coding documents for the separate sections: blood components, hematopoietic progenitor cells (draft), source plasma (draft) and tissues (draft). The documentation is supported by databases: Country/Collection Facility, Product Code (blood components), Product Code (hematopoietic progenitor sells), Product Code (source plasma), Product Code (tissues) and Special Testing. ISBT 128 is designed as a series of data structures that are designed to be technology-independent and can be used for bar coding, radio frequency tag encoding and electronic data interchange. The HL7 Blood Bank SIG is currently designing example messages that incorporate ISBT 128 coding. No changes of any kind will be needed to use ISBT 128 in HL7 messages.

ICHPPC-2

International Classification of Diseases revision 10 (ICD 10)

International Statistical Classification of Diseases and Related Health Problems (ICD-10): Americanized Version. 10th rev. Geneva (Switzerland): World Health Organization, 1998.

ICD-10-CA (International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Canada) was developed by the World Health Organization (WHO) and enhanced by CIHI to meet Canadian morbidity data needs. ICD-10-CA classifies diseases, injuries and causes of death, as well as external causes of injury and poisoning. It also includes conditions and situations that are not diseases but represent risk factors to health, such as occupational and environmental factors, lifestyle and psychosocial circumstances.

The International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), describes the classification of morbidity and mortality information for statistical purposes and for the indexing of healthcare records by diseases. The ICD-10-CM codes can be used as the value of the Act.cd attribute.

ICD-10 allows dual coding. Refer to Section 3.1.3 of the ICD-10 Instruction Manual (2nd Edition, http://www.who.int/entity/classifications/icd/ICD-10\_2nd\_ed\_volume2.pdf).

This OID identifies the code system that describes how to encode Dual Coding in a CD compatible expression (for Datatypes R2 CD only).

An ICD-10 dual code expression SHALL consist of two ICD-10 codes separated by space. This code system SHALL NOT be used for single ICD-10 codes; the normal ICD-10 code system oid which is 2.16.840.1.113883.6.3 should be used in this case.

Dual code expressions SHALL only be used per the rules described in the ICD-10 instruction manual.

**An example CD:**<br></br> <example code="J21.8 B95.6" codeSystem="2.16.840.1.113883.6.260"><br></br> <originalText value="Staph aureus bronchiolitis"/><br></br> </example><br></br><br></br> Where:<br></br> J21.8 is: Acute bronchiolitis due to other specified organisms<br></br> B95.6 is: Staphylococcus aureus as the cause of diseases classified to other chapters

Hirs, W., H.W. Becker, C. van Boven, S.K. Oskam, I.M. Okkes, H. Lamberts. ICD-10, Dutch Translation, 200403. Amsterdam: Department of General Practice, Academic Medical Center/University of Amsterdam, Dutch College of General Practitioners (NHG), March 20

ICD Procedure Coding System (ICD 10 PCS)

ICD9

International Classification of Diseases revision 9, with Clinical Modifications (ICD 9 CM)

The International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), Volumes I, II (diagnoses) and III (procedures) describes the classification of morbidity and mortality information for statistical purposes and for the indexing of healthcare records by diseases and procedures. The ICD-9-CM codes can be used as the value of the Act.cd attribute.

The International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM), Volumes I, II (diagnoses) and III (procedures) describes the classification of morbidity and mortality information for statistical purposes and for the indexing of healthcare records by diseases and procedures. The ICD-9-CM codes can be used as the value of the Act.cd attribute.

ICD-9 Dual Coding Expression Syntax", description: ICD-9 allows dual coding. Refer to Section ?? of the ICD-9 Instruction Manual (ref?).

This OID identifies the code system that describes how to encode Dual Coding in a CD compatible expression (for Datatypes R2 CD only).

An ICD-9 dual code expression SHALL consist of two ICD-9 codes separated by space. This code system SHALL NOT be used for single ICD-9 codes; the normal ICD-9 code system oid which is 2.16.840.1.113883.6.3 should be used in this case. DisplayName SHALL not be used.

Dual code expressions SHALL only be used per the rules described in the ICD-9 instruction manual.

**An example CD:**<br></br><example code="989.5 E905.9" codeSystem="2.16.840.1.113883.6.261"><br></br><originalText value="ANAPHYLAXIS DUE TO BITE OR STING"/><br></br></example><br></br>Where 989.5 is: "Toxic effect of venom" and E905.9 is: "Bite or sting"

International Classification of Diseases for Oncology)

International Classification of Diseases for Oncology, version 3. For more information see http://www.who.int/classifications/icd/adaptations/oncology/en/.

ICNP(r) is a combinatorial terminology, using a multi-axial structure. ICNP(r) provides standardized terms and codes for terms in two classifications that can be used to compose or create pre-coordinated concepts to represent observations and procedures, specifically, patient problems/nursing diagnoses, nursing interventions including those focused on assessment and actual or expected (goal) outcomes. The ICNP(r) Classification for Nursing Phenomena is used to compose concepts or statements to represent observations (nursing diagnoses, patient problems, patient status, patient outcomes). The ICNP(r) Nursing Actions Classification is used to compose concepts or statements to represent procedures (nursing interventions)

The International Classification of Primary Care (ICPC). Denmark: World Organisation of Family Doctors, 1993. Various language translations are identified beneath this OID.

Hirs, W., H.W. Becker, C. van Boven, S.K. Oskam, I.M. Okkes, H. Lamberts. International Classification of Primary Care 2E: 2nd ed. electronic. Dutch Translation. Amsterdam: Department of General Practice, Academic Medical Center/University of Amsterdam, D

International Classification of Primary Care / prepared by the Classification Committee of the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA), known more briefly as the World

International Classification of Primary Care, Version 2-Plus. Produced by NLM. Bethesda (MD): National Library of Medicine, UMLS project. This node has the various modifications and translations produced under it.

International Classification of Primary Care, Version 2-Plus, Australian Modification. Americanized English Equivalents, January, 2000. Produced by NLM. Bethesda (MD): National Library of Medicine, UMLS project

International Classification of Primary Care, Version 2-Plus, Australian Modification. January, 2000

International Classification of Primary Care / prepared by the Classification Committee of the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA), known more briefly as the World

Becker, H.W., C. van Boven, S.K. Oskam, I.M. Okkes, W. Hirs, H. Lamberts. ICPC2 - ICD10 Thesaurus, Version March, 2004. Amsterdam: Project "Adaptation ICPC, integration and implementation of ICPC2 and ICD10(-CM)." Department of General Practice, Academic

A diagnostic Terminology for semi-automatic Double Coding in Electronic Patient Records

The thesaurus is a part of the CD Rom: "ICPC in the Amsterdam Transition Project. Extended Version. IM Okkes, SK Oskam, H. Lamberts. Amsterdam: Academic Medical Center/University of Amsterdam. Department of Family Medicine", see also the web site http://www.transitieproject.nl for this application of the thesaurus.

This bilingual (English/Dutch) ICPC2-ICD10 thesaurus is derived from an extended version of the CD-Rom ICPC in the Amsterdam Transition Project, that was published as a companion to ICPC-2-R by Oxford University Press (2005). As was the case with the former thesaurus (published in Dutch in 2003), the content of this new thesaurus may be copied for academic purposes, and be used for teaching and research under the usual referencing conditions. Any other and/or commercial use requires prior permission from the authors, represented by Dr. Inge Okkes (see below).

It is strongly recommended that you first go through the ICPC Tutorial, the Manual and the Glossary, and consider printing them.

Becker, H.W., C. van Boven, S.K. Oskam, I.M. Okkes, W. Hirs, H. Lamberts. ICPC2 - ICD10 Thesaurus, Version March, 2004. Amsterdam: Project "Adaptation ICPC, integration and implementation of ICPC2 and ICD10(-CM)." Department of General Practice, Academic

The International Classification of Primary Care (ICPC). Basque Translation. Denmark: World Organisation of Family Doctors, 1993.

The International Classification of Primary Care (ICPC). Danish Translation. Denmark: World Organisation of Family Doctors, 1993.

The International Classification of Primary Care (ICPC). Dutch Translation. Denmark: World Organisation of Family Doctors, 1993.

The International Classification of Primary Care (ICPC). Swedish Translation. Denmark: World Organisation of Family Doctors, 1993.

The International Classification of Primary Care (ICPC). Finnish Translation. Denmark: World Organisation of Family Doctors, 1993.

The International Classification of Primary Care (ICPC). French Translation. Denmark: World Organisation of Family Doctors, 1993.

The International Classification of Primary Care (ICPC). German Translation. Denmark: World Organisation of Family Doctors, 1993.

The International Classification of Primary Care (ICPC). Hebrew Translation, Denmark: World Organisation of Family Doctors, 1993

The International Classification of Primary Care (ICPC). Hungarian Translation. Denmark: World Organisation of Family Doctors, 1993.

The International Classification of Primary Care (ICPC). Italian Translation. Denmark: World Organisation of Family Doctors, 1993.

The International Classification of Primary Care (ICPC). Norwegian Translation. Denmark: World Organisation of Family Doctors, 1993.

The International Classification of Primary Care (ICPC). Portuguese Translation. Denmark: World Organisation of Family Doctors, 1993.

The International Classification of Primary Care (ICPC). Spanish Translation. Denmark: World Organisation of Family Doctors, 1993.

The International Classification of Primary Care (ICPC). Swedish Translation. Denmark: World Organisation of Family Doctors, 1993.

ICCS

International Classification of Sleep Disorders

UPDATE:

Specifies the reliability with which the identifier is known. This attribute MAY be used to assist with identifier matching algorithms.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. An additional concept code that was also attributed to a concept Description:The identifier was issued by the system responsible for constructing the instance. Description:The identifier was provided to the system that constructed the instance, but has not been verified. e.g. a Drivers license entered manually into a system by a user. Description:The identifier was not issued by the system responsible for constructing the instance, but the system that captured the id has verified the identifier with the issuing authority, or with another system that has verified the identifier.
UPDATE: Description:Codes to specify the scope in which the identifier applies to the object with which it is associated, and used in the datatype property II. en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. Description:An identifier whose scope is defined by the business practices associated with the object. In contrast to the other scope identifiers, the scope of the use of the id is not necessarily restricted to a single object, but may be reused for other objects closely associated with the object due to business practice. Description:The identifier associated with a particular object. It remains consistent as the object undergoes state transitions. Description:An identifier that references a particular object as it existed at a given point in time. The identifierSHALLchange with each state transition on the object. I.e. The version identifier of an object prior to a 'suspend' state transition is distinct from the identifier of the object after the state transition. Each version identifier can be tied to exactly one ControlAct event which brought that version into being (though the control act may never be instantiated).NOTE:Applications that do not support versioning of objects must ignore and not persist these ids to avoid confusion resulting from leaving the same identifier on an object that undergoes changes. Description:An identifier that references a particular object as it existed at a given point in time. The identifierSHALLchange with each state transition on the object.ExampleThe version identifier of an object prior to a 'suspend' state transition is distinct from the identifier of the object after the state transition. Each version identifier can be tied to exactly one ControlAct event which brought that version into being (though the control act may never be instantiated).NOTE:Applications that do not support versioning of objects must ignore and not persist these ids to avoid confusion resulting from leaving the same identifier on an object that undergoes changes.

Codes representing languages for which a person has some level of proficiency for written or spoken communication.

Examples:Spanish, Italian, German, English, American Sign, etc.

Older value from OID registry. Superceded; see recommendations in BCP-47.

UPDATE:

**** MISSING DESCRIPTION ****

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

This algorithm is defined in FIPS PUB 180-1: Secure Hash Standard. As of April 17, 1995.

This algorithm is defined in FIPS PUB 180-2: Secure Hash Standard.

ISO/IEC 21000-6:2004 describes a Rights Data Dictionary which comprises a set of clear, consistent, structured, integrated and uniquely identified terms to support the MPEG-21 Rights Expression Language (REL), ISO/IEC 21000-5. Annex A specifies the methodology for and structure of the RDD Dictionary, and specifies how further Terms may be defined under the governance of a Registration Authority, requirements for which are described in Annex C.

Taken together, these specifications and the RDD Dictionary and Database make up the RDD System. Use of the RDD System will facilitate the accurate exchange and processing of information between interested parties involved in the administration of rights in, and use of, Digital Items, and in particular it is intended to support ISO/IEC 21000-5 (REL). Clause 6 describes how ISO/IEC 21000-6:2004 relates to ISO/IEC 21000-5.

As well as providing definitions of terms for use in ISO/IEC 21000-5, the RDD System is designed to support the mapping of terms from different namespaces. Such mapping will enable the transformation of metadata from the terminology of one namespace (or Authority) into that of another namespace. Mapping, to ensure minimum ambiguity or loss of semantic integrity, will be the responsibility of the Registration Authority. Provision of automated trm look-up is also a requirement.

The RDD Dictionary is a prescriptive dctionary, in the sense that it defines a single meaning for a trm represented by a particular RddAuthorized TermName, but it is also inclusive in that it can recognize the prescription of other Headwords and definitions by other Authorities and incorporates them through mappings. The RDD Dictionary also supports the circumstance that the same name may have different meanings under different Authorities. ISO/IEC 21000-6:2004describes audit provisions so that additions, amendments and deletions to Terms and their attributes can be tracked.

ISO/IEC 21000-6:2004 recognizes legal definitions as and only as Terms from other Authorities that can be mapped into the RDD Dictionary. Therefore Terms that are directly authorized by the RDD Registration Authority neither define nor prescribe intellectual property rights or other legal entities.

This OID identifies the coding system published in the ISO 3166-1 Standard for Country codes. It contains 3 sets of synonyms for the country codes: 2-character alphabetic, 3-character alphabetic, and numeric. Note that this is the 2nd edition of the standard.

Identifies the coding system published in the ISO 3166-1 Standard for Country codes, 2nd edition, 2-character alphabetic codes.

Identifies the coding system published in the ISO 3166-1 Standard for Country codes, 2nd edition, 3-character alphabetic codes.

Identifies the coding system published in the ISO 3166-1 Standard for Country codes, 2nd edition, numeric codes.

Identifies the coding system published in the ISO 3166-2 Standard for Country Subdivision codes. This standard is released periodically, and a new OID will be assigned by ISO for new editions.

ISO 4217 currency codes.

Description:Codes for the Representation of Names of Languages Part 1: Alpha-2 Code. Used as part of the IETF 3066 specification for languages throughout the HL7 specification.

This part of ISO 639 provides a code consisting of language code elements comprising two-letter language identifiers for the representation of names of languages. The language identifiers according to this part of ISO 639 were devised originally for use in terminology, lexicography and linguistics, but may be adopted for any application requiring the expression of language in two- letter coded form, especially in computerized systems. The alpha-2 code was devised for practical use for most of the major languages of the world that are not only most frequently represented in the total body of the world's literature, but which also comprise a considerable volume of specialized languages and terminologies. Additional language identifiers are created when it becomes apparent that a significant body of documentation written in specialized languages and terminologies exists. Languages designed exclusively for machine use, such as computer-programming languages, are not included in this code.

The code set is available from http://www.iso.org/iso/iso\_catalogue/catalogue\_ics/catalogue\_detail\_ics.htm? csnumber=22109&ICS1=1&ICS2=140&ICS3=20

Codes for the Representation of Names of Languages Part 1: Alpha-2 Code. Used as part of the IETF 3066 specification for languages throughout the HL7 specification.

DeprecationComment:This code system is being deprecated, as the OID identifying it has been replaced with the correct ISO OID of 1.0.639.1
Description:Codes for the representation of names of languages, 3 character alphabetic codes. This has been superceded by ISO 639-3 for many purposes. ISO 639-2 was released in 1998.

The code set is available from http://www.iso.org/iso/iso\_catalogue/catalogue\_tc/catalogue\_detail.htm?csnumber=4767

Codes for the Representation of Names of Languages Part 2: Alpha-3 Code. Used as part of the IETF 3066 specification for languages throughout the HL7 specification.

DeprecationComment:This code system is being deprecated, as the OID identifying it has been replaced with the correct ISO OID of 1.0.639.2
Description:ISO 639-3 is a code that aims to define three-letter identifiers for all known human languages. At the core of ISO 639-3 are the individual languages already accounted for in ISO 639-2. The large number of living languages in the initial inventory of ISO 639-3 beyond those already included in ISO 639-2 was derived primarily from Ethnologue (15th edition). Additional extinct, ancient, historic, and constructed languages have been obtained from Linguist List.

SIL International has been designated as the ISO 639-3/RA for the purpose of processing requests for alpha-3 language codes comprising the International Standard, Codes for the representation of names of languages - Part 3: Alpha-3 code for comprehensive coverage of languages. The ISO 639-3/RA receives and reviews applications for requesting new language codes and for the change of existing ones according to criteria indicated in the standard. It maintains an accurate list of information associated with registered language codes which can be viewed on or downloaded from this website, and processes updates of registered language codes. Notification of pending and adopted updates are also distributed on a regular basis to subscribers and other parties.

IUPAC/IFCC Component Codes

IUPAC/IFCC Property Codes

Japanese Chemistry

UPDATE:

A value representing the method of expression of the language.

*Example:*Expressed spoken, expressed written, expressed signed, received spoken, received written, received signed.

OpenIssue:Description copied from Concept Domain of same name. Must be verified.
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.
UPDATE:

A value representing the level of proficiency in a language.

*Example:*Excellent, good, fair, poor.

OpenIssue:Description copied from Concept Domain of same name. Must be verified.
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.
UPDATE:

A code depicting the living arrangements of a person

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. Definition:A group living arrangement specifically for the care of those in need of temporary and crisis housing assistance. Examples include domestic violence shelters, shelters for displaced or homeless individuals, Salvation Army, Jesus House, etc. Community based services may be provided.

Group Home

Independent Household

Definition:Living arrangements lacking a permanent residence.

Institution

Nomadic

Nursing Home

Definition:A living arrangement within a private residence for single family.

Retirement Community

Definition:Assisted living in a single family residence for persons with physical, behavioral, or functional health, or socio-economic challenges. There may or may not be on-site supervision but the housing is designed to assist the client with developing independent living skills. Community based services may be provided.

Transient

Extended care facility

UPDATE:

Tells a receiver to ignore just the local markup tags (local\_markup, local\_header, local\_attr) when value="markup", or to ignore the local markup tags and all contained content when value="all"

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.
UPDATE:

A value representing the current state of control associated with the device.

Examples:A device can either work autonomously (localRemoteControlStateCode="Local") or it can be controlled by another system (localRemoteControlStateCode="Remote").Rationale:The control status of a device must be communicated between devices prior to remote commands being transmitted. If the device is not in "Remote" status then external commands will be ignored.
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

An equipment can either work autonomously ('Local' control state).

An equipment can be controlled by another system, e.g., LAS computer ('Remote' control state).

In collaboration with NCBI, the European Bioinformatics Institute (EBI) is developing the Locus Reference Genomic Sequences (LRG) database, which is a database of reference sequences.

LRG is a system for providing a genomic DNA sequence representation of a single gene that is idealized, has a permanent ID (with no versioning), and core content that never changes. LRG is not a nomenclature system. More than one LRG could be created for a region of interest, should that need arise. Additional annotations will be present that may change with time (each item carrying its own date stamp), so that the latest ancillary knowledge about a gene is directly available. In other words, an LRG sequence and its core annotation are not meant to represent current biology knowledge, but to provide a standard for reporting variation in a stable coordinate system. The combination of the LRG plus the updatable-annotation layer will be used to support the biological interpretation of variants.

LRG identifiers can be used with the HL7 coded data type (code data type that accepts expression data, or a coded expression data type). This coded data type will be gene symbols can be used with the HL7 coded data type. For example, in the HL7 messages specified according to the HL7 V2 Clinical Genomics Fully LOINC-Qualified Genetic Variation Model, LRG identifiers can be used to as the observation values for Genomic Reference Sequence Identifier (LOINC code: 48013-7).

LRG is a database that can be used freely by the public.

UPDATE:

Codes representing the defined possible states of a Managed Participation, as defined by the Managed Participation class state machine.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

The state representing the fact that the Participation is in progress.

The terminal state resulting from cancellation of the Participation prior to activation.

The terminal state representing the successful completion of the Participation.

The 'typical' state. Excludes "nullified" which represents the termination state of a participation instance that was created in error.

The state representing the termination of a Participation instance that was created in error.

The state representing that fact that the Participation has not yet become active.

UPDATE:

The closeness or quality of the mapping between the HL7 concept (as represented by the HL7 concept identifier) and the source coding system. The values are patterned after the similar relationships used in the UMLS Metathesaurus. Because the HL7 coding sy

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

The first concept is at a more abstract level than the second concept. For example, Hepatitis is broader than Hepatitis A, and endocrine disease is broader than Diabetes Mellitus. Broader than is the opposite of the narrower than relationship.

The two concepts have identical meaning.

The first concept is at a more detailed level than the second concept. For example, Pennicillin G is narrower than Pennicillin, and vellus hair is narrower than hair. Narrower than is the opposite of broader than.

UPDATE:

\* \* \* No description supplied \* \* \*

Open Issue:The specific meanings of these codes can vary somewhat by jurisdiction and implementation so caution should be used when determining equivalency.Open Issue:fixing and completion of the hierarchy and proper good definitions of all the concepts is badly needed.
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Marriage contract has been declared null and to not have existed

a marriage recognized in some jurisdictions and based on the parties' agreement to consider themselves married and can also be based on documentation of cohabitation.

This definition was based on https://www.merriam-webster.com/dictionary/common-law%20marriage.

Marriage contract has been declared dissolved and inactive

Subject to an Interlocutory Decree.

A current marriage contract is active

More than 1 current spouse

No marriage contract has ever been entered

Person declares that a domestic partner relationship exists.

Currently not in a marriage contract.

The spouse has died

The nomenclature relates primarily to vital signs monitoring, but also includes semantics of other medical devices that are commonly used in acute care settings. There are multiple coding partitions each of which has a systematic name consisting of a set of base concepts and differentiating criteria.

Medispan Drug Descriptor ID

Entry autogenerated to support Sources from the UMLS. Full metadata set still incomplete.

Medispan Diagnostic Codes

UPDATE: Deprecation Comment:Deprecated as per 11/2008 Harmonization cleanup; internal and obsolete HL7 usage, no longer used. en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

For attributes representing the location at which an organization, person, or item may be found or reached.

For attributes representing some concept. Note that names of individual things are not considered concepts.

For attributes representing communication addresses, such as telephones, fax, pagers, e-mail, Web-sites and other devices and their respective protocols. See also PHON.

For attributes representing a statement used to describe something.

For attributes representing a point in time at which an event happened or will happen. Levels of precision and variation are part of this concept and should usually not be specified in separate attributes.

For attributes representing formalized text that is to be evaluated primarily by computes. An attribute named "constraint\_text" is most likely such a formal expression and should be renamed to "constraint\_expr".

For attributes that represent a fraction or proportion. The former attribute type PCT for "percentage" is superceded by FRC and is no longer permitted. See also QTY.

For attributes that serve to identify some instance of an information model class. Note that real world Identifiers (e.g., SSN) exist not as attributes but as an association to a special information model class. The attribute type "id" without a prefix is reserved to be the main instance identifier of the class.

For attributes representing a specific condition as true or false.

For attributes representing dimensionless numbers. Note that there is a big conceptual difference between integer numbers and floating point numbers. See also QTY.

For attributes that represent a name by which an instance of the class is known.

For attributes representing telephone number of a telecommunication device. See also COM.

For attributes representing a quantity. The nature of the quantity must be further specified through the choice of data type and through additional constraints. For physical quantities (including elapsed time) the PQ data type must be used. For monetary amounts the MO data type must be used. Parallel unit attributes are not permitted in these cases. Counted objects are not physical quantities and the count nouns are not units of measure.

A range of time between a start and an end time having a duration. The range may be infinite or undefined on either side.

A range of time between a start and an end time having a duration. The range may be infinite or undefined on either side.

For attributes representing non-descriptive, non-naming text not targeted to human interpretation. Formal expressions evaluated by computers should use the EXPR attribute type instead.

For an attribute (e.g., Observation.value) that represents a value whose data type is determined dynamically and is not predefined by the static class diagram.

UPDATE:

Code to identify the source of a Message Element Type represented in the 'of MET' column of an HMD.

Deprecation Comment:Deprecated as per 11/2008 Harmonization cleanup; internal and obsolete HL7 usage, no longer used.
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

This message element type is an HL7 common message element type.

This message element type is an HL7 data type.

This row represents a reference to a previously defined type. Such a reference means that, in a given message, the message element instance for the current row is identical to the message element instance that instantiates the referred row.

New type. This row starts the definition of a new message element type. The subordinate rows beneath it compose the definition of the type. Each of these subordinate rows has the name of the message element type being defined in the In Message Element Type column. That name will be the same one that is in the Of Message Element Type of this row.

This row represents the recursive reuse of the message element type within which is appears. See 10.3.3.3.

This message element type was previously defined in this HMD and is being reused

UPDATE:

The row type codes for the tabular representation of a Hierarchical Message Description.

Deprecation Comment:Deprecated as per 11/2008 Harmonization cleanup; internal and obsolete HL7 usage, no longer used.
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Identifies an association leading from the "class" (or association) that is most directly above this row

Identifies an attribute of the "class" (or association) that is most directly above this row.

Identifies "class" in the HMD. There is only one class entry in a Hierarchical Message Definition. This is the root class for the message.

Always the first row of the table, identifies the particular Hierarchical Message Definition in the nomenclature of the HL7 Repository.

Identifies a message element that represents one of whatever is repeated in a collection

This row corresponds to a subcomponent of the row above; it would not normally be included in an HMD, but it is included in order to be able to state a constraint on the subtype. This is explained in 10.2.2.4.

UPDATE:

The row types for the tabular representation of an R-MIM.

Deprecation Comment:Deprecated as per 11/2008 Harmonization cleanup; internal and obsolete HL7 usage, no longer used.
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Identifies an association leading from the class that is most directly above this row

Identifies an attribute of the "class" that is most directly above this row

Identifies a "class" in the Refined Message Information Model

Always the first row of the table, identifies the particular Refined Message Information Model in the nomenclature of the HL7 Repository

This row corresponds to a subcomponent of the row above; it would not normally be included in an Refined Message Information Model, but it is included in order to be able to state a constraint on the subtype. This is explained in 10.2.2.4.

UPDATE:

The standard prefixes used in Rose for RIM subject areas that determine the role or function of each subject area.

Deprecation Comment:Deprecated as per 11/2008 Harmonization cleanup; internal and obsolete HL7 usage, no longer used.
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Holds classes that are of interest to the committee identified by the rest of the Subject Area Name.

Holds a sub-set of the RIM that is the domain information model for the committee identified by the rest of the Subject Area name.

Is one of a set of subject areas that hold the classes defined in the Reference Information Model (RIM).

Holds classes whose steward is the committee identified by the remaining portions of the Subject Area Name.

MedDRA is a multilingual standardised international medical terminology which can be used for regulatory communication and evaluation of data pertaining to medicinal products for human use. MedDRA is designed for use in the registration, documentation and safety monitoring of medicinal products through all phases of the development cycle (i.e., from clinical trials to post-marketing surveillance).#13;

MedDRA is structured as a five level hierarchy. System Organ Classes (SOCs) are the broadest terms (e.g., Cardiac disorders, Investigations). The lowest level of the terminology is the Lowest Level Term (LLT) level.

Medical Dictionary for Regulatory Activities Terminology (MedDRA), American English Equivalents, Version 7.0. Bethesda, MD: National Library of Medicine, March 1, 2004 This is the English language version as encapsulated in the UMLS..

Medical Dictionary for Regulatory Activities Terminology (MedDRA) Version 7.0, Dutch Edition. International conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). Reston, VA: MedDRA MSSO, March 1, 2004 This is the Dutch language version as encapsulated in the UMLS..

Medical Dictionary for Regulatory Activities Terminology (MedDRA), American English Equivalents with expanded abbreviations, Version 7.0. Bethesda, MD: National Library of Medicine, March 1, 2004.

Medical Dictionary for Regulatory Activities Terminology (MedDRA), with expanded abbreviations, Version 7.0. Bethesda, MD: National Library of Medicine, March 1, 2004.

Medical Dictionary for Regulatory Activities Terminology (MedDRA) Version 7.0, French Edition. International conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). Reston, VA: MedDRA MSSO, March 1, 2004 This is the French language version as encapsulated in the UMLS..

Medical Dictionary for Regulatory Activities Terminology (MedDRA) Version 7.0, German Edition. International conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). Reston, VA: MedDRA MSSO, March 1, 2004 This is the German language version as encapsulated in the UMLS..

Medical Dictionary for Regulatory Activities Terminology (MedDRA) Version 7.0, Portuguese Edition. International conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). Reston, VA: MedDRA MSSO, March 1, 2004. This is the Portuguese language version as encapsulated in the UMLS..

Medical Dictionary for Regulatory Activities Terminology (MedDRA) Version 7.0, Spanish Edition. International conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). Reston, VA: MedDRA MSSO, March 1, 2004. This is the Spanish language version as encapsulated in the UMLS..

Medical Economics Drug Codes

MEDCIN contains more than 175,000 clinical data elements arranged in a hierarchy, with each item having weighted links to relevant diagnoses. The clinical data elements are organized into six basic termtypes designed to accommodate information relevant to a clinical encounter. The basic termtypes in MEDCIN's terminological hierarchy are as follows:

Symptoms History Physical Examination Tests Diagnoses Therapy

Within this basic structure, MEDCIN terms are further organized in a ten level terminological hierarchy, supplemented by an optional, multi-hierarchical diagnostic index. For example, the symptom of "difficulty breathing" is placed in the terminological hierarchy as a subsidiary (or "child") finding of "pulmonary symptoms," although the presence (or absence) of difficulty breathing can related to conditions as diverse as myocardial infarction, bronchitis, pharyngeal foreign bodies, asthma, pulmonary embolism, etc. MEDCIN's diagnostic index provides more than 800 such links for difficulty breathing.

UPDATE:

Internet Assigned Numbers Authority (IANA) Mime Media Types. Identifies the type of the encapsulated data and identifies a method to interpret or render the data. The IANA defined domain of media types is established by the Internet standard RFC 2045 \[http://www.ietf.org/rfc/rfc2045.txt\] and 2046 \[http://www.ietf.org/rfc/rfc2046.txt\]. RFC 2046 defines the media type to consist of two parts:

  • top level media type, and

  • media subtype

However, this HL7 datatypes specification treats the entire media type as one atomic code symbol in the form defined by IANA, i.e., top level type followed by a slash "/" followed by media subtype. Currently defined media types are registered in a database \[http://www.iana.org/assignments/media-types/index.html\] maintained by IANA. Currently several hundred different MIME media types are defined, with the list growing rapidly. In general, all those types defined by the IANA MAY be used.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. An additional concept code that was also attributed to a concept

Application specific media type.

Digital Imaging and Communications in Medicine (DICOM) MIME type defined in RFC3240 \[http://ietf.org/rfc/rfc3240.txt\].

This format is very prone to compatibility problems. If sharing of edit-able text is required, text/plain, text/html or text/rtf should be used instead.

The Portable Document Format is recommended for written text that is completely laid out and read-only. PDF is a platform independent, widely deployed, and open specification with freely available creation and rendering tools.

Audio media type.

This is a format for single channel audio, encoded using 8bit ISDN mu-law \[PCM\] at a sample rate of 8000 Hz. This format is standardized by: CCITT, Fascicle III.4 -Recommendation G.711. Pulse Code Modulation (PCM) of Voice Frequencies. Geneva, 1972.

ADPCM allows compressing audio data. It is defined in the Internet specification RFC 2421 \[ftp://ftp.isi.edu/in-notes/rfc2421.txt\]. Its implementation base is unclear.

MPEG-1 Audio layer-3 is an audio compression algorithm and file format defined in ISO 11172-3 and ISO 13818-3. MP3 has an adjustable sampling frequency for highly compressed telephone to CD quality audio.

Image media type.

This is recommended only for fax applications.

GIF is a popular format that is universally well supported. However GIF is patent encumbered and should therefore be used with caution.

This format is required for high compression of high color photographs. It is a "lossy" compression, but the difference to lossless compression is almost unnoticeable to the human vision.

Portable Network Graphics (PNG) \[http://www.cdrom.com/pub/png\] is a widely supported lossless image compression standard with open source code available.

Although TIFF (Tag Image File Format) is an international standard it has many interoperability problems in practice. Too many different versions that are not handled by all software alike.

Model media type.

This is an openly standardized format for 3D models that can be useful for virtual reality applications such as anatomy or biochemical research (visualization of the steric structure of macromolecules)

Multipart Media Type

The HL7 clinical document Architecture, Level 1 MIME package.

For any text

For marked-up text according to the Hypertext Mark-up Language. HTML markup is sufficient for typographically marking-up most written-text documents. HTML is platform independent and widely deployed.

**Description:**For any plain text. This is the default and is used for a character string (ST) data type.

The Rich Text Format is widely used to share word-processor documents. However, RTF does have compatibility problems, as it is quite dependent on the word processor. May be useful if word processor edit-able text should be shared.

For structured character based data. There is a risk that general SGML/XML is too powerful to allow a sharing of general SGML/XML documents between different applications.

For compatibility, this represents the HL7 v2.x FT data type. Its use is recommended only for backward compatibility with HL7 v2.x systems.

Description:The content described by the CDA Narrative Block (not just used by CDA).

For structured character based data. There is a risk that general SGML/XML is too powerful to allow a sharing of general SGML/XML documents between different applications.

Video media type.

Video format by the Motion Picture Experts Group under ISO/IEC 14496

MPEG is an international standard, widely deployed, highly efficient for high color video; open source code exists; highly interoperable.

Proprietary video format from Apple, Inc.

A royalty-free audiovisual media file format.

The AVI file format is just a wrapper for many different codecs; it is a source of many interoperability problems.

Proprietary video format from Microsoft, Inc.

Medical Economics Diagnostic Codes

UPDATE: Deprecation Comment:Deprecated as per 11/2008 Harmonization cleanup; internal and obsolete HL7 usage, no longer used.This isn't referenced in the RIM and is a copy of old v2 codes. It's superseded by AcknowledgementDetailCode en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Success. Optional, as in version 2.x the AA conveys success. Used for systems that must always return a status code.

The message elements were not in the proper order, or required elements are missing.

A required message element is missing.

An element is represented by a data type that is not compatible with that which is allowable.

The value received for a common HL7 or user defined table was not found to match allowable table values.

The message type is not supported.

The identified interaction is not supported.

The ProcessingID is not supported.

The VersionID is not supported.

The identifier for a patient, order, etc. was not found. Occurs for transactions other than additions.

The identifier for a patient, order, etc. already exists. Occurs in response to addition transactions (e.g. new Admit, new Order, etc.).

The transaction could not be performed at the application storage level, e.g. database locked.

A catchall for internal errors not explicitly covered by other error codes.

UPDATE:

Indicates that the receiver has messages for the sender

OpenIssue:Description does not make sense relative to name of coding system. Must be reviewed and improved.
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The source concept code is "less than" the target concept in a strictly ordinal sense. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

High priority messages are available

Low priority messages are available

Medium priority messages are available

A collection of metabolic risk factors in one individual. The root causes of metabolic syndrome are overweight / obesity, physical inactivity, and genetic factors. Various risk factors have been included in metabolic syndrome. Factors generally accepted as being characteristic of this syndrome include abdominal obesity, atherogenic dyslipidemia, raised blood pressure, insulin resistence with or without glucose intolerance, prothrombotic state, and proinflammatory state.

Medispan GPI

UPDATE:

Indicates whether the subscription to a query is new or is being modified.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Modified subscription to a query server.

New subscription to a query server.

The Medical Subject Headings (MeSH) thesaurus is a controlled and hierarchically-organized vocabulary produced by the National Library of Medicine. It is used for indexing, cataloging, and searching of biomedical and health-related information. MeSH includes the subject headings appearing in MEDLINE/PubMed, the NLM Catalog, and other NLM databases.

MeSH can be downloaded from https://www.nlm.nih.gov/databases/download/mesh.html

MeSH can be browsed here: https://meshb.nlm.nih.gov/search

Henk Lamberts and Inge Hofmans-Okkes. International Classification of Primary Care 2nd Edition, Electronic, 2E, American English Equivalents. Amsterdam: International Classification of Primary Care / prepared by the Classification Committee of the World Health Organization. Entry derived from the UMLS Metathesaurus.

International Classification of Primary Care / prepared by the Classification Committee of the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA), known more briefly as the World

International Classification of Primary Care / prepared by the Classification Committee of the World Organization of National Colleges, Academies and Academic Associations of General Practitioners/Family Physicians (WONCA), known more briefly as the World

Metathesaurus Forms of Medical Dictionary for Regulatory Activities Terminology (MedDRA) Version 7.0, Spanish Edition. Bethesda, MD: National Library of Medicine, March 2004.

Broadly, the fields and values in the Multum Lexicon and the VantageRx Database are intended to be available for use in any HL7 message that includes a reference to non-veterinary drug products or active ingredients that are either approved for sale by the FDA or readily available in the United States. The following inter-related definitions recently circulated by us to the HL7 Vocabulary Technical Committee explain the scope of what we mean by "drug product" and "active ingredient". (A definition for "drug ingredient" is also provided here because the definition of "active ingredient" is reliant on this term.)

Drug Product A drug product is a manufactured or extemporaneously-compounded physiologically-active material intended by the preparer to achieve therapeutic, diagnostic, or preventative effects via biochemical mechanisms when applied to an epithelial surface or placed in an internal body space of a targeted organism.

Drug Ingredient A drug ingredient is a chemical compound or biologic agent that occurs in a drug product.

Active Ingredient An active ingredient is a drug ingredient that mediates one or more of the intended therapeutic, diagnostic, or preventative effects of a drug product and is present in sufficient quantities to achieve such effects according to the allopathic tradition of healthcare practice.

"The CDC's National Center for Immunization and Respiratory Diseases (NCIRDhttps://www.cdc.gov/ncird/)) developed and maintains HL7 Table 0227, Manufacturers of Vaccines (MVX). It includes both active and inactive manufacturers of vaccines in the US. Inactive MVX codes allow transmission of historical immunization records. When MVX code is paired with a CVX (vaccine administered) code, the specific trade named vaccine may be indicated. MVX is the underlying Master Code System for V2 table 0227 (Manufacturers Of Vaccines (code=MVX). The machine readable name for MVX in PHIN VADS is PH_VaccinesAdministeredCVX_CDC_NIP.

Status indicates if the manufacturer is currently making vaccine for distribution in the United States.

Last Updated indicates the last time this particular manufacturer code was updated in this table.

Questions regarding MVX should be directed to theIIS Technical Assistance Teammailto:iisinfo@cdc.gov)(or use https://www2.cdc.gov/vaccines/iis/iisstandards/vaccines.asp?rpt=mvx#addr."For more information, please seeherehttps://www2.cdc.gov/vaccines/iis/iisstandards/vaccines.asp?rpt=mvx.

NAACCR Cancer Registry

North American Industry Classification System(NAICS) for the United States, a new economic classification system that replaces the 1987 Standard Industrial Classification (SIC) for statistical purposes. NAICS is a system for classifying establishments by type of economic activity. Its purposes are: (1) to facilitate the collection, tabulation, presentation, and analysis of data relating to establishments, and (2) to promote uniformity and comparability in the presentation of statistical data describing the economy. NAICS will be used by Federal statistical agencies that collect or publish data by industry.

The NANDA-I classification is a set of nursing diagnoses developed by the NANDA International. This purpose of the terminology is to provide nursing diagnoses used to describe patients’ responses to actual or potential health problems and life processes responses to diseases rather than classifying the conditions of diseases and disorders.

NCI Thesaurus NCI Thesaurus is a biomedical thesaurus created specifically to meet the needs of the cancer research community, especially those engaged in translational research NCI Thesaurus is produced by the NCI Enterprise Vocabulary Services project. The NCI Thesaurus is provided under an open content license.

The National Drug File RT (NDF-RT) is published by the US Veterans' Administration (VA). NDF-RT covers clinical drugs used at the VA. The NCI version of NDF-RT is used by NCI to provide automated terminology access to the Food and Drug Administration (FDA) Structured Product Label (SPL) initiative. NCI makes its version of NDF-RT available publicly thru the Web, download via FTP and via open APIs for Java, SOAP and HTTP.

National drug codes

National Drug Data File Plus Source Vocabulary 2004. San Bruno, CA: First DataBank, March 11, 2004.

This entry was generated to support the Sources in the UMLS. Additional metadata is still missing.

NHSN Blood Stream Infection Risk Factors

NHSN Hip Replacement

NHSN Infection Type

NHSN Knee Replacement

NHSN Laboratory Confirmed Bloodstream Infection Pathways

NHSN Occasion Of Detection

NHSN Procedure Category

NHSN Spinal Fusion Approach

NHSN Spinal Fusion Level

NHSN Surgical Site Infection Anatomic Site

NHSN SSI LocationType

NHSN Summary Data

NHSN HAI Vocabulary used for Single Value bindingsto Observation Identifier

NIC provides names and values for procedures/orders/service intent related to the treatment activities of nurses and other providers who may perform the same treatment activities. Names, definitions, and associated codes are attached for 486 interventions. Defining activities (anywhere from ten to several dozen) are listed for each of the interventions in the NIC classification book but are not attached to this document.

The NMDS is the minimum set of items of information with uniform definitions and categories concerning the specific dimension of the context of patient care delivery. It represents the minimum data used to support the management and administration of patient/nursing care delivery across all types of settings.

The NMMDS is the minimum set of items of information with uniform definitions and categories concerning the specific dimension of the context of patient care delivery. It represents the minimum data used to support the management and administration of patient/nursing care delivery across all types of settings. The NMMDS is composed of seventeen (17) data elements organized into three categories: environment, nurse resources, and financial resources. See Tables 1-3 for the elements and related definitions organized by each categories. The NMMDS most appropriately focuses at the first level of accountability for patient/client/family/community nursing care: this may be the delivery unit, service, or center of excellence level. The NMMDS supports numerous constructed variables as well as aggregation of data at the unit, institution, network, and system, etc levels. This minimum data set provides the structure for the collection of uniform information that influences quality of patient care, directly and indirectly.

NOC - Nursing Outcome Codes

National Uniform Billing Council, UB 92

The Provider Taxonomy Code List is published (released) twice a year on July 1st and January 1st. The July publication is effective for use on October 1st and the January publication is effective for use on April 1st. The time between the publication release and the effective date is considered an implementation period to allow providers, payers and vendors an opportunity to incorporate any changes into their systems. This listing includes Active codes approved for use effective April 1st, 2003, version 3.0; and codes that are New and approved for use effective October 1st, 2003, version 3.1.

It was identified that there is an IP licensure issue with the republishing of the content for this code system by HL7, so the content was removed as of the July 2016 Harmonization cycle release. This external code system content may be accessed from the web page located at http://www.nucc.org/index.php/code-sets-mainmenu-41/provider-taxonomy-mainmenu-40. Multiple formats and means of accessing the content are available from this page. Note this code system stub has been retired; it is missing the copyright information, and has been superceded.

UPDATE:

A collection of codes specifying why a valid value is not present.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired..

Information was sought but not found (e.g., patient was asked but didn't know)

**Description:**An actual value may exist, but it must be derived from the provided information (usually an EXPR generic data type extension will be used to convey the derivation expressionexpression .

**Description:**The value as represented in the instance is not a member of the set of permitted data values in the constrained value domain of a variable.

There is information on this item available but it has not been provided by the sender due to security, privacy or other reasons. There may be an alternate mechanism for gaining access to this information.

Note: using this null flavor does provide information that may be a breach of confidentiality, even though no detail data is provided. Its primary purpose is for those circumstances where it is necessary to inform the receiver that the information does exist without providing any detail.

Known to have no proper value (e.g., last menstrual period for a male).

This information has not been sought (e.g., patient was not asked)

Information is not available at this time but it is expected that it will be available later.

Information is not available at this time (with no expectation regarding whether it will or will not be available in the future).

**Description:**The value is exceptional (missing, omitted, incomplete, improper). No information as to the reason for being an exceptional value is provided. This is the most general exceptional value. It is also the default exceptional value.

Negative infinity of numbers.

Value is not present in a message. This is only defined in messages, never in application data! All values not present in the message must be replaced by the applicable default, or no-information (NI) as the default of all defaults.

**Description:**The actual value is not a member of the set of permitted data values in the constrained value domain of a variable. (e.g., concept not provided by required code system).

**Usage Notes**: This flavor and its specializations are most commonly used with the CD datatype and its flavors. However, it may apply to \*any\* datatype where the constraints of the type are tighter than can be conveyed. For example, a PQ that is for a true measured amount whose units are not supported in UCUM, a need to convey a REAL when the type has been constrained to INT, etc.

With coded datatypes, this null flavor may only be used if the vocabulary binding has a coding strength of CNE. By definition, all local codes and original text are part of the value set if the coding strength is CWE.

This flavor and its specializations are most commonly used with the CD datatype and its flavors. However, it may apply to *any* datatype where the constraints of the type are tighter than can be conveyed. For example, a PQ that is for a true measured amount whose units are not supported in UCUM, a need to convey a REAL when the type has been constrained to INT, etc. With coded datatypes, this null flavor may only be used if the vocabulary binding has a coding strength of CNE. By definition, all local codes and original text are part of the value set if the coding strength is CWE.

Positive infinity of numbers.

**Description:**The specific quantity is not known, but is known to be non-zero and is not specified because it makes up the bulk of the material. e.g. 'Add 10mg of ingredient X, 50mg of ingredient Y, and sufficient quantity of water to 100mL.' The null flavor would be used to express the quantity of water.

The content is greater than zero, but too small to be quantified.

Description:The actual value has not yet been encoded within the approved value domain.

**Example**: Original text or a local code has been specified but translation or encoding to the approved value set has not yet occurred due to limitations of the sending system. Original text has been captured for a PQ, but not attempt has been made to split the value and unit or to encode the unit in UCUM.

**Usage Notes**: If it is known that it is not possible to encode the concept, OTH should be used instead. However, use of UNC does not necessarily guarantee the concept will be encodable, only that encoding has not been attempted.

Data type properties such as original text and translations may be present when this null flavor is included.

If it is known that it is not possible to encode the concept, OTH should be used instead. However, use of UNC does not necessarily guarantee the concept will be encodable, only that encoding has not been attempted. Data type properties such as original text and translations may be present when this null flavor is included.

**Description:**A proper value is applicable, but not known.

**Usage Notes**: This means the actual value is not known. If the only thing that is unknown is how to properly express the value in the necessary constraints (value set, datatype, etc.), then the OTH or UNC flavor should be used. No properties should be included for a datatype with this property unless:

  • Those properties themselves directly translate to a semantic of "unknown". (E.g. a local code sent as a translation that conveys 'unknown')

  • Those properties further qualify the nature of what is unknown. (E.g. specifying a use code of "H" and a URL prefix of "tel:" to convey that it is the home phone number that is unknown.)

This means the actual value is not known. If the only thing that is unknown is how to properly express the value in the necessary constraints (value set, datatype, etc.), then the OTH or UNC flavor should be used. No properties should be included for a datatype with this property unless: Those properties themselves directly translate to a semantic of "unknown". (E.g. a local code sent as a translation that conveys 'unknown') Those properties further qualify the nature of what is unknown. (E.g. specifying a use code of "H" and a URL prefix of "tel:" to convey that it is the home phone number that is unknown.)
UPDATE:

High level observation categories for the general type of observation being made.

URL: http://hl7-fhir.github.io/valueset-observation-category.html

This is an inline code system http://hl7.org/fhir/observation-category.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Observations generated by physical exam findings including direct observations made by a clinician and use of simple instruments and the result of simple maneuvers performed directly on the patient's body.

Observations generated by imaging. The scope includes observations, plain x-ray, ultrasound, CT, MRI, angiography, echocardiography, nuclear medicine.

The results of observations generated by laboratories. Laboratory results are typically generated by laboratories providing analytic services in areas such as chemistry, hematology, serology, histology, cytology, anatomic pathology, microbiology, and/or virology. These observations are based on analysis of specimens obtained from the patient and submitted to the laboratory.

Observations generated by other procedures. This category includes observations resulting from interventional and non-interventional procedures excluding lab and imaging (e.g. cardiology catheterization, endoscopy, electrodiagnostics, etc.). Procedure results are typically generated by a clinician to provide more granular information about component observations made during a procedure, such as where a gastroenterologist reports the size of a polyp observed during a colonoscopy.

The Social History Observations define the patient's occupational, personal (e.g. lifestyle), social, and environmental history and health risk factors, as well as administrative data such as marital status, race, ethnicity and religious affiliation.

Assessment tool/survey instrument observations (e.g. Apgar Scores, Montreal Cognitive Assessment (MoCA))

Observations generated by non-interventional treatment protocols (e.g. occupational, physical, radiation, nutritional and medication therapy)

Clinical observations measure the body's basic functions such as such as blood pressure, heart rate, respiratory rate, height, weight, body mass index, head circumference, pulse oximetry, temperature, and body surface area.

UPDATE:

One or more codes providing a rough qualitative interpretation of the observation, such as "normal" / "abnormal", "low" / "high", "better" / "worse", "resistant" / "susceptible", "expected" / "not expected". The value set is intended to be for ANY use where coded representation of an interpretation is needed.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. A property that indicates the status of the concept. One of active, experimental, deprecated, or retired.

The result is below the minimum detection limit (the test procedure or equipment is the limiting factor).

Synonyms: Below analytical limit, low off scale.

The result is above the maximum quantifiable limit (the test procedure or equipment is the limiting factor).

Synonyms: Above analytical limit, high off scale.

The result or observation value is outside the reference range or expected norm (as defined for the respective test procedure).

\[Note: Typically applies to non-numeric results.\]

The result or observation value is outside a reference range or expected norm at a level at which immediate action should be considered for patient safety (as defined for the respective test procedure).

\[Note: Typically applies to non-numeric results. Analogous to critical/panic limits for numeric results.\]

A valid result cannot be obtained for the specified component / analyte due to the presence of anti-complementary substances in the sample.

Deprecation Comment:This code is being deprecated to match the status in V2 Table 0078 "Interpretation Codes.

The current result or observation value has improved compared to the previous result or observation value (the change is significant as defined in the respective test procedure).

\[Note: This can be applied to quantitative or qualitative observations.\]

The patient is considered as carrier based on the testing results. A carrier is an individual who carries an altered form of a gene which can lead to having a child or offspring in future generations with a genetic disorder.

The patient is considered as carrier based on the testing results. A carrier is an individual who carries an altered form of a gene which can lead to having a child or offspring in future generations with a genetic disorder.

Deprecation Comment:This code is currently the same string as the print name for this concept and is inconsistent with the conventions being used for the other codes in the coding system, as it is a full word with initial capitalization, rather than an all upper case mnemonic. The recommendation from OO is to deprecate the code "Carrier" and to add "CAR" as the new active code representation for this concept.

The current result has decreased from the previous result for a quantitative observation (the change is significant as defined in the respective test procedure).

The measurement of the specified component / analyte, organism or clinical sign above the limit of detection of the performed test or procedure.

The test or procedure was successfully performed, but the results are borderline and can neither be declared positive / negative nor detected / not detected according to the current established criteria.

The observation/test result is interpreted as being outside the inclusion range for a particular protocol within which the result is being reported.

Example:A positive result on a Hepatitis screening test.Open Issue:EX, HX, LX: These three concepts do not seem to meet a clear need in the vocabulary, and their use in observation interpretation appears likely to be covered by other existing concepts (e.g., A, H, L). The only apparent significant difference is their reference to use in protocols for exclusion of study subjects. These concepts/codes were proposed by RCRIM for use in the CTLaboratory message. They were submitted and approved in the November 2005 Harmonization cycle in proposal "030103C\_VOCAB\_RCRIM\_l\_quade\_RCRIM Obs Interp\_20051028154455". However, this proposal was not fully implemented in the vocabulary. The proposal recommended creation of the x\_ClinicalResearchExclusion domain in ObservationInterpretation with a value set including those three concepts/codes, but there is no subdomain of that name or equivalent with a binding to either of the value sets that contain these concepts/codes. Members of the OO WG have recently attempted to contact members of RCRIM regarding these concepts, both by email and at the recent WGM in Atlanta, without response. It is felt by OO that the best course of action to take at this time is to add this comprehensive Open Issue rather than deprecate these three concepts at this time, until further discussion is held.

This result has been evaluated in light of known contraindicators. Once those contraindicators have been taken into account the result is determined to be "Expected" (e.g., presence of drugs in a patient that is taking prescription medication for pain management).

The result for a quantitative observation is above the upper limit of the reference range (as defined for the respective test procedure).

Synonym: Above high normal

A test result that is significantly higher than the reference (normal) or therapeutic interval, but has not reached the critically high value and might need special attention, as defined by the laboratory or the clinician.

\[Note: This level is situated between 'H' and 'HH'.\]

Deprecation Comment:The code 'H>' is being deprecated in order to align with the use of the code 'HU' for "Very high" in V2 Table 0078 "Interpretation Codes".

\[Note: The use of code 'H>' is non-preferred, as this code is deprecated and on track to be retired; use code 'HU' instead.

The result for a quantitative observation is above a reference level at which immediate action should be considered for patient safety (as defined for the respective test procedure).

Synonym: Above upper panic limits.

Hold for Medical Review

Usage Note:This code is not intended for use in V3 artifacts. It is included in the code system to maintain alignment with the V2 Table 0078 "Interpretation Codes."

A test result that is significantly higher than the reference (normal) or therapeutic interval, but has not reached the critically high value and might need special attention, as defined by the laboratory or the clinician.

The observation/test result is interpreted as being outside the inclusion range for a particular protocol within which the result is being reported.

Example:A positive result on a Hepatitis screening test.Open Issue:EX, HX, LX: These three concepts do not seem to meet a clear need in the vocabulary, and their use in observation interpretation appears likely to be covered by other existing concepts (e.g., A, H, L). The only apparent significant difference is their reference to use in protocols for exclusion of study subjects. These concepts/codes were proposed by RCRIM for use in the CTLaboratory message. They were submitted and approved in the November 2005 Harmonization cycle in proposal "030103C\_VOCAB\_RCRIM\_l\_quade\_RCRIM Obs Interp\_20051028154455". However, this proposal was not fully implemented in the vocabulary. The proposal recommended creation of the x\_ClinicalResearchExclusion domain in ObservationInterpretation with a value set including those three concepts/codes, but there is no subdomain of that name or equivalent with a binding to either of the value sets that contain these concepts/codes. Members of the OO WG have recently attempted to contact members of RCRIM regarding these concepts, both by email and at the recent WGM in Atlanta, without response. It is felt by OO that the best course of action to take at this time is to add this comprehensive Open Issue rather than deprecate these three concepts at this time, until further discussion is held.

Bacterial strain inhibited in vitro by a concentration of an antimicrobial agent that is associated with uncertain therapeutic effect. Reference: CLSI (http://www.clsi.org/Content/NavigationMenu/Resources/HarmonizedTerminologyDatabase/Harmonized\_Terminolo.htm) Projects: ISO 20776-1, ISO 20776-2

\[Note 1: Bacterial strains are categorized as intermediate by applying the appropriate breakpoints in a defined phenotypic test system.\]

\[Note 2: This class of susceptibility implies that an infection due to the isolate can be appropriately treated in body sites where the drugs are physiologically concentrated or when a high dosage of drug can be used.\]

\[Note 3: This class also indicates a "buffer zone," to prevent small, uncontrolled, technical factors from causing major discrepancies in interpretations.\]

\[Note 4: These breakpoints can be altered due to changes in circumstances (e.g., changes in commonly used drug dosages, emergence of new resistance mechanisms).\]

There is insufficient evidence that the species in question is a good target for therapy with the drug. A categorical interpretation is not possible.

\[Note: A MIC with "IE" and/or a comment may be reported (without an accompanying S, I or R-categorization).\]

The specified component / analyte, organism or clinical sign could neither be declared positive / negative nor detected / not detected by the performed test or procedure.

Usage Note:For example, if the specimen was degraded, poorly processed, or was missing the required anatomic structures, then "indeterminate" (i.e. "cannot be determined") is the appropriate response, not "equivocal".

The result for a quantitative observation is below the lower limit of the reference range (as defined for the respective test procedure).

Synonym: Below low normal

A test result that is significantly lower than the reference (normal) or therapeutic interval, but has not reached the critically low value and might need special attention, as defined by the laboratory or the clinician.

\[Note: This level is situated between 'L' and 'LL'.\]

Deprecation Comment:The code 'L<' is being deprecated in order to align with the use of the code 'LU' for "Very low" in V2 Table 0078 "Interpretation Codes".

\[Note: The use of code 'L<' is non-preferred, as this code is deprecated and on track to be retired; use code 'LU' instead.

The result for a quantitative observation is below a reference level at which immediate action should be considered for patient safety (as defined for the respective test procedure).

Synonym: Below lower panic limits.

A test result that is significantly lower than the reference (normal) or therapeutic interval, but has not reached the critically low value and might need special attention, as defined by the laboratory or the clinician.

The numeric observation/test result is interpreted as being below the low threshold value for a particular protocol within which the result is being reported.

Example:A Total White Blood Cell Count falling below a protocol-defined threshold value of 3000/mm^3Open Issue:EX, HX, LX: These three concepts do not seem to meet a clear need in the vocabulary, and their use in observation interpretation appears likely to be covered by other existing concepts (e.g., A, H, L). The only apparent significant difference is their reference to use in protocols for exclusion of study subjects. These concepts/codes were proposed by RCRIM for use in the CTLaboratory message. They were submitted and approved in the November 2005 Harmonization cycle in proposal "030103C\_VOCAB\_RCRIM\_l\_quade\_RCRIM Obs Interp\_20051028154455". However, this proposal was not fully implemented in the vocabulary. The proposal recommended creation of the x\_ClinicalResearchExclusion domain in ObservationInterpretation with a value set including those three concepts/codes, but there is no subdomain of that name or equivalent with a binding to either of the value sets that contain these concepts/codes. Members of the OO WG have recently attempted to contact members of RCRIM regarding these concepts, both by email and at the recent WGM in Atlanta, without response. It is felt by OO that the best course of action to take at this time is to add this comprehensive Open Issue rather than deprecate these three concepts at this time, until further discussion is held.

The patient is considered as carrier based on the testing results. A carrier is an individual who carries an altered form of a gene which can lead to having a child or offspring in future generations with a genetic disorder.

Deprecation Comment:This antimicrobial susceptibility test interpretation concept is recommended by OO to be deprecated as it is no longer recommended for use in susceptibility testing by CLSI (reference CLSI document M100-S22; Vol. 32 No.3; CLSI Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Second Informational Supplement. Jan 2012).

The result or observation value is within the reference range or expected norm (as defined for the respective test procedure).

\[Note: Applies to numeric or non-numeric results.\]

Use when not enough clinical trial data published by the Clinical and Laboratory Standards Institutes (CLSI) is available to establish the breakpoints for susceptible / intermediate and resistant.

The presence of the specified component / analyte, organism or clinical sign could not be determined within the limit of detection of the performed test or procedure.

An absence finding of the specified component / analyte, organism or clinical sign based on the established threshold of the performed test or procedure.

\[Note: Negative does not necessarily imply the complete absence of the specified item.\]

An absence finding used to indicate that the specified component / analyte did not react measurably with the reagent.

A category used for isolates for which only a susceptible interpretive criterion has been designated because of the absence or rare occurrence of resistant strains. Isolates that have MICs above or zone diameters below the value indicated for the susceptible breakpoint should be reported as non-susceptible.

NOTE 1: An isolate that is interpreted as non-susceptible does not necessarily mean that the isolate has a resistance mechanism. It is possible that isolates with MICs above the susceptible breakpoint that lack resistance mechanisms may be encountered within the wild-type distribution subsequent to the time the susceptible-only breakpoint is set.

NOTE 2: For strains yielding results in the "nonsusceptible" category, organism identification and antimicrobial susceptibility test results should be confirmed.

Synonym: decreased susceptibility.

Interpretation qualifiers in separate OBX segments

Usage Note:This code is not intended for use in V3 artifacts. It is included in the code system to maintain alignment with the V2 Table 0078 "Interpretation Codes."

Interpretations of the presence or absence of a component / analyte or organism in a test or of a sign in a clinical observation. In keeping with laboratory data processing practice, these concepts provide a categorical interpretation of the "meaning" of the quantitative value for the same observation.

Interpretation of the observed result taking into account additional information (contraindicators) about the patient's situation. Concepts in this category are mutually exclusive, i.e., at most one is allowed.

A presence finding of the specified component / analyte, organism or clinical sign based on the established threshold of the performed test or procedure.

A result cannot be considered valid for the specified component / analyte or organism due to failure in the quality control testing component.

Deprecation Comment:This code is being deprecated to match the status in V2 Table 0078 "Interpretation Codes.

Bacterial strain inhibited in vitro by a concentration of an antimicrobial agent that is associated with a high likelihood of therapeutic failure. Reference: CLSI (http://www.clsi.org/Content/NavigationMenu/Resources/HarmonizedTerminologyDatabase/Harmonized\_Terminolo.htm) Projects: ISO 20776-1, ISO 20776-2

\[Note 1: Bacterial strains are categorized as resistant by applying the appropriate breakpoints in a defined phenotypic test system.\]

\[Note 2: This breakpoint can be altered due to changes in circumstances (e.g., changes in commonly used drug dosages, emergence of new resistance mechanisms).\]

A presence finding used to indicate that the specified component / analyte reacted with the reagent above the reliably measurable limit of the performed test.

Interpretations of the presence and level of reactivity of the specified component / analyte with the reagent in the performed laboratory test.

Bacterial strain inhibited by in vitro concentration of an antimicrobial agent that is associated with a high likelihood of therapeutic success. Reference: CLSI (http://www.clsi.org/Content/NavigationMenu/Resources/HarmonizedTerminologyDatabase/Harmonized\_Terminolo.htm) Synonym (earlier term): Sensitive Projects: ISO 20776-1, ISO 20776-2

\[Note 1: Bacterial strains are categorized as susceptible by applying the appropriate breakpoints in a defined phenotypic system.\]

\[Note 2: This breakpoint can be altered due to changes in circumstances (e.g., changes in commonly used drug dosages, emergence of new resistance mechanisms).\]

A category that includes isolates with antimicrobial agent minimum inhibitory concentrations (MICs) that approach usually attainable blood and tissue levels and for which response rates may be lower than for susceptible isolates.

Reference: CLSI document M44-A2 2009 "Method for antifungal disk diffusion susceptibility testing of yeasts; approved guideline - second edition" - page 2.

A category for isolates where the bacteria (e.g. enterococci) are not susceptible in vitro to a combination therapy (e.g., high-level aminoglycoside and cell wall active agent). This is predictive that this combination therapy will not be effective.

Usage Note:Since the use of penicillin or ampicillin alone often results in treatment failure of serious enterococcal or other bacterial infections, combination therapy is usually indicated to enhance bactericidal activity. The synergy between a cell wall active agent (such as penicillin, ampicillin, or vancomycin) and an aminoglycoside (such as gentamicin, kanamycin or streptomycin) is best predicted by screening for high-level bacterial resistance to the aminoglycoside.Open Issue:The print name of the code is very general and the description is very specific to a pair of classes of agents, which may lead to confusion of these concepts in the future should other synergies be found.

A category for isolates where the bacteria (e.g. enterococci) are susceptible in vitro to a combination therapy (e.g., high-level aminoglycoside and cell wall active agent). This is predictive that this combination therapy will be effective.

Usage Note:Since the use of penicillin or ampicillin alone often results in treatment failure of serious enterococcal or other bacterial infections, combination therapy is usually indicated to enhance bactericidal activity. The synergy between a cell wall active agent (such as penicillin, ampicillin, or vancomycin) and an aminoglycoside (such as gentamicin, kanamycin or streptomycin) is best predicted by screening for high-level bacterial resistance to the aminoglycoside.Open Issue:The print name of the code is very general and the description is very specific to a pair of classes of agents, which may lead to confusion of these concepts in the future should other synergies be found.

A valid result cannot be obtained for the specified organism or cell line due to the presence of cytotoxic substances in the sample or culture.

Deprecation Comment:This code is being deprecated to match the status in V2 Table 0078 "Interpretation Codes.

The current result has increased from the previous result for a quantitative observation (the change is significant as defined in the respective test procedure).

This result has been evaluated in light of known contraindicators. Once those contraindicators have been taken into account the result is determined to be "Unexpected" (e.g., presence of non-prescribed drugs in a patient that is taking prescription medication for pain management).

The patient is considered as carrier based on the testing results. A carrier is an individual who carries an altered form of a gene which can lead to having a child or offspring in future generations with a genetic disorder.

Deprecation Comment:This antimicrobial susceptibility test interpretation concept is recommended by OO to be deprecated as it is no longer recommended for use in susceptibility testing by CLSI (reference CLSI document M100-S22; Vol. 32 No.3; CLSI Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Second Informational Supplement. Jan 2012).

The current result or observation value has degraded compared to the previous result or observation value (the change is significant as defined in the respective test procedure).

\[Note: This can be applied to quantitative or qualitative observations.\]

A weighted presence finding used to indicate that the specified component / analyte reacted with the reagent, but below the reliably measurable limit of the performed test.

Codes that specify interpretation of genetic analysis, such as "positive", "negative", "carrier", "responsive", etc.

Interpretations of change of quantity and/or severity. At most one of B or W and one of U or D allowed.

Technical exceptions resulting in the inability to provide an interpretation. At most one allowed. Does not imply normality or severity.

Interpretation of normality or degree of abnormality (including critical or "alert" level). Concepts in this category are mutually exclusive, i.e., at most one is allowed.

Interpretations of anti-microbial susceptibility testing results (microbiology). At most one allowed.

UPDATE:

A code that provides additional detail about the means or technique used to ascertain the observation.

Examples:Blood pressure measurement method: arterial puncture vs. sphygmomanometer (Riva-Rocci), sitting vs. supine position, etc.OpenIssue:Description copied from Concept Domain of same name. Must be verified. Note that the Domain has a full discussion about use of the attribute and constraining that is not appropriate for the code system description. Needs to be improved.
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.. Haven't a clue!

Complement fixation

Computed axial tomography

Susceptibility, High Level Aminoglycoside Resistance agar test

Visual, Macroscopic observation

Computed, Magnetic resonance

Computed, Morphometry

Computed, Positron emission tomography

SAMHSA drug assay confirmation

SAMHSA drug assay screening

Serum Neutralization

Titration

Ultrasound

X-ray crystallography

Agglutination

Agglutination, Buffered acidified plate

Agglutination, Card

Agglutination, Hemagglutination

Agglutination, Hemagglutination inhibition

Agglutination, Latex

Agglutination, Plate

Agglutination, Rapid Plate

Agglutination, RBC

Agglutination, Rivanol

Agglutination, Tube

Bioassay

Bioassay, Animal Inoculation

Bioassay, Cytotoxicity

Bioassay, Embryo Infective Dose 50

Bioassay, Embryo Lethal Dose 50

Bioassay, Mouse intercerebral inoculation

Bioassay, qualitative

Bioassay, quantitative

Chemical

Chemical, Differential light absorption

Chemical, Dipstick

Chemical, Dipstick colorimetric laboratory test

Chemical, Test strip

Chromatography

Chromatography, Affinity

Chromatography, Gas liquid

Chromatography, High performance liquid

Chromatography, Liquid

Chromatography, Protein A affinity

Coagulation

Coagulation, Tilt tube

Coagulation, Tilt tube reptilase induced

Count, Automated

Count, Manual

Count, Platelet, Rees-Ecker

Culture, Aerobic

Culture, Anaerobic

Culture, Chicken Embryo

Culture, Delayed secondary enrichment

Culture, Microaerophilic

Culture, Quantitative microbial, cup

Culture, Quantitative microbial, droplet

Culture, Quantitative microbial, filter paper

Culture, Quantitative microbial, pad

Culture, Quantitative microbial, pour plate

Culture, Quantitative microbial, surface streak

Culture, Somatic Cell

Diffusion, Agar

Diffusion, Agar Gel Immunodiffusion

Electrophoresis

Electrophoresis, Agaorse gel

Electrophoresis, citrate agar

Electrophoresis, Immuno

Electrophoresis, Polyacrylamide gel

Electrophoresis, Starch gel

ELISA

ELISA, antigen capture

ELISA, avidin biotin peroxidase complex

ELISA, Kinetic

ELISA, peroxidase-antiperoxidase

Identification, API 20 Strep

Identification, API 20A

Identification, API 20C AUX

Identification, API 20E

Identification, API 20NE

Identification, API 50 CH

Identification, API An-IDENT

Identification, API Coryne

Identification, API Rapid 20E

Identification, API Staph

Identification, API ZYM

Identification, Bacterial

Identification, mini VIDAS

Identification, Phage susceptibility typing

Identification, Quad-FERM+

Identification, RAPIDEC Staph

Identification, Staphaurex

Identification, VIDAS

Identification, Vitek

Identification, VITEK 2

Immune stain

Immune stain, Immunofluorescent antibody, direct

Immune stain, Immunofluorescent antibody, indirect

Immune stain, Immunoperoxidase, Avidin-Biotin Complex

Immune stain, Immunoperoxidase, Peroxidase anti-peroxidase complex

Immune stain, Immunoperoxidase, Protein A-peroxidase complex

Immunoassay

Immunoassay, qualitative, multiple step

Immunoassay, qualitative, single step

Immunoassay, Radioimmunoassay

Immunoassay, semi-quantitative, multiple step

Immunoassay, semi-quantitative, single step

Microscopy

Microscopy, Darkfield

Microscopy, Electron

Microscopy, Electron microscopy tomography

Microscopy, Electron, negative stain

Microscopy, Electron, thick section transmission

Microscopy, Electron, thin section transmission

Microscopy, Light

Microscopy, Polarized light

Microscopy, Scanning electron

Microscopy, Transmission electron

Microscopy, Transparent tape direct examination

Molecular, 3 Self-Sustaining Sequence Replication

Molecular, Branched Chain DNA

Molecular, Hybridization Protection Assay

Molecular, Immune blot

Molecular, In-situ hybridization

Molecular, Ligase Chain Reaction

Molecular, Ligation Activated Transcription

Molecular, Nucleic Acid Probe

Molecular, Nucleic acid probe

Molecular, Nucleic acid probe with amplification

Rationale:Duplicate of code 0126. Use code 0126 instead.

Molecular, Nucleic acid probe with target amplification

Molecular, Nucleic acid reverse transcription

Molecular, Nucleic Acid Sequence Based Analysis

Molecular, Polymerase chain reaction

Molecular, Q-Beta Replicase or probe amplification category method

Molecular, Restriction Fragment Length Polymorphism

Molecular, Southern Blot

Molecular, Strand Displacement Amplification

Molecular, Transcription Mediated Amplification

Molecular, Western Blot

Precipitation, Flocculation

Precipitation, Immune precipitation

Precipitation, Milk ring test

Precipitation, Precipitin

Stain, Acid fast

Stain, Acid fast, fluorochrome

Stain, Acid fast, Kinyoun's cold carbolfuchsin

Stain, Acid fast, Ziehl-Neelsen

Stain, Acid phosphatase

Stain, Acridine orange

Stain, Active brilliant orange KH

Stain, Alazarin red S

Stain, Alcian blue

Stain, Alcian blue with Periodic acid Schiff

Stain, Argentaffin

Stain, Argentaffin silver

Stain, Azure-eosin

Stain, Basic Fuschin

Stain, Bennhold

Stain, Bennhold's Congo red

Stain, Bielschowsky

Stain, Bielschowsky's silver

Stain, Bleach

Stain, Bodian

Stain, Brown-Brenn

Stain, Butyrate-esterase

Stain, Calcofluor white fluorescent

Stain, Carbol-fuchsin

Stain, Carmine

Stain, Churukian-Schenk

Stain, Congo red

Stain, Cresyl echt violet

Stain, Crystal violet

Stain, De Galantha

Stain, Dieterle silver impregnation

Stain, Fite-Farco

Stain, Fontana-Masson silver

Stain, Fouchet

Stain, Gomori

Stain, Gomori methenamine silver

Stain, Gomori-Wheatly trichrome

Stain, Gridley

Stain, Grimelius silver

Stain, Grocott

Stain, Grocott methenamine silver

Stain, Hale's colloidal ferric oxide

Stain, Hale's colloidal iron

Stain, Hansel

Stain, Harris regressive hematoxylin and eosin

Stain, Hematoxylin and eosin

Stain, Highman

Stain, Holzer

Stain, Iron hematoxylin

Stain, Jones

Stain, Jones methenamine silver

Stain, Kossa

Stain, Lawson-Van Gieson

Stain, Loeffler methylene blue

Stain, Luxol fast blue with cresyl violet

Stain, Luxol fast blue with Periodic acid-Schiff

Stain, MacNeal's tetrachrome blood

Stain, Mallory-Heidenhain

Stain, Masson trichrome

Stain, Mayer mucicarmine

Stain, Mayers progressive hematoxylin and eosin

Stain, May-Grunwald Giemsa

Stain, Methyl green

Stain, Methyl green pyronin

Stain, Modified Gomori-Wheatly trichrome

Stain, Modified Masson trichrome

Stain, Modified trichrome

Stain, Movat pentachrome

Stain, Mucicarmine

Stain, Neutral red

Stain, Night blue

Stain, Non-specific esterase

Stain, Oil red-O

Stain, Orcein

Stain, Perls'

Stain, Phosphotungstic acid-hematoxylin

Stain, Potassium ferrocyanide

Stain, Prussian blue

Stain, Putchler modified Bennhold

Stain, Quinacrine fluorescent

Stain, Reticulin

Stain, Rhodamine

Stain, Safranin

Stain, Schmorl

Stain, Seiver-Munger

Stain, Silver

Stain, Specific esterase

Stain, Steiner silver

Stain, Sudan III

Stain, Sudan IVI

Stain, Sulfated alcian blue

Stain, Supravital

Stain, Thioflavine-S

Stain, Three micron Giemsa

Stain, Vassar-Culling

Stain, Vital

Stain, von Kossa

Susceptibility, Antibiotic sensitivity, disk

Susceptibility, BACTEC susceptibility test

Susceptibility, Disk dilution

Susceptibility, Minimum bactericidal concentration, macrodilution

Susceptibility, Minimum bactericidal concentration, microdilution

Susceptibility, Minimum Inhibitory concentration, macrodilution

Susceptibility, Minimum Inhibitory concentration, microdilution

Turbidometric

Turbidometric, Refractometric

Chromatography, Thin Layer

Immunoassay, enzyme-multiplied technique (EMIT)

Flow Cytometry

Radial Immunodiffusion

Immunoassay, Fluorescence Polarization

Electrophoresis, Immunofixation

Dialysis, Direct Equilibrium

Acid Elution, Kleihauer-Betke Method

Immunofluorescence, Anti-Complement

Gas Chromatography/Mass Spectroscopy

Light Scatter, Nephelometry

Immunoassay, IgE Antibody Test

Lymphocyte Microcytotoxicity Assay

Spectrophotometry

Spectrophotometry, Atomic Absorption

Electrochemical, Ion Selective Electrode

Chromatography, Gas

Isoelectric Focusing

Immunoassay, Chemiluminescent

Immunoassay, Microparticle Enzyme

Inductively-Coupled Plasma/Mass Spectrometry

Immunoassay, Immunoradiometric Assay

Coagulation, Photo Optical Clot Detection

Testing to measure the minimum concentration of the antibacterial agent in a given culture medium below which bacterial growth is not inhibited.

Testing to measure the minimum concentration of the antibacterial agent in a given culture medium below which bacterial growth is not inhibited.

Test methods designed to determine a microorganismaTMs susceptibility to being killed by an antibiotic.

Reaching a decision through the application of an algorithm designed to weigh the different factors involved.

Average of non-null values in the referenced set of values

Reaching a decision through the use of Bayesian statistical analysis.

Count of non-null values in the referenced set of values

Reaching a decision by consideration of the totality of factors involved in order to reach a judgement.

Largest of all non-null values in the referenced set of values.

The median of all non-null values in the referenced set of values.

Smallest of all non-null values in the referenced set of values.

The most common value of all non-null values in the referenced set of values.

Description:Polymerase Chain Reaction

Standard Deviation of the values in the referenced set of values, computed over the population.

Standard Deviation of the values in the referenced set of values, computed over a sample of the population.

Sum of non-null values in the referenced set of values

Variance of the values in the referenced set of values, computed over the population.

Variance of the values in the referenced set of values, computed over a sample of the population.

Verification by means of document.

Example:Fax, letter, attachment to e-mail.

verification by means of a response to an electronic query

Example:query message to a Covered Party registry application or Coverage Administrator.

Verification by means of electronic token.

Example:smartcard, magnetic swipe card, RFID device.

Verification by means of voice.

Example:By speaking with or calling the Coverage Administrator or Covered Party

**Description:**Provides additional methodology information not present in the associated AllergyTestCode term.

**Description:**Used in a patient care message to value simple clinical (non-lab) observation methods, such as found in SOAP (subjective, objective, assessment, plan) progress notes: subjective section (used for history from patient and other informants); objective section (used for physical exam, lab, and other common results), and assessment section (used for the clinicians assessment of the implications of subjective and objective sections).

Provides codes for decision methods, initially for assessing the causality of events.

A code that provides additional detail about the means or technique used to ascertain the genetic analysis. Example, PCR, Micro Array

Provides additional detail about the aggregation methods used to compute the aggregated values for an observation. This is an abstract code.

UPDATE:

This code system covers all concepts of HL7-defined values for the Observation value element, when it has a coded datatype.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. A property that indicates the status of the concept. One of active, experimental, deprecated, or retired.

**Description:**Patient exhibits no reaction to the challenge agent.

**Description:**Patient exhibits a minimal reaction to the challenge agent.

**Description:**Patient exhibits a mild reaction to the challenge agent.

**Description:**Patient exhibits moderate reaction to the challenge agent.

**Description:**Patient exhibits a severe reaction to the challenge agent.

Security metadata observation values used to indicate the use of a more abstract version of the content, e.g., replacing exact value of an age or date field with a range, or remove the left digits of a credit card number or SSN.

Indication of abuse victim.

Definition:Coverage is in effect for healthcare service(s) and/or product(s). Definition:Coverage is in effect for healthcare service(s) and/or product(s) - Pending Investigation

**Description:**Child over an age as specified by coverage policy or program, e.g., student, differently abled, and income dependent.

Indicator of adoption.

Security metadata observation values used to indicate the use of an algorithmic combination of actual values with the result of an aggregate function, e.g., average, sum, or count in order to limit disclosure of an IT resource (data, information object, service, or system capability) to the minimum necessary.

Security provenance metadata observation value used to indicate that an IT resource (data, or information object) was asserted by a Artificial Intelligence (e.g. Clinical Decision Support, Machine Learning, Algorithm).

Code specifying that the measure uses all-or-nothing scoring. All-or-nothing scoring places an individual in the numerator of the composite measure if and only if they are in the numerator of all component measures in which they are in the denominator.

Living alone. Maps to PD1-2 Living arrangement (IS) 00742 \[A\]

Indicator of annuity ownership or status as beneficiary.

Security metadata observation value conveying the alteration integrity of an IT resource (data, information object, service, or system capability) by used to indicate the mechanism by which software systems can strip portions of the resource that could allow the identification of the source of the information or the information subject. No key to relink the data is retained.

A measure that assesses the use of one or more processes where the expected health benefit exceeds the expected negative consequences.

Codes specifying asset indicators used to assess or establish eligibility for coverage under a policy or program.

Indicator of birth.

Indicator of creditable coverage.

**Description:**Dependent biological, adopted, foster child as specified by coverage policy or program.

Indicator of child support payments received or provided.

Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was asserted by a clinician.

Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was reported by a clinician.

Indicator of clothing expenses.

A measure in which either short-term cross-section or long-term longitudinal analysis is performed over a group of subjects defined by a set of common properties or defining characteristics (e.g., Male smokers between the ages of 40 and 50 years, exposure to treatment, exposure duration).

A measure that is composed from one or more other measures and indicates an overall summary of those measures.

A measure score in which each individual value for the measure can fall anywhere along a continuous scale (e.g., mean time to thrombolytics which aggregates the time in minutes from a case presenting with chest pain to the time of administration of thrombolytics).

Worst case result of a future exposure is assessed to be life-threatening or having high potential for organ system failure.

Worst case result of a future exposure is not assessed to be life-threatening or having high potential for organ system failure.

Unable to assess the worst case result of a future exposure.

Security metadata observation value used to indicate the mechanism by which software systems can establish that data was not modified in transit.

Rationale:This definition is intended to align with the ISO 22600-2 3.3.19 definition of cryptographic checkvalue: Information which is derived by performing a cryptographic transformation (see cryptography) on the data unit. The derivation of the checkvalue may be performed in one or more steps and is a result of a mathematical function of the key and a data unit. It is usually used to check the integrity of a data unit.Examples:

* SHA-1 * SHA-2 (Secure Hash Algorithm)

Patients who should be removed from the eMeasure population and denominator before determining if numerator criteria are met. Denominator exclusions are used in proportion and ratio measures to help narrow the denominator.

Denominator exceptions are those conditions that should remove a patient, procedure or unit of measurement from the denominator only if the numerator criteria are not met. Denominator exceptions allow for adjustment of the calculated score for those providers with higher risk populations. Denominator exceptions are used only in proportion eMeasures. They are not appropriate for ratio or continuous variable eMeasures. Denominator exceptions allow for the exercise of clinical judgment and should be specifically defined where capturing the information in a structured manner fits the clinical workflow. Generic denominator exception reasons used in proportion eMeasures fall into three general categories:

* Medical reasons * Patient reasons * System reasons

It can be the same as the initial patient population or a subset of the initial patient population to further constrain the population for the purpose of the eMeasure. Different measures within an eMeasure set may have different Denominators. Continuous Variable eMeasures do not have a Denominator, but instead define a Measure Population.

**Description:**Person requiring functional and/or financial assistance from another person as specified by coverage policy or program.

Living with one or more dependent children requiring moderate supervision.

Living with disabled spouse requiring functional and health care assistance

Living with one or more dependent children requiring intensive supervision

Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was asserted by a device.

Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was reported by a device.

Security provenance metadata observation value used to indicate that an IT resource (data, or information object) was asserted by a Dictation algorithm transforming human communications (e.g. speech).

Security metadata observation value used to indicate the mechanism by which software systems use digital signature to establish that data has not been modified.

Rationale:This definition is intended to align with the ISO 22600-2 3.3.26 definition of digital signature: Data appended to, or a cryptographic transformation (see cryptography) of, a data unit that allows a recipient of the data unit to prove the source and integrity of the data unit and protect against forgery e.g., by the recipient.

Indicator of disability income replacement payment.

Indication of disability.

**Description:**Persons registered as a family unit in a domestic partner registry as specified by law and by coverage policy or program.

Indicator of driving status.

Indication of drug use.

A person who is scheduled for work during daytime hours (for example between 6am and 6pm) on a regular basis.

Improvement is indicated as a decrease in the score or measurement (e.g. Lower score indicates better quality)

**Description:**An individual employed by an employer who receive remuneration in wages, salary, commission, tips, piece-rates, or pay-in-kind through the employeraTMs payment system (i.e., not a contractor) as specified by coverage policy or program.

A measure related to the efficiency of medical treatment.

Definition:Coverage is in effect for healthcare service(s) and/or product(s).

Code specifying eligibility indicators used to assess or establish eligibility for coverage under a policy or program eligibility status, e.g., certificates of creditable coverage; student enrollment; adoption, marriage or birth certificate.

Consistent Early morning schedule of 13 hours or less per shift (between 2 am and 2 pm)

A person who is scheduled for work during evening hours (for example between 2pm and midnight) on a regular basis.

A measure related to the level of patient engagement or patient experience of care.

Individuals who, during the last week: a) did any work for at least 1 hour as paid or unpaid employees of a business or government organization; worked in their own businesses, professions, or on their own farms; or b) were not working, but who have a job or business from which the individual was temporarily absent because of vacation, illness, bad weather, childcare problems, maternity or paternity leave, labor-management dispute, job training, or other family or personal reasons, regardless of whether or not they were paid for the time off or were seeking other jobs.

Living with family. Maps to PD1-2 Living arrangement (IS) 00742 \[F\]

**Description:**As specified by coverage policy or program.

Indicator of transportation expenses.

Indicator of foster child status.

Value for Act.partialCompletionCode attribute that implies 81-99% completion

Indicates the condition may be life-threatening or has the potential to cause permanent injury.

Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was asserted by a healthcare professional.

Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was reported by a healthcare professional.

Indicator of health expenses; including medication costs, health service costs, financial participations, and health coverage premiums.

Code specifying non-clinical indicators related to health status used to assess or establish eligibility for coverage under a policy or program, e.g., pregnancy, disability, drug use, mental health issues.

Indication of status as homeless.

Indicator of housing expense, e.g., household appliances, fixtures, furnishings, and maintenance and repairs.

Security metadata observation value used to indicate that the veracity or trustworthiness of an IT resource (data, information object, service, or system capability) for a specified purpose of use is perceived to be or deemed by policy to be very high.

Description:An individual having different alleles at one or more loci regarding a specific character

Indication of status as illegal immigrant.

Definition:Coverage is not in effect for healthcare service(s) and/or product(s).

Indication of status as incarcerated.

Code specifying income indicators used to assess or establish eligibility for coverage under a policy or program; e.g., pay or pension check, child support payments received or provided, and taxes paid.

**Description:**Person as specified by coverage policy or program.

Definition:Coverage is not in effect for healthcare service(s) and/or product(s) - Pending Investigation. Definition:Coverage is not in effect for healthcare service(s) and/or product(s) - Pending Eligibility Update.

A measure that evaluates the change over time of a physiologic state observable that is associated with a specific long-term health outcome.

Indicator of investment income, e.g., dividend check, annuity payment; real estate rent, investment divestiture proceeds; trust or endowment check.

The initial population refers to all entities to be evaluated by a specific quality measure who share a common set of specified characteristics within a specific measurement set to which a given measure belongs.

The initial patient population refers to all patients to be evaluated by a specific quality measure who share a common set of specified characteristics within a specific measurement set to which a given measure belongs. Details often include information based upon specific age groups, diagnoses, diagnostic and procedure codes, and enrollment periods.

Indication of IV drug use .

Improvement is indicated as an increase in the score or measurement (e.g. Higher score indicates better quality)

Indicates the condition may result in some adverse consequences but is unlikely to substantially affect the situation of the subject.

Value for Act.partialCompletionCode attribute that implies 61-80% completion

Indicator of legal expenses.

Code specifying that the measure uses linear scoring. Linear scoring computes the fraction of component measures in which the individual appears in the numerator, giving equal weight to each component measure.

Code specifying observations related to living dependency, such as dependent upon spouse for activities of daily living.

Codes specifying living expense indicators used to assess or establish eligibility for coverage under a policy or program.

Code specifying observations related to living situation for a person in a private residence.

Lying on the left side.

The value assigned as the indicator of the digital quality or reliability of the verification and validation process used to verify the claimed identity of an entity by securely associating an identifier and its authenticator. \[Based on ISO 7498-2\]

For example, the degree of confidence in the vetting process used to establish the identity of the individual to whom the credential was issued, and 2) the degree of confidence that the individual who uses the credential is the individual to whom the credential was issued. \[OMB M-04-04 E-Authentication Guidance for Federal Agencies\]

Indicator of low digital quality or reliability of the digital reliability of the verification and validation process used to verify the claimed identity of an entity by securely associating an identifier and its authenticator. \[Based on ISO 7498-2\]

The degree of confidence in the vetting process used to establish the identity of the individual to whom the credential was issued, and 2) the degree of confidence that the individual who uses the credential is the individual to whom the credential was issued. \[OMB M-04-04 E-Authentication Guidance for Federal Agencies\]

Low authentication level of assurance indicates that the relying party may have little or no confidence in the asserted identity's validity. Level 1 requires little or no confidence in the asserted identity. No identity proofing is required at this level, but the authentication mechanism should provide some assurance that the same claimant is accessing the protected transaction or data. A wide range of available authentication technologies can be employed and any of the token methods of Levels 2, 3, or 4, including Personal Identification Numbers (PINs), may be used. To be authenticated, the claimant must prove control of the token through a secure authentication protocol. At Level 1, long-term shared authentication secrets may be revealed to verifiers. Assertions issued about claimants as a result of a successful authentication are either cryptographically authenticated by relying parties (using approved methods) or are obtained directly from a trusted party via a secure authentication protocol. \[Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.\]

Indicator of basic digital quality or reliability of the digital reliability of the verification and validation process used to verify the claimed identity of an entity by securely associating an identifier and its authenticator. \[Based on ISO 7498-2\]

The degree of confidence in the vetting process used to establish the identity of the individual to whom the credential was issued, and 2) the degree of confidence that the individual who uses the credential is the individual to whom the credential was issued. \[OMB M-04-04 E-Authentication Guidance for Federal Agencies\]

Basic authentication level of assurance indicates that the relying party may have some confidence in the asserted identity's validity. Level 2 requires confidence that the asserted identity is accurate. Level 2 provides for single-factor remote network authentication, including identity-proofing requirements for presentation of identifying materials or information. A wide range of available authentication technologies can be employed, including any of the token methods of Levels 3 or 4, as well as passwords. Successful authentication requires that the claimant prove through a secure authentication protocol that the claimant controls the token. Eavesdropper, replay, and online guessing attacks are prevented. Long-term shared authentication secrets, if used, are never revealed to any party except the claimant and verifiers operated by the CSP; however, session (temporary) shared secrets may be provided to independent verifiers by the CSP. Approved cryptographic techniques are required. Assertions issued about claimants as a result of a successful authentication are either cryptographically authenticated by relying parties (using approved methods) or are obtained directly from a trusted party via a secure authentication protocol. \[Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.\]

Indicator of medium digital quality or reliability of the digital reliability of verification and validation of the process used to verify the claimed identity of an entity by securely associating an identifier and its authenticator. \[Based on ISO 7498-2\]

The degree of confidence in the vetting process used to establish the identity of the individual to whom the credential was issued, and 2) the degree of confidence that the individual who uses the credential is the individual to whom the credential was issued. \[OMB M-04-04 E-Authentication Guidance for Federal Agencies\]

Medium authentication level of assurance indicates that the relying party may have high confidence in the asserted identity's validity. Level 3 is appropriate for transactions that need high confidence in the accuracy of the asserted identity. Level 3 provides multifactor remote network authentication. At this level, identity-proofing procedures require verification of identifying materials and information. Authentication is based on proof of possession of a key or password through a cryptographic protocol. Cryptographic strength mechanisms should protect the primary authentication token (a cryptographic key) against compromise by the protocol threats, including eavesdropper, replay, online guessing, verifier impersonation, and man-in-the-middle attacks. A minimum of two authentication factors is required. Three kinds of tokens may be used:

* "soft" cryptographic token, which has the key stored on a general-purpose computer, * "hard" cryptographic token, which has the key stored on a special hardware device, and * "one-time password" device token, which has symmetric key stored on a personal hardware device that is a cryptographic module validated at FIPS 140-2 Level 1 or higher. Validation testing of cryptographic modules and algorithms for conformance to Federal Information Processing Standard (FIPS) 140-2, Security Requirements for Cryptographic Modules, is managed by NIST.

Authentication requires that the claimant prove control of the token through a secure authentication protocol. The token must be unlocked with a password or biometric representation, or a password must be used in a secure authentication protocol, to establish two-factor authentication. Long-term shared authentication secrets, if used, are never revealed to any party except the claimant and verifiers operated directly by the CSP; however, session (temporary) shared secrets may be provided to independent verifiers by the CSP. Approved cryptographic techniques are used for all operations. Assertions issued about claimants as a result of a successful authentication are either cryptographically authenticated by relying parties (using approved methods) or are obtained directly from a trusted party via a secure authentication protocol. \[Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.\]

Indicator of high digital quality or reliability of the digital reliability of the verification and validation process used to verify the claimed identity of an entity by securely associating an identifier and its authenticator. \[Based on ISO 7498-2\]

The degree of confidence in the vetting process used to establish the identity of the individual to whom the credential was issued, and 2) the degree of confidence that the individual who uses the credential is the individual to whom the credential was issued. \[OMB M-04-04 E-Authentication Guidance for Federal Agencies\]

High authentication level of assurance indicates that the relying party may have very high confidence in the asserted identity's validity. Level 4 is for transactions that need very high confidence in the accuracy of the asserted identity. Level 4 provides the highest practical assurance of remote network authentication. Authentication is based on proof of possession of a key through a cryptographic protocol. This level is similar to Level 3 except that only “hard� cryptographic tokens are allowed, cryptographic module validation requirements are strengthened, and subsequent critical data transfers must be authenticated via a key that is bound to the authentication process. The token should be a hardware cryptographic module validated at FIPS 140-2 Level 2 or higher overall with at least FIPS 140-2 Level 3 physical security. This level requires a physical token, which cannot readily be copied, and operator authentication at Level 2 and higher, and ensures good, two-factor remote authentication.

Level 4 requires strong cryptographic authentication of all parties and all sensitive data transfers between the parties. Either public key or symmetric key technology may be used. Authentication requires that the claimant prove through a secure authentication protocol that the claimant controls the token. Eavesdropper, replay, online guessing, verifier impersonation, and man-in-the-middle attacks are prevented. Long-term shared authentication secrets, if used, are never revealed to any party except the claimant and verifiers operated directly by the CSP; however, session (temporary) shared secrets may be provided to independent verifiers by the CSP. Strong approved cryptographic techniques are used for all operations. All sensitive data transfers are cryptographically authenticated using keys bound to the authentication process. \[Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.\]

The value assigned as the indicator of the digital quality or reliability of a defined sequence of messages between a Claimant and a Verifier that demonstrates that the Claimant has possession and control of a valid token to establish his/her identity, and optionally, demonstrates to the Claimant that he or she is communicating with the intended Verifier. \[Based on NIST SP 800-63-2\]

Indicator of the low digital quality or reliability of a defined sequence of messages between a Claimant and a Verifier that demonstrates that the Claimant has possession and control of a valid token to establish his/her identity, and optionally, demonstrates to the Claimant that he or she is communicating with the intended Verifier. \[Based on NIST SP 800-63-2\]

Low authentication process level of assurance indicates that (1) long-term shared authentication secrets may be revealed to verifiers; and (2) assertions and assertion references require protection from manufacture/modification and reuse attacks. \[Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.\]

Indicator of the basic digital quality or reliability of a defined sequence of messages between a Claimant and a Verifier that demonstrates that the Claimant has possession and control of a valid token to establish his/her identity, and optionally, demonstrates to the Claimant that he or she is communicating with the intended Verifier. \[Based on NIST SP 800-63-2\]

Basic authentication process level of assurance indicates that long-term shared authentication secrets are never revealed to any other party except Credential Service Provider (CSP). Sessions (temporary) shared secrets may be provided to independent verifiers by CSP. Long-term shared authentication secrets, if used, are never revealed to any other party except Verifiers operated by the Credential Service Provider (CSP); however, session (temporary) shared secrets may be provided to independent Verifiers by the CSP. In addition to Level 1 requirements, assertions are resistant to disclosure, redirection, capture and substitution attacks. Approved cryptographic techniques are required. \[Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.\]

Indicator of the medium digital quality or reliability of a defined sequence of messages between a Claimant and a Verifier that demonstrates that the Claimant has possession and control of a valid token to establish his/her identity, and optionally, demonstrates to the Claimant that he or she is communicating with the intended Verifier. \[Based on NIST SP 800-63-2\]

Medium authentication process level of assurance indicates that the token can be unlocked with password, biometric, or uses a secure multi-token authentication protocol to establish two-factor authentication. Long-term shared authentication secrets are never revealed to any party except the Claimant and Credential Service Provider (CSP).

Authentication requires that the Claimant prove, through a secure authentication protocol, that he or she controls the token. The Claimant unlocks the token with a password or biometric, or uses a secure multi-token authentication protocol to establish two-factor authentication (through proof of possession of a physical or software token in combination with some memorized secret knowledge). Long-term shared authentication secrets, if used, are never revealed to any party except the Claimant and Verifiers operated directly by the CSP; however, session (temporary) shared secrets may be provided to independent Verifiers by the CSP. In addition to Level 2 requirements, assertions are protected against repudiation by the Verifier.

Indicator of the high digital quality or reliability of a defined sequence of messages between a Claimant and a Verifier that demonstrates that the Claimant has possession and control of a valid token to establish his/her identity, and optionally, demonstrates to the Claimant that he or she is communicating with the intended Verifier. \[Based on NIST SP 800-63-2\]

High authentication process level of assurance indicates all sensitive data transfer are cryptographically authenticated using keys bound to the authentication process. Level 4 requires strong cryptographic authentication of all communicating parties and all sensitive data transfers between the parties. Either public key or symmetric key technology may be used. Authentication requires that the Claimant prove through a secure authentication protocol that he or she controls the token. All protocol threats at Level 3 are required to be prevented at Level 4. Protocols shall also be strongly resistant to man-in-the-middle attacks. Long-term shared authentication secrets, if used, are never revealed to any party except the Claimant and Verifiers operated directly by the CSP; however, session (temporary) shared secrets may be provided to independent Verifiers by the CSP. Approved cryptographic techniques are used for all operations. All sensitive data transfers are cryptographically authenticated using keys bound to the authentication process. \[Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.\]

The value assigned as the indicator of the high quality or reliability of the statement from a Verifier to a Relying Party (RP) that contains identity information about a Subscriber. Assertions may also contain verified attributes.

Indicator of the low quality or reliability of the statement from a Verifier to a Relying Party (RP) that contains identity information about a Subscriber. Assertions may also contain verified attributes.

Assertions and assertion references require protection from modification and reuse attacks. \[Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.\]

Indicator of the basic quality or reliability of the statement from a Verifier to a Relying Party (RP) that contains identity information about a Subscriber. Assertions may also contain verified attributes.

Assertions are resistant to disclosure, redirection, capture and substitution attacks. Approved cryptographic techniques are required for all assertion protocols. \[Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.\]

Indicator of the medium quality or reliability of the statement from a Verifier to a Relying Party (RP) that contains identity information about a Subscriber. Assertions may also contain verified attributes.

Assertions are protected against repudiation by the verifier. \[Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.\]

Indicator of the high quality or reliability of the statement from a Verifier to a Relying Party (RP) that contains identity information about a Subscriber. Assertions may also contain verified attributes.

Strongly resistant to man-in-the-middle attacks. "Bearer" assertions are not used. "Holder-of-key" assertions may be used. RP maintains records of the assertions. \[Summary of the technical requirements specified in NIST SP 800-63 for the four levels of assurance defined by the December 2003, the Office of Management and Budget (OMB) issued Memorandum M-04-04, E-Authentication Guidance for Federal Agencies.\]

Indicator of the digital quality or reliability of the activities performed by the Credential Service Provider (CSP) subsequent to electronic authentication registration, identity proofing and issuance activities to manage and safeguard the integrity of an issued credential and its binding to an identity. \[Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]

Indicator of the low digital quality or reliability of the activities performed by the Credential Service Provider (CSP) subsequent to electronic authentication registration, identity proofing and issuance activities to manage and safeguard the integrity of an issued credential and its binding to an identity. Little or no confidence that an individual has maintained control over a token that has been entrusted to him or her and that that token has not been compromised. Characteristics include weak identity binding to tokens and plaintext passwords or secrets not transmitted across a network. \[Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]

Indicator of the basic digital quality or reliability of the activities performed by the Credential Service Provider (CSP) subsequent to electronic authentication registration, identity proofing and issuance activities to manage and safeguard the integrity of an issued credential and its binding to an identity. Some confidence that an individual has maintained control over a token that has been entrusted to him or her and that that token has not been compromised. Characteristics include: Verification must prove claimant controls the token; token resists online guessing, replay, session hijacking, and eavesdropping attacks; and token is at least weakly resistant to man-in-the middle attacks. \[Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]

Indicator of the medium digital quality or reliability of the activities performed by the Credential Service Provider (CSP) subsequent to electronic authentication registration, identity proofing and issuance activities to manage and safeguard the integrity of an issued credential and it's binding to an identity. High confidence that an individual has maintained control over a token that has been entrusted to him or her and that that token has not been compromised. Characteristics include: Ownership of token verifiable through security authentication protocol and credential management protects against verifier impersonation attacks. \[Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]

Indicator of the high digital quality or reliability of the activities performed by the Credential Service Provider (CSP) subsequent to electronic authentication registration, identity proofing and issuance activities to manage and safeguard the integrity of an issued credential and it's binding to an identity. Very high confidence that an individual has maintained control over a token that has been entrusted to him or her and that that token has not been compromised. Characteristics include: Verifier can prove control of token through a secure protocol; credential management supports strong cryptographic authentication of all communication parties. \[Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]

Indicator of the quality or reliability in the process of ascertaining that an individual is who he or she claims to be.

Indicator of low digital quality or reliability in the process of ascertaining that an individual is who he or she claims to be. Requires that a continuity of identity be maintained but does not require identity proofing. \[Based on Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]

Indicator of some digital quality or reliability in the process of ascertaining that that an individual is who he or she claims to be. Requires identity proofing via presentation of identifying material or information. \[Based on Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]

Indicator of high digital quality or reliability in the process of ascertaining that an individual is who he or she claims to be. Requires identity proofing procedures for verification of identifying materials and information. \[Based on Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]

Indicator of high digital quality or reliability in the process of ascertaining that an individual is who he or she claims to be. Requires identity proofing procedures for verification of identifying materials and information. \[Based on Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]

Indicator of the digital quality or reliability in the process of establishing proof of delivery and proof of origin. \[Based on ISO 7498-2\]

Indicator of low digital quality or reliability in the process of establishing proof of delivery and proof of origin. \[Based on ISO 7498-2\]

Indicator of basic digital quality or reliability in the process of establishing proof of delivery and proof of origin. \[Based on ISO 7498-2\]

Indicator of medium digital quality or reliability in the process of establishing proof of delivery and proof of origin. \[Based on ISO 7498-2\]

Indicator of high digital quality or reliability in the process of establishing proof of delivery and proof of origin. \[Based on ISO 7498-2\]

Indicator of the digital quality or reliability of the information exchange between network-connected devices where the information cannot be reliably protected end-to-end by a single organization's security controls. \[Based on NIST SP 800-63-2\]

Indicator of low digital quality or reliability of the information exchange between network-connected devices where the information cannot be reliably protected end-to-end by a single organization's security controls. \[Based on NIST SP 800-63-2\]

Indicator of basic digital quality or reliability of the information exchange between network-connected devices where the information cannot be reliably protected end-to-end by a single organization's security controls. \[Based on NIST SP 800-63-2\]

Indicator of medium digital quality or reliability of the information exchange between network-connected devices where the information cannot be reliably protected end-to-end by a single organization's security controls. \[Based on NIST SP 800-63-2\]

Indicator of high digital quality or reliability of the information exchange between network-connected devices where the information cannot be reliably protected end-to-end by a single organization's security controls. \[Based on NIST SP 800-63-2\]

Indicator of the digital quality or reliability of single and multi-token authentication. \[Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]

Indicator of the low digital quality or reliability of single and multi-token authentication. Permits the use of any of the token methods of Levels 2, 3, or 4. \[Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]

Indicator of the basic digital quality or reliability of single and multi-token authentication. Requires single factor authentication using memorized secret tokens, pre-registered knowledge tokens, look-up secret tokens, out of band tokens, or single factor one-time password devices. \[Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]

Indicator of the medium digital quality or reliability of single and multi-token authentication. Requires two authentication factors. Provides multi-factor remote network authentication. Permits multi-factor software cryptographic token. \[Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]

Indicator of the high digital quality or reliability of single and multi-token authentication. Requires token that is a hardware cryptographic module validated at validated at Federal Information Processing Standard (FIPS) 140-2 Level 2 or higher overall with at least FIPS 140-2 Level 3 physical security. Level 4 token requirements can be met by using the PIV authentication key of a FIPS 201 compliant Personal Identity Verification (PIV) Card. \[Electronic Authentication Guideline - Recommendations of the National Institute of Standards and Technology, NIST Special Publication 800-63-1, Dec 2011\]

Indicates the condition may result in noticable adverse adverse consequences but is unlikely to be life-threatening or cause permanent injury.

Security metadata observation value used to indicate that the IT resource semantic content has been transformed from one encoding to another.

Usage Note:"MAP" code does not indicate the semantic fidelity of the transformed content.

To indicate semantic fidelity for maps of HL7 to other code systems, this security alteration integrity observation may be further specified using an Act valued with Value Set: MapRelationship (2.16.840.1.113883.1.11.11052).

Semantic fidelity of the mapped IT Resource may also be indicated using a SecurityIntegrityConfidenceObservation.

Security metadata observation value conveying the alteration integrity of an IT resource (data, information object, service, or system capability) by indicating the mechanism by which software systems can make data unintelligible (that is, as unreadable and unusable by algorithmically transforming plaintext into ciphertext) such that it can only be accessed or used by authorized users. An authorized user may be provided a key to decrypt per license or "shared secret".

Usage Note:"MASKED" may be used, per applicable policy, as a flag to indicate to a user or receiver that some portion of an IT resource has been further encrypted, and may be accessed only by an authorized user or receiver to which a decryption key is provided.

Value for Act.partialCompletionCode attribute that implies 41-60% completion

Indicator of status as covered member under a policy or program, e.g., member id card or coverage document.

Value for Act.partialCompletionCode attribute that implies 1-20% completion

Indicator of military status.

Indicator of mortgage amount, interest, and payments.

Indicator of marriage status.

Measure population is used only in continuous variable eMeasures. It is a narrative description of the eMeasure population. (e.g., all patients seen in the Emergency Department during the measurement period).

Value for Act.partialCompletionCode attribute that implies 0% completion

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

Scheduled for work during nighttime hours (for example between 9pm and 8am) on a regular basis.

Numerators are used in proportion and ratio eMeasures. In proportion measures the numerator criteria are the processes or outcomes expected for each patient, procedure, or other unit of measurement defined in the denominator. In ratio measures the numerator is related, but not directly derived from the denominator (e.g., a numerator listing the number of central line blood stream infections and a denominator indicating the days per thousand of central line usage in a specific time period).

Numerator Exclusions are used only in ratio eMeasures to define instances that should not be included in the numerator data. (e.g., if the number of central line blood stream infections per 1000 catheter days were to exclude infections with a specific bacterium, that bacterium would be listed as a numerator exclusion.)

Persons not classified as employed or unemployed, meaning those who have no job and are not looking for one.

Code specifying that the measure uses opportunity-based scoring. In opportunity-based scoring the measure score is determined by combining the denominator and numerator of each component measure to determine an overall composite score.

A measure that indicates the result of the performance (or non-performance) of a function or process.

Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was asserted by a patient acquaintance.

Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was reported by a patient acquaintance.

Indicator of citizenship.

Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was asserted by a patient.

Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was reported by a patient.

Indicator of paid employment, e.g., letter of hire, contract, employer letter; copy of pay check or pay stub.

Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was asserted by a payer.

Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was reported by a payer.

Non-clinical report of pregnancy.

Lying with the front or ventral surface downward; lying face down.

A measure that is a comparison of patient reported outcomes for a single or multiple patients collected via an instrument specifically designed to obtain input directly from patients.

Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was asserted by a professional.

Indication of probation status.

A measure which focuses on a process which leads to a certain outcome, meaning that a scientific basis exists for believing that the process, when executed well, will increase the probability of achieving a desired outcome.

Indicator of real property ownership, e.g., deed or real estate contract.

A score derived by dividing the number of cases that meet a criterion for quality (the numerator) by the number of eligible cases within a given time frame (the denominator) where the numerator cases are a subset of the denominator cases (e.g., percentage of eligible women with a mammogram performed in the last year).

Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was reported by a professional.

Security metadata observation value conveying the alteration integrity of an IT resource (data, information object, service, or system capability), by indicating the mechanism by which software systems can strip portions of the resource that could allow the identification of the source of the information or the information subject. Custodian may retain a key to relink data necessary to reidentify the information subject.

Rationale:Personal data which has been processed to make it impossible to know whose data it is. Used particularly for secondary use of health data. In some cases, it may be possible for authorized individuals to restore the identity of the individual, e.g.,for public health case management. Based on ISO/TS 25237:2008 Health informatics-Pseudonymization

A score that may have a value of zero or greater that is derived by dividing a count of one type of data by a count of another type of data (e.g., the number of patients with central lines who develop infection divided by the number of central line days).

Security metadata observation value used to indicate the mechanism by which software systems can filter an IT resource (data, information object, service, or system capability) to remove any portion of the resource that is not authorized to be access, used, or disclosed.

Usage Note:"REDACTED" may be used, per applicable policy, as a flag to indicate to a user or receiver that some portion of an IT resource has filtered and not included in the content accessed or received.

Indication of refugee status.

Living with one or more relatives. Maps to PD1-2 Living arrangement (IS) 00742 \[R\]

Continued living in private residence requires functional and health care assistance from one or more relatives.

Security metadata observation value used to indicate that the veracity or trustworthiness of an IT resource (data, information object, service, or system capability) for a specified purpose of use is perceived to be or deemed by policy to be adequate.

Indicator of rental or lease payments.

A measure related to the extent of use of clinical resources or cost of care.

Indicator of retirement investment account ownership.

Indicator of retirement payment, e.g., pension check.

Lying on the right side.

Scheduled for work times that change periodically between days, and/or evenings, and includes some night shifts.

Scheduled for work days/times that change periodically between days, but does not include night or evening work.

Lying on the back, on an inclined plane, typically about 30-45 degrees with head raised and feet lowered.

Value for Act.partialCompletionCode attribute that implies 21-40% completion

Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was asserted by a substitute decision maker.

Security provenance metadata observation value used to indicate that an IT resource (data, information object, service, or system capability) was reported by a substitute decision maker.

Observation value used to indicate aspects of trust applicable to an IT resource (data, information object, service, or system capability).

A semi-sitting position in bed with the head of the bed elevated approximately 45 degrees.

Resting the body on the buttocks, typically with upper torso erect or semi erect.

Code specifying observations or indicators related to socio-economic status used to assess to assess for services, e.g., discharge planning, or to establish eligibility for coverage under a policy or program.

Indicator of spousal or partner support payments received or provided; e.g., alimony payment; support stipulations in a divorce settlement.

Living only with spouse or life partner. Maps to PD1-2 Living arrangement (IS) 00742 \[S\]

Continued living in private residence requires functional and health care assistance from spouse or life partner.

Shift consisting of two distinct work periods each day that are separated by a break of a few hours (for example 2 to 4 hours)

**Description:**A pair of people of the same gender who live together as a family as specified by coverage policy or program, e.g., Naomi and Ruth from the Book of Ruth; Socrates and Alcibiades

To be stationary, upright, vertical, on one's legs.

A measure related to the structure of patient care.

Indicator of student status.

Metadata observation used to indicate that some information has been removed from the source object when the view this object contains was constructed because of configuration options when the view was created. The content may not be suitable for use as the basis of a record update

Usage Note:This is not suitable to be used when information is removed for security reasons - see the code REDACTED for this use.

Indicator of transportation expenses.

Indicator of income supplement, e.g., gifting, parental income support; stipend, or grant.

Security metadata observation value used to indicate that the IT resource syntax has been transformed from one syntactical representation to another.

Usage Note:"SYNTAC" code does not indicate the syntactical correctness of the syntactically transformed IT resource.

Indicator of tax obligation or payment, e.g., statement of taxable income.

Indicator of transportation expenses, e.g., vehicle payments, vehicle insurance, vehicle fuel, and vehicle maintenance and repairs.

Lying on the back, on an inclined plane, typically about 30-45 degrees, with head lowered and feet raised.

Security metadata observation value used to indicate that the IT resource has been translated from one human language to another.

Usage Note:"TRSLT" does not indicate the fidelity of the translation or the languages translated.

The fidelity of the IT Resource translation may be indicated using a SecurityIntegrityConfidenceObservation.

To indicate languages, use the Value Set:HumanLanguage (2.16.840.1.113883.1.11.11526)

Values for security trust accreditation metadata observation made about the formal declaration by an authority or neutral third party that validates the technical, security, trust, and business practice conformance of Trust Agents to facilitate security, interoperability, and trust among participants within a security domain or trust framework.

Values for security trust agreement metadata observation made about privacy and security requirements with which a security domain must comply. \[ISO IEC 10181-1\] \[ISO IEC 10181-1\]

Values for security trust certificate metadata observation made about a set of security-relevant data issued by a security authority or trusted third party, together with security information which is used to provide the integrity and data origin authentication services for an IT resource (data, information object, service, or system capability). \[Based on ISO IEC 10181-1\]

For example, a Certificate Policy (CP), which is a named set of rules that indicates the applicability of a certificate to a particular community and/or class of application with common security requirements. A particular Certificate Policy might indicate the applicability of a type of certificate to the authentication of electronic data interchange transactions for the trading of goods within a given price range. Another example is Cross Certification with Federal Bridge.

Values for security trust framework metadata observation made about a complete set of contracts, regulations or commitments that enable participating actors to rely on certain assertions by other actors to fulfill their information security requirements. \[Kantara Initiative\]

Values for security trust assurance metadata observation made about the digital quality or reliability of a trust assertion, activity, capability, information exchange, mechanism, process, or protocol.

Values for security trust mechanism metadata observation made about a security architecture system component that supports enforcement of security policies.

Indicator of status as trust beneficiary.

Security metadata observation value used to indicate that the veracity or trustworthiness of an IT resource (data, information object, service, or system capability) for a specified purpose of use is perceived to be or deemed by policy to be uncertain.

Indication of unemployed status.

Living with one or more unrelated persons.

Security metadata observation value used to indicate that the veracity or trustworthiness of an IT resource (data, information object, service, or system capability) for a specified purpose of use is perceived to be or deemed by policy to be inadequate.

Continued living in private residence requires functional and health care assistance from one or more unrelated persons.

Indicator of transportation expenses.

Persons who currently have no employment, but are available for work and have made specific efforts to find employment.

Security metadata observation value conveying the alteration integrity of an IT resource (data, information object, service, or system capability) which indicates that the resource only retains versions of an IT resource for access and use per applicable policy

Usage Note:When this code is used, expectation is that the system has removed historical versions of the data that falls outside the time period deemed to be the effective time of the applicable version.

Shifts of 17 or more hours.

Irregular, unpredictable hours scheduled on a short notice (for example, less than 2 day notice): inconsistent schedule, on-call, as needed, as available.

Code specifying that the measure uses weighted scoring. Weighted scoring assigns a factor to each component measure to weight that measure's contribution to the overall score.

Codes specify the category of observation, evidence, or document used to assess for services, e.g., discharge planning, or to establish eligibility for coverage under a policy or program. The type of evidence is coded as observation values.

Code specifying financial indicators used to assess or establish eligibility for coverage under a policy or program; e.g., pay stub; tax or income document; asset document; living expenses.

Indicates the result of a particular allergy test. E.g. Negative, Mild, Moderate, Severe

A code that provides information on the overall effect or outcome of the adverse reaction/adverse event reported in the ICSR. Note the criterion applies to the case as a whole and not to an individual reaction.

Example concepts are: death, disability, hospitalization, congenital anomaly/ birth defect, and other medically important condition.

Definition:The non-laboratory, non-DI (diagnostic imaging) coded observation if no value is also required to convey the full meaning of the observation. This may be a single concept code or a complex expression. Definition:The non-laboratory, non-diagnostic imaging coded result of the coded observable or "question" represented by the paired concept from the the NonLabDICodedObservationType domain.

\]

**Examples:**An APGAR result, a functional assessment, etc. The value must not require a specific unit of measure.

**Description:**Used in a patient care message to value simple clinical (non-lab) observations.

Observation values that communicate the method used in a quality measure to combine the component measure results included in an composite measure.

Definition:The category of addiction used for coverage purposes that may refer to a substance, the consumption of which may result in physical or emotional harm.

**Description:**Coded observation values for types or instances of items for which coverage is provided under a policy or program, e.g., a type of vehicle or a named work of art.

**Description:**Coded observation values for types of covered parties under a policy or program based on their personal relationships or employment status.

**Description:**Coded observation values for coverage limitations, for e.g., types of claims or types of parties covered under a policy or program.

**Description:**Coded observation values for types or instances of locations for which coverage is provided under a policy or program, e.g., in the covered party home, in state or in the country.

A clinical judgment as to the worst case result of a future exposure (including substance administration). When the worst case result is assessed to have a life-threatening or organ system threatening potential, it is considered to be of high criticality.

A code set that includes codes that are used to characterize the outcome of the device evaluation process. The code defines the manufacturer's conclusions following the evaluation.

Examples include: inadequate alarms, device maintenance contributed to event, device failed just prior to use, user error caused event

Code assigned to indicate a relevant fact within the context of the evaluation of a reported product. There are a number of concept types including the status of the evaluation, the type of evaluation findings, and the type of activity carried out as part of the evaluation process.

Examples include: Actual device involved in incident was evaluated, electrical tests performed, visual examination.

Code assigned to indicate an outcome of the manufacturer's investigation of a product for which a defect has been reported.

Examples include:.component/subassembly failure: air cleaner, computer-, imaging system-, microprocessor-controlled device problem: cache memory, design -- not fail safe.

Diagnosis Value

Concepts representing whether a person does or does not currently have a job or is not currently in the labor pool seeking employment.

Description:The domain contains genetic analysis specific observation values, e.g. Homozygote, Heterozygote, etc.

Indicates the specific observation result which is the reason for the action (prescription, lab test, etc.). E.g. Headache, Ear infection, planned diagnostic image (requiring contrast agent), etc.

This domain is established as a parent to a variety of value domains being defined to support the communication of Individual Case Safety Reports to regulatory bodies. Arguably, this aggregation is not taxonomically pure, but the grouping will facilitate the management of these domains.

Values for observations of injuries.

Codes identifying pariticular groupings of allergens and other agents which cause allergies and intolerances. E.g. the drug, allergen group, food or environmental agent which triggers the intolerance

The combined domain for different types of coded observation issue triggers, such as diagnoses, allergies, etc.

Observation values that indicate what change in a measurement value or score is indicative of an improvement in the measured item or scored issue.

Observation values used to indicate the type of scoring (e.g. proportion, ratio) used by a health quality measure.

Observation values used to indicate what kind of health quality measure is used.

Observation values used to assert various populations that a subject falls into.

Indicates an observed reason for a medical action other than an indication or symptom. E.g. Need for a contrast agent prior to a diagnostic image, need for anesthesia prior to surgery, etc.

A code to capture the reporter's assessment of the extent to which the reaction is related to the suspect product reported in the ICSR.

Example concepts include: related, not related, possibly related and unlikely related.

A code that characterizes the role that the primary reporter felt that the suspect intervention -- either a substance administration or a device related procedure - played in the incident being reported. This code will capture the primary reporter's assessment of the role that the suspect product played in the incident reported in the ICSR.

Examples include: Suspect, Concomitant, Interacting, Re-challenge.

Code used to indicate the action taken by practitioner in response to the problem (whether drug or device related) that is reported in the ICSR.

Examples include: failing device replaced, medication stopped, medication dose adjusted.

Abstract security metadata observation values used to indicate mechanism used for authorized alteration of an IT resource (data, information object, service, or system capability)

Abstract security observation values used to indicate security category metadata.

Examples:Codes conveying:

* privacy law * information sensitivity * consent directive types

Abstract security observation values used to indicate security classification metadata.

Examples:Confidentiality Codes

Abstract security observation values used to indicate security control metadata.

Examples:Codes conveying dissemination controls, information handling caveats, purpose of use, refrain policies, and obligations to which custodians and information receivers must comply.

Abstract security observation values used to indicate data integrity metadata.

Examples:Codes conveying the mechanism used to preserve the accuracy and consistency of an IT resource such as a digital signature and a cryptographic hash function.

Abstract security observation value used to indicate integrity confidence metadata.

Examples:Codes conveying the level of reliability and trustworthiness of an IT resource.

Abstract security observation values used to indicate security integrity metadata.

Examples:Codes conveying integrity status, integrity confidence, and provenance.

Abstract security provenance metadata observation value used to indicate the entity that asserted an IT resource (data, information object, service, or system capability).

Examples:Codes conveying the provenance metadata about the entity asserting the resource.

Abstract security metadata observation value used to indicate the provenance of an IT resource (data, information object, service, or system capability).

Examples:Codes conveying the provenance metadata about the entity reporting an IT resource.

Abstract security provenance metadata observation value used to indicate the entity that reported the resource (data, information object, service, or system capability).

Examples:Codes conveying the provenance metadata about the entity reporting an IT resource.

Abstract security observation values used to indicate integrity status metadata.

Examples:Codes, such as those in the HL7 DocumentClassification code system conveying the workflow status of resource as authenticated, legally authenticated, and in progress.

Observation values used to indicate security observation metadata.

Potential values for observations of severity.

Contains codes for defining the observed, physical position of a subject, such as during an observation, assessment, collection of a specimen, etc. ECG waveforms and vital signs, such as blood pressure, are two examples where a general, observed position typically needs to be noted.

A code to capture the kind of reaction that was suffered by the investigated subject, and that is being reported in the ICSR. At this point, SNOMED or MedDRA have been suggested as code systems to be used for providing this information.

Example concepts include hives, swelling, rash, anaphylactic shock.

Code that captures the emphasis that the reporter placed on this reaction.

Examples include: highlighted by the reporter, NOT serious, Not highlighted by the reporter, NOT serious, Highlighted by the reporter, SERIOUS, Not highlighted by the reporter, SERIOUS.

Code that captures the type of outcome from an individual outcome of a reaction to the suspect product reported in the ICSR.

Examples include: Recovered/resolved. Recovering/resolving, Not recovered/not resolved, Recovered/resolved with sequelae, Fatal.

Indicates an observed abnormality in the patientaTMs condition, but does not assert causation. E.g. Runny nose, swelling, flaky skin, etc.

Values for observations of verification act results

Examples:Verified, not verified, verified with warning.

Concepts that describe an individual's typical arrangement of working hours for an occupation.

The Omaha System provides standardized terms, definitions, and codes for observations and procedures, specifically for client problems, multidisciplinary interventions including those focusing on assessment and care, and problem-specific client outcomes.

Codes to identify products and services that do not have DIN's and which need to be billed. http://www.atlanticpharmaceutical.ca/default.asp?mn=5.23

UPDATE: OpenIssue:Missing description. en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired..

A solid dosage form in the shape of a small ball.

A solid dosage form in which the drug is enclosed within either a hard or soft soluble container or "shell" made from a suitable form of gelatin.

A substance that serves to produce solid union between two surfaces.

A solid dosage form usually in the form of a rectangle that is meant to be chewed.

A solid dosage form containing medicinal substances with or without suitable diluents that is intended to be chewed, producing a pleasant tasting residue in the oral cavity that is easily swallowed and does not leave a bitter or unpleasant after-taste.

A semisolid dosage form containing one or more drug substances dissolved or dispersed in a suitable base; more recently, the term has been restricted to products consisting of oil-in-water emulsions or aqueous microcrystalline dispersions of long chain fatty acids or alcohols that are water washable and more cosmetically and aesthetically acceptable.

A naturally produced angular solid of definite form in which the ultimate units from which it is built up are systematically arranged; they are usually evenly spaced on a regular space lattice.

A solid dosage form containing medicinal substances which disintegrates rapidly, usually within a matter of seconds, when placed upon the tongue.

A circular plate-like organ or structure.

A liquid preparation, intended for the irrigative cleansing of the vagina, that is prepared from powders, liquid solutions, or liquid concentrates and contains one or more chemical substances dissolved in a suitable solvent or mutually miscible solvents.

A clear, pleasantly flavored, sweetened hydroalcoholic liquid containing dissolved medicinal agents; it is intended for oral use.

A rectal preparation for therapeutic, diagnostic, or nutritive purposes.

A solid dosage form in which the drug is enclosed within either a hard or soft soluble container made from a suitable form of gelatin, and which releases a drug (or drugs) in such a manner to allow a reduction in dosing frequency as compared to that drug (or drugs) presented as a conventional dosage form.

Rationale:Duplicate of code ERENTCAP. Use code ERENTCAP instead.

A solid dosage form containing a drug which allows at least a reduction in dosing frequency as compared to that drug presented in conventional dosage form.

A semisolid system consisting of either suspensions made up of small inorganic particles or large organic molecules interpenetrated by a liquid.

A small particle or grain.

A sweetened and flavored insoluble plastic material of various shapes which when chewed, releases a drug substance into the oral cavity.

A sterile solution intended to bathe or flush open wounds or body cavities; they're used topically, never parenterally.

A solution or mixture of various substances in oil, alcoholic solutions of soap, or emulsions intended for external application.

The term "lotion" has been used to categorize many topical suspensions, solutions and emulsions intended for application to the skin.

An unctuous, combustible substance which is liquid, or easily liquefiable, on warming, and is soluble in ether but insoluble in water. Such substances, depending on their origin, are classified as animal, mineral, or vegetable oils.

A semisolid preparation intended for external application to the skin or mucous membranes.

A solid preparation containing one or more medicaments, usually in a flavored, sweetened base which is intended to dissolve or disintegrate slowly in the mouth.

A semisolid dosage form that contains one or more drug substances intended for topical application.

A drug delivery system that contains an adhesived backing and that permits its ingredients to diffuse from some portion of it (e.g., the backing itself, a reservoir, the adhesive, or some other component) into the body from the external site where it is applied.

A small sterile solid mass consisting of a highly purified drug (with or without excipients) made by the formation of granules, or by compression and molding.

A small, round solid dosage form containing a medicinal agent intended for oral administration.

An intimate mixture of dry, finely divided drugs and/or chemicals that may be intended for internal or external use.

An aqueous solution which is most often used for its deodorant, refreshing, or antiseptic effect.

A liquid soap or detergent used to clean the hair and scalp and is often used as a vehicle for dermatologic agents.

A liquid preparation that contains one or more chemical substances dissolved, i.e., molecularly dispersed, in a suitable solvent or mixture of mutually miscible solvents.

A solid body of various weights and shapes, adapted for introduction into the rectal, vaginal, or urethral orifice of the human body; they usually melt, soften, or dissolve at body temperature.

A wad of absorbent material usually wound around one end of a small stick and used for applying medication or for removing material from an area.

An oral solution containing high concentrations of sucrose or other sugars; the term has also been used to include any other liquid dosage form prepared in a sweet and viscid vehicle, including oral suspensions.

A solid dosage form containing medicinal substances with or without suitable diluents.

A paste formulation intended to clean and/or polish the teeth, and which may contain certain additional agents.

A thin slice of material containing a medicinal agent.

Any elastic aeriform fluid in which the molecules are separated from one another and have free paths.

A state of substance that is an intermediate one entered into as matter goes from solid to gas; liquids are also intermediate in that they have neither the orderliness of a crystal nor the randomness of a gas. (Note: This term should not be used to describe solutions, only pure chemicals in their liquid state.)

A two-phase system in which one liquid is dispersed throughout another liquid in the form of small droplets.

A liquid preparation which consists of solid particles dispersed throughout a liquid phase in which the particles are not soluble.

UPDATE: Deprecation Comment:Deprecated as per 11/2008 Harmonization cleanup; internal and obsolete HL7 usage, no longer used. All of these are maintained under EntityNameType. This was created in error and should never be used. en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

An alias, typically a shorter name than the legal name. This is the default.

The full legal name of the organization as used in public records.

A stock market ticker symbol.

UPDATE: Deprecation Comment:Deprecated as per 11/2008 Harmonization cleanup; internal and obsolete HL7 usage, no longer used. en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. UPDATE:

This code is used to specify the exact function an actor had in a service in all necessary detail. This domain may include local extensions (CWE).

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

A physician who admitted a patient to a hospital or other care unit that is the context of this service.

In a typical anesthesia setting an anesthesiologist or anesthesia resident in charge of the anesthesia and life support, but only a witness to the surgical procedure itself. To clarify responsibilities anesthesia should always be represented as a separate service related to the surgery.

In a typical anesthesia setting the nurse principally assisting the anesthesiologist during the critical periods.

A device that operates independently of an author on custodian's algorithms for data extraction of existing information for purpose of generating a new artifact.

UsageConstraint:ASSEMBLER ParticipationFunction should be used with DEV (device) ParticipationType.

A physician who is primarily responsible for a patient during the hospitalization, which is the context of the service.

**Description:**Caregiver authorized to receive patient health information.

**Description:**Entity authorized to override a consent directive.

**Description:**Entity authorized to override a consent directive or privacy policy in an emergency.

**Description:**Provider with legitimate relationship authorized to receive patient health information.

**Description:**Member of care team authorized to receive patient health information.

**Description:**Entities within specified work area authorized to receive patient health information.

Definition:Manages all operations required to adjudicate fee for service claims or managed care encounter reports.

A device used by an author to record new information, which may also be used by the author to select existing information for aggregation with newly recorded information for the purpose of generating a new artifact.

UsageConstraint:COMPOSER ParticipationFunction should be used with DEV (device) ParticipationType.Usage Note:This code will enable implementers to more specifically represent the manner in which a Device participated in and facilitated the generation of a CDA Clinical Document or a CDA Entry by the responsible Author, which is comprised of the Author's newly entered content, and may include the pre-existing content selected by the Author, for the purpose of establishing the provenance and accountability for these acts.

A physician who discharged a patient from a hospital or other care unit that is the context of this service.

Definition:Managing the enrollment of covered parties.

In a typical surgery setting the assistant facing the primary surgeon. The first assistant performs parts of the operation and assists in others (e.g., incision, approach, electrocoutering, ligatures, sutures).

Definition:Managing all operations required to administer a fee for service or indemnity health plan including enrolling covered parties and providing customer service, provider contracting, claims payment, care management and utilization review. Definition:Responsibility taken by a sponsor to contract with one or more underwriters for the assumption of full responsibility for the risk and administration of a policy or program.

**Description:**Legal guardian of the subject of consent authorized to author a consent directive for the subject of consent.

Definition:Managing all operations required to administer a managed care plan including enrolling covered parties and providing customer service,, provider contracting, claims payment, care management and utilization review.

A person (usually female) helping a woman deliver a baby. Responsibilities vary locally, ranging from a mere optional assistant to a full required participant, responsible for (normal) births and pre- and post-natal care for both mother and baby.

In a typical surgery setting the non-sterile nurse handles material supply from the stock, forwards specimen to pathology, and helps with other non-sterile tasks (e.g., phone calls, etc.).

Definition:Contracting for the provision and administration of health services to payors while retaining the risk for coverage. Contracting may be for all provision and administration; or for provision of certain types of services; for provision of services by region; and by types of administration, e.g., claims adjudication, enrollment, provider management, and utilization management. Typically done by underwriters for sponsors who need coverage provided to covered parties in multiple regions. The underwriter may act as the payor in some, but not all of the regions in which coverage is provided.

The healthcare provider that holds primary responsibility for the overall care of a patient.

**Description:**Person authorized with healthcare power of attorney to author a consent directive for the subject of consent.

**Description:**Personal representative of the subject of consent authorized to author a consent directive for the subject of consent.

In a typical surgery setting the primary performing surgeon.

**Definition:**Provider authorized to mask information to protect the patient, a third party, or to ensure that the provider has consulted with the patient prior to release of this information.

Definition:Managing provider contracting, provider services, credentialing, profiling, performance measures, and ensuring network adequacy. Definition:Underwriting reinsurance for another underwriter for the policy or program. Definition:Underwriting reinsurance for another reinsurer.

A verifier who is accountable for reviewing and asserting that the verification of an Act complies with jurisdictional or organizational policy.

UsageConstraint:UsageConstraint: Specifies the exact function that an actor is authorized to have as a verifier of an Act. Connotes that a specialized verifier asserts compliance for veracity of the review per jurisdictional or organizational policy. E.g., The Provider who takes responsibility for authenticity of a record submitted to a payer.

REVIEW ParticipationFunction should be used with VFR (verifier)

A physician who made rounds on a patient in a hospital or other care center.

In a typical surgery setting the assistant who primarily holds the hooks.

Definition:Responsibility taken by a sponsor to organize the underwriting of risk and administration of a policy or program.

In a typical surgery setting the nurse in charge of the instrumentation.

**Description:**Subject of consent authorized to author a consent directive.

Definition:Delegating risk for a policy or program to one or more subcontracting underwriters, e.g., a major health insurer may delegate risk for provision of coverage under a national health plan to other underwriters by region .

In a typical surgery setting there is rarely a third assistant (e.g., in some Hip operations the third assistant postures the affected leg).

Definition:Managing utilization of services by ensuring that providers adhere to, e.g., payeraTMs clinical protocols for medical appropriateness and standards of medical necessity. May include management of authorizations for services and referrals. Definition:Provision of underwriting analysis for another underwriter without assumption of risk.

This code is used to specify the exact function an actor is authorized to have in a service in all necessary detail.

This code is used to specify the exact function an actor is authorized to have as a receiver of information that is the subject of a consent directive or consent override.

This code is used to specify the exact function an actor is authorized to have in authoring a consent directive.

Definition:Set of codes indicating the manner in which sponsors, underwriters, and payers participate in a policy or program.

This code is used to specify the exact function an actor is authorized to have in authoring a consent override.

Definition:Set of codes indicating the manner in which payors participate in a policy or program.</ Definition:Set of codes indicating the manner in which sponsors participate in a policy or program. NOTE: use only when the Sponsor is not further specified with a SponsorRoleType as being either a fully insured sponsor or a self insured sponsor. Definition:Set of codes indicating the manner in which underwriters participate in a policy or program.
UPDATE:

A set of codes specifying the modality by which the Entity playing the Role is participating in the Act.

Examples:Physically present, over the telephone, written communication.Rationale:Particularly for author (originator) participants this is used to specify whether the information represented by the act was initially provided verbally, (hand-)written, or electronically.Open Issue:There needs to be a reexamination of the hierarchies as there seems to be some muddling between ELECTRONIC and other concepts that involve electronic communication that are in other hierarchies.
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Participation by text or diagrams transmitted over an online app, e.g. Facebook Messenger, WhatsApp, or similar web app.

Participation by pre-recorded voice. Communication is limited to one direction (from the recorder to recipient).

Participation by non-human-languaged based electronic signal

Participation by text or diagrams transmitted over an electronic mail system.

Participation by voice communication where parties speak to each other directly.

Participation by text or diagrams printed on paper that have been transmitted over a fax device

Participation by text or diagrams printed on paper or other recording medium

Participation by text or diagrams printed on paper transmitted physically (e.g. by courier service, postal service).

Participation by text or diagrams transmitted by an MMS message.

Participation by messaging typically from a mobile phone or mobile device through a cellular network or Internet. Includes secured or unsecured messaging transmission and includes online chat. Also includes submission of photos or other images.

Participation by text or diagrams submitted by computer network, e.g. online survey.

Participation by voice communication where the voices of the communicating parties are transported over an electronic medium

Participation by direct action where subject and actor are in the same location. (The participation involves more than communication.)

Participation by direct action where subject and actor are in separate locations, and the actions of the actor are transmitted by electronic or mechanical means. (The participation involves more than communication.)

Participation by text or diagrams transmitted by an SMS message.

Participation by text or diagrams printed on paper or other recording medium where the recording was performed using a typewriter, typesetter, computer or similar mechanism.

Participation by voice communication

Participation by voice and visual communication where the voices and images of the communicating parties are transported over an electronic medium

Participation by human language recorded on a physical material

UPDATE:

A set of codes specifying whether and how the participant has attested his participation through a signature and or whether such a signature is needed.

Examples:A surgical Procedure act object (representing a procedure report) requires a signature of the performing and responsible surgeon, and possibly other participants. (See also: Participation.signatureText.)
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

The particpant intends to provide a signature.

Signature has been affixed, either written on file, or electronic (incl. digital) signature in Participation.signatureText.

A signature for the service is required of this actor.

UPDATE:

A code specifying the meaning and purpose of every Participation instance. Each of its values implies specific constraints on the Roles undertaking the participation.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.. If true, indicates that ActRelationships or Participations of the specified type (and any specializations thereof) will normally conduct. For more usage information, refer to the Core Principles specification. Name of relationship from Act to Participation Name of relationship from Role to Participation Sort key for relationship from Act to Participation Sort key for relationship from Role to Participation If true, indicates that the Act attribute or association (as represented by a typeCode for eaither ActRelationship or Pareticipation is a descriptor of the document (record) represented by the act object. If false, indicates the property is a descriptor of the action itself, actual, intended, or potential. Applies to interpretation of attributes and associations with respect to changes in the value of Act.actionNegationInd and Act.moodCode. (See descriptions of these attributes for further discussion.) For example, in an order, the id attribute [isDocumentCharacteristic = true] is an identifier of the record of the order, not an identifier of the intended event. On the other hand, the code attribute [isDocumentCharacteristic = false] describes a characteristic of the intended event.

The practitioner who is responsible for admitting a patient to a patient encounter.

The target of an Observation action. Links an observation to a Role whose player is the substance or most specific component entity (material, micro-organism, etc.) being measured within the subject.

Examples:A "plasma porcelain substance concentration" has analyte a Role with player substance Entity "porcelain".UsageNotes:The Role that this participation connects to may be any Role whose player is that substance measured. Very often, the scoper may indicate the system in which the component is being measured. E.g., for "plasma porcelain" the scoper could be "Plasma".
The Role that this participation connects to may be any Role whose player is that substance measured. Very often, the scoper may indicate the system in which the component is being measured. E.g., for "plasma porcelain" the scoper could be "Plasma".

The practitioner that has responsibility for overseeing a patient's care during a patient encounter.

Definition:A party that originates the Act and therefore has responsibility for the information given in the Act and ownership of this Act.Example:the report writer, the person writing the act definition, the guideline author, the placer of an order, the EKG cart (device) creating a report etc. Every Act should have an author. Authorship is regardless of mood always actual authorship.

Examples of such policies might include:

* The author and anyone they explicitly delegate may update the report; * All administrators within the same clinic may cancel and reschedule appointments created by other administrators within that clinic;

A party that is neither an author nor a party who is extended authorship maintenance rights by policy, may only amend, reverse, override, replace, or follow up in other ways on this Act, whereby the Act remains intact and is linked to another Act authored by that other party.

A verifier who attests to the accuracy of an act, but who does not have privileges to legally authenticate the act. An example would be a resident physician who sees a patient and dictates a note, then later signs it. Their signature constitutes an authentication.

In an obstetric service, the baby.

Target on behalf of whom the service happens, but that is not necessarily present in the service. Can occur together with direct target to indicate that a target is both, as in the case where the patient is the indirect beneficiary of a service rendered to a family member, e.g. counseling or given home care instructions. This concept includes a participant, such as a covered party, who derives benefits from a service act covered by a coverage act.

Note that the semantic role of the intended recipient who benefits from the happening denoted by the verb in the clause. Thus, a patient who has no coverage under a policy or program may be a beneficiary of a health service while not being the beneficiary of coverage for that service.

Definition: A factor, such as a microorganism, chemical substance, or form of radiation, whose presence, excessive presence, or (in deficiency diseases) relative absence is essential, in whole or in part, for the occurrence of a condition.

Constraint: The use of this participation is limited to observations.

A person or organization who should be contacted for follow-up questions about the act in place of the author.

The catalyst of a chemical reaction, such as an enzyme or a platinum surface. In biochemical reactions, connects the enzyme with the molecular interaction

An advisor participating in the service by performing evaluations and making recommendations.

The target participation for an individual in a health care coverage act in which the target role is either the policy holder of the coverage, or a covered party under the coverage.

Participant material that is taken up, diminished, altered, or disappears in the act.

An entity (person, organization or device) that is in charge of maintaining the information of this act (e.g., who maintains the report or the master service catalog item, etc.).

Participant used in performing the act without being substantially affected by the act (i.e. durable or inert with respect to that particular service).

Examples:monitoring equipment, tools, but also access/drainage lines, prostheses, pace maker, etc.

Target participant that is substantially present in the act and which is directly involved in the action (includes consumed material, devices, etc.).

The practitioner who is responsible for the discharge of a patient from a patient encounter.

Distributes material used in or generated during the act.

In some organ transplantation services and rarely in transfusion services a donor will be a target participant in the service. However, in most cases transplantation is decomposed in three services: explantation, transport, and implantation. The identity of the donor (recipient) is often irrelevant for the explantation (implantation) service.

The destination for services. May be a static building (or room therein) or a movable facility (e.g., ship).

A location where data about an Act was entered.

A person entering the data into the originating system. The data entry person is collected optionally for internal quality control purposes. This includes the transcriptionist for dictated text.

Only with Transportation services. A person who escorts the patient.

Description:The entity playing the associated role is the physical (including energy), chemical or biological substance that is participating in the exposure. For example in communicable diseases, the associated playing entity is the disease causing pathogen.

**Description:**Direct participation in an exposure act where it is unknown that the participant is the source or subject of the exposure. If the participant is known to be the contact of an exposure then the SBJ participation type should be used. If the participant is known to be the source then the EXSRC participation type should be used.

Description:The entity playing the associated role is the target (contact) of exposure.

**Description:**The entity playing the associated role is the source of exposure.

The target person or organization contractually recognized by the issuer as a participant who has assumed fiscal responsibility for another personaTMs financial obligations by guaranteeing to pay for amounts owed to a particular account

*Example:*The subscriber of the patientaTMs health insurance policy signs a contract with the provider to be fiscally responsible for the patient billing account balance amount owed.

Participant who posses an instrument such as a financial contract (insurance policy) usually based on some agreement with the author.

Target that is not substantially present in the act and which is not directly affected by the act, but which will be a focus of the record or documentation of the act.

A source of reported information (e.g., a next of kin who answers questions about the patient's history). For history questions, the patient is logically an informant, yet the informant of history questions is implicitly the subject.

A party, who may or should receive or who has recieved the Act or subsequent or derivative information of that Act. Information recipient is inert, i.e., independent of mood." Rationale: this is a generalization of a too diverse family that the definition can't be any more specific, and the concept is abstract so one of the specializations should be used.

A verifier who legally authenticates the accuracy of an act. An example would be a staff physician who sees a patient and dictates a note, then later signs it. Their signature constitutes a legal authentication.

The facility where the service is done. May be a static building (or room therein) or a moving location (e.g., ambulance, helicopter, aircraft, train, truck, ship, etc.)

An information recipient to notify for urgent matters about this Act. (e.g., in a laboratory order, critical results are being called by phone right away, this is the contact to call; or for an inpatient encounter, a next of kin to notify when the patient becomes critically ill).

The entity (person or organization) who legally attests that the information present in the Act is a true replica of an original.

A device that changes ownership due to the service, e.g., a pacemaker, a prosthesis, an insulin injection equipment (pen), etc. Such material may need to be restocked after he service.

The location of origin for services. May be a static building (or room therein) or a movable facility (e.g., ship).

Indicates that the target of the participation is involved in some manner in the act, but does not qualify how.

The principal or primary performer of the act.

Information recipient to whom an act statement is primarily directed. E.g., a primary care provider receiving a discharge letter from a hospitalist, a health department receiving information on a suspected case of infectious disease. Multiple of these participations may exist on the same act without requiring that recipients be ranked as primary vs. secondary.

Participant material that is brought forth (produced) in the act (e.g., specimen in a specimen collection, access or drainage in a placement service, medication package in a dispense service). It does not matter whether the material produced had existence prior to the service, or whether it is created in the service (e.g., in supply services the product is taken from a stock).

Definition:A person, non-person living subject, organization or device that who actually and principally carries out the action. Device should only be assigned as a performer in circumstances where the device is performing independent of human intervention. Need not be the principal responsible actor.Exampe:A surgery resident operating under supervision of attending surgeon, a search and rescue dog locating survivors, an electronic laboratory analyzer or the laboratory discipline requested to perform a laboratory test. The performer may also be the patient in self-care, e.g. fingerstick blood sugar. The traditional order filler is a performer. This information should accompany every service event.Note:that existing HL7 designs assign an organization as the playing entity of the Role that is the performer. These designs should be revised in subsequent releases to make this the scooping entity for the role involved.

The record target indicates whose medical record holds the documentation of this act. This is especially important when the subject of a service is not the patient himself.

The person (or organization) who receives the product of an Act.

A device that does not change ownership due to the service, i.e., a surgical instrument or tool or an endoscope. The distinction between reuseable and non-reuseable must be made in order to know whether material must be re-stocked.

A person having referred the subject of the service to the performer (referring physician). Typically, a referring physician will receive a report.

A participant (e.g. provider) who has referred the subject of an act (e.g. patient).

Typically, a referred by participant will provide a report (e.g. referral).

The person who receives the patient

The person or organization that has primary responsibility for the act. The responsible party is not necessarily present in an action, but is accountable for the action through the power to delegate, and the duty to review actions with the performing actor after the fact. This responsibility may be ethical, legal, contractual, fiscal, or fiduciary in nature.

Example:A person who is the head of a biochemical laboratory; a sponsor for a policy or government program.

Some services take place at multiple concurrent locations (e.g., telemedicine, telephone consultation). The location where the principal performing actor is located is taken as the primary location (LOC) while the other location(s) are considered "remote."

The principle target on which the action happens.

Examples:The patient in physical examination, a specimen in a lab observation. May also be a patient's family member (teaching) or a device or room (cleaning, disinfecting, housekeeping).UsageNotes:Not all direct targets are subjects. Consumables and devices used as tools for an act are not subjects. However, a device may be a subject of a maintenance action.
Not all direct targets are subjects. Consumables and devices used as tools for an act are not subjects. However, a device may be a subject of a maintenance action.

The subject of non-clinical (e.g. laboratory) observation services is a specimen.

A person assisting in an act through his substantial presence and involvement This includes: assistants, technicians, associates, or whatever the job titles may be.

Something incorporated in the subject of a therapy service to achieve a physiologic effect (e.g., heal, relieve, provoke a condition, etc.) on the subject. In an administration service the therapeutic agent is a consumable, in a preparation or dispense service, it is a product. Thus, consumable or product must be specified in accordance with the kind of service.

An entity entering the data into the originating system. The data entry entity is collected optionally for internal quality control purposes. This includes the transcriptionist for dictated text transcribed into electronic form.

A secondary information recipient, who receives copies (e.g., a primary care provider receiving copies of results as ordered by specialist).

For services, an intermediate location that specifies a path between origin an destination.

A person who verifies the correctness and appropriateness of the service (plan, order, event, etc.) and hence takes on accountability.

Only with service events. A person witnessing the action happening without doing anything. A witness is not necessarily aware, much less approves of anything stated in the service event. Example for a witness is students watching an operation or an advanced directive witness.

Participations related, but not primary to an act. The Referring, Admitting, and Discharging practitioners must be the same person as those authoring the ControlAct event for their respective trigger events.

Parties that may or should contribute or have contributed information to the Act. Such information includes information leading to the decision to perform the Act and how to perform the Act (e.g., consultant), information that the Act itself seeks to reveal (e.g., informant of clinical history), or information about what Act was performed (e.g., informant witness).

UPDATE:

Patient VIP code

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Board member of health care organization

Family member of staff physician

Member of the health care organization physician staff

Financial donor to the health care organization

Foreign citizen dignitary of interest to the health care organization

Government dignitary of interest to the organization

Family member of staff member

Staff member of the health care organization

Very important person of interest to the health care organization

UPDATE:

Describes payment terms for a financial transaction, used in an invoice.

This is typically expressed as a responsibility of the acceptor or payor of an invoice.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Payment in full for products and/or services is required as soon as the service is performed or goods delivered.

Payment in full for products and/or services is required 30 days from the time the service is performed or goods delivered.

Payment in full for products and/or services is required 60 days from the time the service is performed or goods delivered.

Payment in full for products and/or services is required 90 days from the time the service is performed or goods delivered.

The pan Canadian LOINC Observation Code Database (pCLOCD) is the Canadian version of the LOINC(tm) database. It was created using the LOINC(tm) records and attributes that were constrained for Canadian use and supplemented to specifically meet Canadian requirements. It contains the core LOINC(tm) attributes as required by Regenstrief copyright rules. The LOINC(tm) Component has been customized to meet Canadian requirements and is displayed as the pan Canadian Component Name. This component name is the basis for the pan Canadian Display Name. Core attributes are include both English and Canadian French.

This code system contains supplemental "X" codes defined in the pCLOCD that do not yet exist in the LOINC code system.

**** MISSING DESCRIPTION ****

en
UPDATE:

A code identifying a person's disability.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Vision impaired

Hearing impaired

Speech impaired

Mentally impaired

A crib is required to move the person

Person requires crutches to ambulate

A gurney is required to move the person

Person requires a wheelchair to be ambulatory

Person requires a walker to ambulate

2010 Industry coding system used by CDC (NIOSH and NCHS) for coding industry text. Industry describes an economic/business sector comprised of businesses/ enterprises concerned with the output of a specified category of products or services.

2010 Occupation coding system used by CDC (NIOSH and NCHS) for coding occupation text. Occupation describes a set of activities or tasks that individuals are paid to perform or, if unpaid, define a person's contribution to a household/family business/community.

The concepts representing the values supporting Occupational Data for Health, including Job Supervisory Level or Pay Grade (ODH) code system consists of data elements that describe a person's work information, structured to facilitate individual, population, and public health use; not intended to support billing.).

The U.S. Centers for Disease Control and Prevention (CDC) has prepared a code set for use in coding race and ethnicity data. This code set is based on current federal standards for classifying data on race and ethnicity, specifically the minimum race and ethnicity categories defined by the U.S. Office of Management and Budget (OMB) and a more detailed set of race and ethnicity categories maintained by the U.S. Bureau of the Census (BC). The main purpose of the code set is to facilitate use of federal standards for classifying data on race and ethnicity when these data are exchanged, stored, retrieved, or analyzed in electronic form. At the same time, the code set can be applied to paper-based record systems to the extent that these systems are used to collect, maintain, and report data on race and ethnicity in accordance with current federal standards.

The content is available at https://phinvads.cdc.gov/vads/ViewCodeSystem.action?id=2.16.840.1.113883.6.238#.

The PNDS provides standardized terms and codes for patient problems/nursing diagnoses, nursing interventions including actual or expected (goal) outcomes. The PNDS provides standardized terms and codes for nursing diagnoses (a subset of NANDA), nursing interventions and outcomes. The outcomes and interventions are in a relational database. The PNDS intervention and outcome statements are attached in an Access Database. The NANDA diagnoses in the PNDS have already been registered by HL7.

POS Codes

UPDATE: Deprecation Comment:This code system was deprecated as of the November 2007 harmonization meeting. The content was folded into AddressUse (2.16.840.1.113883.5.1119), which replaces this code system. en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired..

A flag indicating that the address is bad, in fact, useless.

Indicates a work place address or telecommunication address that reaches the individual or organization directly without intermediaries. For phones, often referred to as a 'private line'.

A communication address at a home, attempted contacts for business purposes might intrude privacy and chances are one will contact family or other household members instead of the person one wishes to call. Typically used with urgent cases, or if no other contacts are available.

The primary home, to reach a person after business hours.

A vacation home, to reach a person while on vacation.

Used primarily to visit an address.

Used to send mail.

Indicates a work place address or telecommunication address that is a 'standard' address which may reach a reception service, mail-room, or other intermediary prior to the target entity.

A temporary address, may be good for visit or mailing. Note that an address history can provide more detailed information.

An office address. First choice for business related contacts during business hours.

UPDATE:

**** MISSING DESCRIPTION ****

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

The beta-distribution is used for data that is bounded on both sides and may or may not be skewed (e.g., occurs when probabilities are estimated.) Two parameters a and b are available to adjust the curve. The mean m and variance s2 relate as follows: m = a/ (a + b) and s2 = ab/((a + b)2 (a + b + 1)).

Used for data that describes extinction. The exponential distribution is a special form of g-distribution where a = 1, hence, the relationship to mean m and variance s2 are m = b and s2 = b2.

Used to describe the quotient of two c2 random variables. The F-distribution has two parameters n1 and n2, which are the numbers of degrees of freedom of the numerator and denominator variable respectively. The relationship to mean m and variance s2 are: m = n2 / (n2 - 2) and s2 = (2 n2 (n2 + n1 - 2)) / (n1 (n2 - 2)2 (n2 - 4)).

The gamma-distribution used for data that is skewed and bounded to the right, i.e. where the maximum of the distribution curve is located near the origin. The g-distribution has a two parameters a and b. The relationship to mean m and variance s2 is m = a b and s2 = a b2.

The logarithmic normal distribution is used to transform skewed random variable X into a normally distributed random variable U = log X. The log-normal distribution can be specified with the properties mean m and standard deviation s. Note however that mean m and standard deviation s are the parameters of the raw value distribution, not the transformed parameters of the lognormal distribution that are conventionally referred to by the same letters. Those log-normal parameters mlog and slog relate to the mean m and standard deviation s of the data value through slog2 = log (s2/m2 + 1) and mlog = log m - slog2/2.

This is the well-known bell-shaped normal distribution. Because of the central limit theorem, the normal distribution is the distribution of choice for an unbounded random variable that is an outcome of a combination of many stochastic processes. Even for values bounded on a single side (i.e. greater than 0) the normal distribution may be accurate enough if the mean is "far away" from the bound of the scale measured in terms of standard deviations.

Used to describe the quotient of a normal random variable and the square root of a c2 random variable. The t-distribution has one parameter n, the number of degrees of freedom. The relationship to mean m and variance s2 are: m = 0 and s2 = n / (n - 2)

The uniform distribution assigns a constant probability over the entire interval of possible outcomes, while all outcomes outside this interval are assumed to have zero probability. The width of this interval is 2s sqrt(3). Thus, the uniform distribution assigns the probability densities f(x) = sqrt(2 s sqrt(3)) to values m - s sqrt(3) >= x <= m + s sqrt(3) and f(x) = 0 otherwise.

Used to describe the sum of squares of random variables which occurs when a variance is estimated (rather than presumed) from the sample. The only parameter of the c2-distribution is n, so called the number of degrees of freedom (which is the number of independent parts in the sum). The c2-distribution is a special type of g-distribution with parameter a = n /2 and b = 2. Hence, m = n and s2 = 2 n.

UPDATE:

Codes used to specify whether a message is part of a production, training, or debugging system.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Identifies debugging type of processing.

Identifies production type of processing.

Identifies training type of processing.

UPDATE:

This attribute defines whether the message is being sent in current processing, archive mode, initial load mode, restore from archive mode, etc.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Identifies archive mode of processing.

Identifies initial load mode of processing.

Identifies restore mode of processing.

Identifies on-line mode of processing.

UPDATE:

The domain of coded values used as parameters within QueryByParameter queries.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

**Description:**Returns all dispenses to date for a prescription.

Return all orders.

Filter to only include SubstanceAdministration orders which have no remaining quantity authorized to be dispensed.

**Description:**Result set should not be filtered based on the presence of issues.

**Description:**Result set should be filtered to only include records with associated issues.

**Description:**Result set should be filtered to only include records with associated unmanaged issues.

**Description:**Returns the most recent dispense for a prescription.

Filter to only include SubstanceAdministration orders which have no fulfilling supply events performed.

**Description:**Returns no dispense for a prescription.

Return only those orders that do not have results.

Return only those orders that have results.

Filter to only include SubstanceAdministration orders which have had at least one fulfilling supply event, but which still have outstanding quantity remaining to be authorized.

**Description:**Filter codes used to manage volume of dispenses returned by a parameter-based queries.

Filter codes used to manage types of orders being returned by a parameter-based query.

A "helper" vocabulary used to construct complex query filters based on how and whether a prescription has been dispensed.

**Description:**Indicates how result sets should be filtered based on whether they have associated issues.

UPDATE:

Identifies the time frame in which the response is expected.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Query response is deferred.

Query response is immediate.

UPDATE:

Values in this domain specify the units of a query quantity limited request.

Deprecation Comment:Deprecated as per 11/2008 Harmonization cleanup; internal and obsolete HL7 usage, no longer used. This is a holdover. It is not referenced. It is superseded by QueryRequestLimit.
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Used where size of input buffer has limitations.

Used where lines of respone has limitations.

Used where pages of response has limitations.

Used where number of records or instances of items in the query response result set has limitations.

UPDATE: Definition:Defines the units associated with the magnitude of the maximum size limit of a query response that can be accepted by the requesting application. en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. Definition:The number of matching instances (number of focal classes). The document header class is the focal class of a document, a record would therefore be equal to a document. Definition:The number of matching instances (number of focal classes). The document header class is the focal class of a document, a record would therefore be equal to a document. UPDATE:

A code classifying the general nature of the response to a given query. Includes whether or not data was found, or whether an error occurred.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Query Error. Application Error.

No errors, but no data was found matching the query request specification.

Query reponse data found for 1 or more result sets matching the query request specification.

QueryError. Problem with input ParmetersError

UPDATE:

A code specifying the state of the Query.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Query status aborted

Query Status delivered response

Query Status executing

Query Status new

Query Status wait continued

UPDATE: Deprecation Information:Deprecated per UP-263. This code system is NOT the acknowledged source of truth for Race concepts and codes. It should no longer be used. https://terminology.hl7.org/CodeSystem-CDCREC.html should be used in its place. In the United States, federal standards for classifying data on race determine the categories used by federal agencies and exert a strong influence on categorization by state and local agencies and private sector organizations. The federal standards do not conceptually define race, and they recognize the absence of an anthropological or scientific basis for racial classification. Instead, the federal standards acknowledge that race is a social-political construct in which an individual's own identification with one more race categories is preferred to observer identification. The standards use a variety of features to define five minimum race categories. Among these features are descent from "the original peoples" of a specified region or nation. The minimum race categories are American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander, and White. The federal standards stipulate that race data need not be limited to the five minimum categories, but any expansion must be collapsible to those categories. en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Note that this term remains in the table for completeness, even though within HL7, the notion of Other code is deprecated.

Note that this term remains in the table for completeness, even though within HL7, the notion of Other code is deprecated.

The Read Codes Four Byte Set consists of 4 alphanumeric characters. This version contains approximately 40,000 codes arranged in a hierarchical structure.

Top level hierarchy sections: Disorders Findings Surgical procedures Investigations Occupations Drugs

The Read Codes Version 2 contains over 70,000 coded concepts arranged in a hierarchical structure.

Top level hierarchy sections: Disorders Findings Surgical procedures Investigations Occupations Drugs

Clinical Terms Version 3 contains over 200,000 coded concepts arranged in a sub-type hierarchical structure.

Top level hierarchy sections: Disorders Findings Morphology Surgical procedures Regimes & therapies Investigations Stages & scales Occupations Organisms Units Drugs Appliances & equipment

The Reference Sequence (RefSeq) is one of the NCBI projects, the RefSeq collection aims to provide a comprehensive, integrated, non-redundant, well-annotated set of sequences, including genomic DNA, transcripts, and proteins. ReqSeq is accessible via BLAST, Entrez, and the NCBI FTP site. Information is also available in Entrez Genomes and Entrez Gene, and for some genomes additional information is available in the Map Viewer.

RefSeq entries can be used with the HL7 coded data type. For example, in the HL7 messages specified according to the HL7 V2 Clinical Genomics Fully LOINC-Qualified Genetic Variation Model, RefSeq entries can be used to as the observation values for genomic reference sequence identifiers (LOINC \#: 48013-7).

More information may be found at: http://www.ncbi.nlm.nih.gov/RefSeq

Versioning informaiton: The latest release of RefSeq was released on May 13, 2009 with the release number of 35.

RefSeq generates new releases roughly every two months. The dates of the three previous releases were: Release 34, March 12, 2009 Release 33, January 20, 2009 Release 32, November 17, 2008

RefSeq is a free database for the public.

UPDATE:

Identifies common relational operators used in selection criteria.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Specified set of things includes value being evaluated.

Equal condition applied to comparisons.

Greater than or equal condition applied to comparisons.

A generic comparison selects a record for inclusion in the response if the beginning of the designated element value matches the select string.

Greater than condition applied to comparisons.

Less than or equal condition applied to comparisons.

Less than condition applied to comparisons.

Not equal condition applied to comparisons.

UPDATE:

A code specifying the logical conjunction of the criteria among all the condition-links of Acts (e.g., and, or, exclusive-or.)

Constraints:All AND criteria must be true. If OR and AND criteria occur together, one criterion out of the OR-group must be true and all AND criteria must be true also. If XOR criteria occur together with OR and AND criteria, exactly one of the XOR criteria must be true, and at least one of the OR criteria and all AND criteria must be true. In other words, the sets of AND, OR, and XOR criteria are in turn combined by a logical AND operator (all AND criteria and at least one OR criterion and exactly one XOR criterion.) To overcome this ordering, Act criteria can be nested in any way necessary.
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

This condition must be true.

At least one of the condition among all OR conditions must be true.

One and only one of the XOR conditions must be true.

UPDATE:

Assigment of spiritual faith affiliation

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.
UPDATE:

Specifies whether a response is expected from the addressee of this interaction and what level of detail that response should include

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Respond with exceptions and a notification of completion

Respond with exceptions, completion, modifications and include more detail information (if applicable)

Respond with exceptions only

Respond with exceptions, completion, and modification with detail (as above), and send positive confirmations even if no modifications are being made.

Respond only with message level acknowledgements, i.e., only notify acceptance or rejection of the message, do not include any application-level detail

Respond with exceptions, completions and modifications or revisions done before completion

Do not send any kind of response

UPDATE:

Defines the timing and grouping of the response instances.

OpenIssue:Description copied from Concept Domain of same name. Must be verified.
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Query response to be sent as an HL7 Batch.

Query response to occur in real time.

Query response to sent as a series of responses at the same time without the use of batch formatting.

UPDATE:

Specifies the mode, immediate versus deferred or queued, by which a receiver should communicate its receiver responsibilities.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

The receiver may respond in a non-immediate manner. Note: this will be the default value.

The receiver is required to assume that the sender is blocking and behave appropriately by sending an immediate response.

The receiver shall keep any application responses in a queue until such time as the queue is polled.

UPDATE:

Codes for the Role class hierarchy. The values in this hierarchy, represent a Role which is an association or relationship between two entities - the entity that plays the role and the entity that scopes the role. Roles names are derived from the name of the playing entity in that role.

The role hierarchy stems from three core concepts, or abstract domains:

* **RoleClassOntological** is an abstract domain that collects roles in which the playing entity is defined or specified by the scoping entity. * **RoleClassPartitive** collects roles in which the playing entity is in some sense a "part" of the scoping entity. * **RoleClassAssociative** collects all of the remaining forms of association between the playing entity and the scoping entity. This set of roles is further partitioned between: * **RoleClassPassive** which are roles in which the playing entity is used, known, treated, handled, built, or destroyed, etc. under the auspices of the scoping entity. The playing entity is passive in these roles in that the role exists without an agreement from the playing entity. * **RoleClassMutualRelationship** which are relationships based on mutual behavior of the two entities. The basis of these relationship may be formal agreements or they may be *de facto* behavior. Thus, this sub-domain is further divided into: * **RoleClassRelationshipFormal** in which the relationship is formally defined, frequently by a contract or agreement. * **Personal relationship** which inks two people in a personal relationship.

The hierarchy discussed above is represented In the current vocabulary tables as a set of abstract domains, with the exception of the "Personal relationship" which is a leaf concept.

OpenIssue:Description copied from Concept Domain of same name. Must be verified.
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. A property that indicates the status of the concept. One of active, experimental, deprecated, or retired. The formal name for the class clone under this code The name of the relationship from Role to the payer Entity The name of the relationship from Role to the scoper Entity Sort key for the relationship from the Entity to the playedRole The sort key for the relationship from the Entity to the scopedRole The name of the relationship from the Entity to the playedRole The name of the relationship from the Entity to the scopedRole The name of the relationship from Participation to Role

A role in which the playing entity (material) provides access to another entity. The principal use case is intravenous (or other bodily) access lines that preexist and need to be referred to for medication routing instructions.

Definition:a therapeutically active ingredient (player) in a mixture (scoper), where the mixture is typically a manufactured pharmaceutical. It is unknown if the quantity of such an ingredient is expressed precisely in terms of the playing ingredient substance, or, if it is specified in terms of a closely related substance (active moiety or reference substance). Description:Active ingredient, where the ingredient substance (player) is itself the "basis of strength", i.e., where the Role.quantity specifies exactly the quantity of the player substance in the medicine formulation.Examples:Lopressor 50 mg actually contains 50 mg of metoprolol succinate, even though the active moiety is metoprolol, but also: Tenormin 50 mg contain 50 mg of atenolol, as free base, i.e., where the active ingredient atenolol is also the active moiety. Description:Active ingredient, where not the ingredient substance (player), but itaTMs active moiety is the "basis of strength", i.e., where the Role.quantity specifies the quantity of the player substance's active moiety in the medicine formulation.Examples:1 mL of Betopic 5mg/mL eye drops contains 5.6 mg betaxolol hydrochloride equivalent to betaxolol base 5 mg. Description:Active ingredient, where not the ingredient substance (player) but another reference substance with the same active moiety, is the "basis of strength", i.e., where the Role.quantity specifies the quantity of a reference substance, similar but different from the player substance's in the medicine formulation.Examples:Toprol-XL 50 mg contains 47.5 mg of metoprolol succinate equivalent to 50 mg of metoprolol tartrate.

The molecule or ion that is responsible for the intended pharmacological action of the drug substance, excluding those appended or associated parts of the molecule that make the molecule an ester, salt (including a salt with hydrogen or coordination bonds), or other noncovalent derivative (such as a complex, chelate, or clathrate).

Examples: heparin-sodium and heparin-potassium have the same active moiety, heparin; the active moiety of morphine-hydrochloride is morphine.

A component (player) added to enhance the action of an active ingredient (scoper) (in the manner of a catalyst) but which has no active effect in and of itself. Such ingredients are significant in defining equivalence of products in a way that inactive ingredients are not.

A physical association whereby two Entities are in some (even lose) spatial relationship with each other such that they touch each other in some way.

Examples:the colon is connected (and therefore adjacent) to the jejunum; the colon is adjacent to the liver (even if not actually connected.)UsageConstraints:Adjacency is in principle a symmetrical connection, but scoper and player of the role should, where applicable, be assigned to have scoper be the larger, more central Entity and player the smaller, more distant, appendage.

A material (player) that can be administered to an Entity (scoper).

An ingredient (player) that is added to a base (scoper), that amounts to a minor part of the overall mixture.

Player of the Affiliate role has a business/professional relationship with scoper. Player and scoper may be persons or organization. The Affiliate relationship does not imply membership in a group, nor does it exist for resource scheduling purposes.

Example:A healthcare provider is affiliated with another provider as a business associate.

An entity (player) that acts or is authorized to act on behalf of another entity (scoper).

A portion (player) of an original or source specimen (scoper) used for testing or transportation.

An agent role in which the agent is an Entity acting in the employ of an organization. The focus is on functional role on behalf of the organization, unlike the Employee role where the focus is on the 'Human Resources' relationship between the employee and the organization.

A base ingredient (player) is what comprises the major part of a mixture (scoper). E.g., Water in most i.v. solutions, or Vaseline in salves. Among all ingredients of a material, there should be only one base. A base substance can, in turn, be a mixture.

Relates a place (playing Entity) as the location where a living subject (scoping Entity) was born.

A connection between two atoms of a molecule.

Examples:double bond between first and second C in ethane, peptide bond between two amino-acid, disulfide bridge between two proteins, chelate and ion associations, even the much weaker van-der-Waals bonds can be considered molecular bonds.UsageConstraints:See connection and adjacency for the assignment of player and scoper.

A person responsible for the primary care of a patient at home.

A person, non-person living subject, or place that is the subject of an investigation related to a notifiable condition (health circumstance that is reportable within the applicable public health jurisdiction)

The player of the role is a child of the scoping entity, in a generic sense.

Citizen of apolitical entity

Description:A role played by a party making a claim for coverage under a policy or program. A claimant must be either a person or organization, or a group of persons or organizations. A claimant is not a named insured or a program eligible.Discussion:With respect to liability insurance such as property and casualty insurance, a claimant must file a claim requesting indemnification for a loss that the claimant considers covered under the policy of a named insured. The claims adjuster for the policy underwriter will review the claim to determine whether the loss meets the benefit coverage criteria under a policy, and base any indemnification or coverage payment on that review. If a third party is liable in whole or part for the loss, the underwriter may pursue third party liability recovery. A claimant may be involved in civil or criminal legal proceedings involving claims against a defendant party that is indemnified by an insurance policy or to protest the finding of a claims adjustor. With respect to life insurance, a beneficiary designated by a named insured becomes a claimant of the proceeds of coverage, as in the case of a life insurance policy. However, a claimant for coverage under life insurance is not necessarily a designated beneficiary.Note:A claimant is not a named insured. However, a named insured may make a claim under a policy, e.g., an insured driver may make a claim for an injury under his or her comprehensive automobile insurance policy. Similarly, a program eligible may make a claim under program, e.g., an unemployed worker may claim benefits under an unemployment insurance program, but parties playing these covered party role classes are not, for purposes of this vocabulary and in an effort to clearly distinguish role classes, considered claimants.

In the case of a named insured making a claim, a role type code INSCLM (insured claimant) subtypes the class to indicate that either a named insured or an individual insured has filed a claim for a loss. In the case of a program eligible, a role type code INJWKR (injured worker) subtypes the class to indicate that the covered party in a workers compensation program is an injured worker, and as such, has filed a "claim" under the program for benefits. Likewise, a covered role type code UNEMP (unemployed worker) subtypes the program eligible class to indicate that the covered party in an unemployment insurance program has filed a claim for unemployment benefits.

Example:A claimant under automobile policy that is not the named insured.

An ingredient whose presence is not intended but may not be reasonably avoided given the circumstances of the mixture's nature or origin.

A substance (player) influencing the optical aspect of material (scoper).

An Entity that is authorized to issue or instantiate permissions, privileges, credentials or other formal/legal authorizations.

A person or an organization (player) which provides or receives information regarding another entity (scoper). Examples; patient NOK and emergency contacts; guarantor contact; employer contact.

An adjacency of two Entities held together by a bond which attaches to each of the two entities.

Examples:biceps brachii muscle connected to the radius bone, port 3 on a network switch connected to port 5 on a patch panel.UsageConstraints:See Adjacency for the assignment of scoper (larger, more central) and player (smaller, more distant).

Relates a material as the content (player) to a container (scoper). Unlike ingredients, the content and a container remain separate (not mixed) and the content can be removed from the container. A content is not part of an empty container.

A connection between two regional parts.

Examples:the connection between ascending aorta and the aortic arc, connection between descending colon and sigmoid.UsageConstraints:See connection and adjacency for the assignment of player and scoper.

A role class played by a person who receives benefit coverage under the terms of a particular insurance policy. The underwriter of that policy is the scoping entity. The covered party receives coverage because of some contractual or other relationship with the holder of that policy.

*Discussion:*This reason for coverage is captured in 'Role.code' and a relationship link with type code of indirect authority should be included using the policy holder role as the source, and the covered party role as the target.

Note that a particular policy may cover several individuals one of whom may be, but need not be, the policy holder. Thus the notion of covered party is a role that is distinct from that of the policy holder.

A role played by an entity that receives credentials from the scoping entity.

A role played by a provider, always a person, who has agency authority from a Clinical Research Sponsor to direct the conduct of a clinical research trial or study on behalf of the sponsor.

A role played by an entity, usually an organization, that is the sponsor of a clinical research trial or study. The sponsor commissions the study, bears the expenses, is responsible for satisfying all legal requirements concerning subject safety and privacy, and is generally responsible for collection, storage and analysis of the data generated during the trial. No scoper is necessary, as a clinical research sponsor undertakes the role on its own authority and declaration. Clinical research sponsors are usually educational or other research organizations, government agencies or biopharmaceutical companies.

Definition: Relates a place (playing Entity) as the location where a living subject (scoping Entity) died.

Description:A role played by a person covered under a policy or program based on an association with a subscriber, which is recognized by the policy holder.Note:The party playing the role of a dependent is not a claimant in the sense conveyed by the RoleClassCoveredParty CLAIM (claimant). However, a dependent may make a claim under a policy, e.g., a dependent under a health insurance policy may become the claimant for coverage under that policy for wellness examines or if injured and there is no liable third party. In the case of a dependent making a claim, a role type code INSCLM (insured claimant) subtypes the class to indicate that the dependent has filed a claim for services covered under the health insurance policy.Example:The dependent has an association with the subscriber such as a financial dependency or personal relationship such as that of a spouse, or a natural or adopted child. The policy holder may be required by law to recognize certain associations or may have discretion about the associations. For example, a policy holder may dictate the criteria for the dependent status of adult children who are students, such as requiring full time enrollment, or may recognize domestic partners as dependents. Under certain circumstances, the dependent may be under the indirect authority of a responsible party acting as a surrogate for the subscriber, for example, if the subscriber is differently abled or deceased, a guardian ad Lidem or estate executor may be appointed to assume the subscriberaTMs legal standing in the relationship with the dependent.

A role of a place (player) that is intended to house the provision of services. Scoper is the Entity (typically Organization) that provides these services. This is not synonymous with "ownership."

A material (player) distributed by a distributor (scoper) who functions between a manufacturer and a buyer or retailer.

An entity to be contacted in the event of an emergency.

A relationship between a person or organization and a person or organization formed for the purpose of exchanging work for compensation. The purpose of the role is to identify the type of relationship the employee has to the employer, rather than the nature of the work actually performed. (Contrast with AssignedEntity.)

Description:Specifies the player Entity (the equivalent Entity) as an Entity that is considered to be equivalent to a reference Entity (scoper). The equivalence is in principle a symmetric relationship, however, it is expected that the scoper is a reference entity which serves as reference entity for multiple different equivalent entities.Examples:An innovator's medicine formulation is the reference for "generics", i.e., formulations manufactured differently but having been proven to be biologically equivalent to the reference medicine. Another example is a reference ingredient that serves as basis for quantity specifications (basis of strength, e.g., metoprolol succinate specified in terms of metoprolol tartrate.)

A role played by a place at which the location of an event may be recorded.

An exposure agent carrier is an entity that is capable of conveying an exposure agent from one entity to another. The scoper of the role must be the exposure agent (e.g., pathogen).

A role played by an entity that has been exposed to a person or animal suffering a contagious disease, or with a location from which a toxin has been distributed. The player of the role is normally a person or animal, but it is possible that other entity types could become exposed. The role is scoped by the source of the exposure, and it is quite possible for a person playing the role of exposed party to also become the scoper a role played by another person. That is to say, once a person has become infected, it is possible, perhaps likely, for that person to infect others.

Management of exposures and tracking exposed parties is a key function within public health, and within most public health contexts - exposed parties are known as "contacts."

Description:A vector is a living subject that carries an exposure agent. The vector does not cause the disease itself, but exposes targets to the exposure agent. A mosquito carrying malaria is an example of a vector. The scoper of the role must be the exposure agent (e.g., pathogen).

A substance (player) added to a mixture (scoper) to make it taste a certain way. In food the use is obvious, in pharmaceuticals flavors can hide disgusting taste of the active ingredient (important in pediatric treatments).

Description:A fomite is a non-living entity that is capable of conveying exposure agent from one entity to another. A doorknob contaminated with a Norovirus is an example of a fomite. Anyone touching the doorknob would be exposed to the virus. The scoper of the role must be the exposure agent (e.g., pathogen).

Relates a specialized material concept (player) to its generalization (scoper).

A special link between pharmaceuticals indicating that the target (scoper) is a generic for the source (player).

A person or organization (player) that serves as a financial guarantor for another person or organization (scoper).

Guardian of a ward

Entity that is currently in the possession of a holder (scoper), who holds, or uses it, usually based on some agreement with the owner.

The role of a material (player) that is the physical health chart belonging to an organization (scoper).

An ingredient which is not considered therapeutically active, e.g., colors, flavors, stabilizers, or preservatives, fillers, or structural components added to an active ingredient in order to facilitate administration of the active ingredient but without being considered therapeutically active. An inactive ingredient need not be biologically inert, e.g., might be active as an allergen or might have a pleasant taste, but is not an essential constituent delivering the therapeutic effect.

A role in which the scoping entity designates an identifier for a playing entity.

Description:A role played by a party covered under a policy as the policy holder. An individual may be either a person or an organization.Note:The party playing the role of an individual insured is not a claimant in the sense conveyed by the RoleClassCoveredParty CLAIM (claimant). However, a named insured may make a claim under a policy, e.g., a party that is the named insured and policy holder under a comprehensive automobile insurance policy may become the claimant for coverage under that policy if injured in an automobile accident and there is no liable third party. In the case of an individual insured making a claim, a role type code INSCLM (insured claimant) subtypes the class to indicate that an individual insured has filed a claim for a loss.Example:The individual insured under a comprehensive automobile, disability, or property and casualty policy that is the policy holder.

Relates a component (player) to a mixture (scoper). E.g., Glucose and Water are ingredients of D5W, latex may be an ingredient in a tracheal tube.

An individual piece of material (player) instantiating a class of material (scoper).

An entity that is the subject of an investigation. This role is scoped by the party responsible for the investigation.

A role played by a place at which health care services may be provided without prior designation or authorization.

A microorganism that has been isolated from other microorganisms or a source matrix.

A relationship in which the scoper certifies the player ( e. g. a medical care giver, a medical device or a provider organization) to perform certain activities that fall under the jurisdiction of the scoper (e.g., a health authority licensing healthcare providers, a medical quality authority certifying healthcare professionals).

Relates an entity (player) to a location (scoper) at which it is present in some way. This presence may be limited in time.

Scoped by the manufacturer

A role played by an entity that is a member of a group. The group provides the scope for this role.

Among other uses, groups as used in insurance (groups of covered individuals) and in scheduling where resources may be grouped for scheduling and logistical purposes.

An ingredient (player) of a medication (scoper) that is inseparable from the active ingredients, but has no intended chemical or pharmaceutical effect itself, but which may have some systemic effect on the patient.

An example is a collagen matrix used as a base for transplanting skin cells. The collagen matrix can be left permanently in the graft site. Because it is of bovine origin, the patient may exhibit allergies or may have cultural objections to its use.

A role played by a member of a military service. Scoper is the military service (e.g. Army, Navy, Air Force, etc.) or, more specifically, the unit (e.g. Company C, 3rd Battalion, 4th Division, etc.)

An entity (player) that is maintained by another entity (scoper). This is typical role held by durable equipment. The scoper assumes responsibility for proper operation, quality, and safety.

Description:A role played by a party to an insurance policy to which the insurer agrees to indemnify for losses, provides benefits for, or renders services. A named insured may be either a person, non-person living subject, or an organization, or a group of persons, non-person living subjects, or organizations.Discussion:The coded concept NAMED should not be used where a more specific child concept in this Specializable value set applies. In some cases, the named insured may not be the policy holder, e.g., where a policy holder purchases life insurance policy in which another party is the named insured and the policy holder is the beneficiary of the policy.Note:The party playing the role of a named insured is not a claimant in the sense conveyed by the RoleClassCoveredParty CLAIM (claimant). However, a named insured may make a claim under a policy, e.g., e.g., a party that is the named insured and policy holder under a comprehensive automobile insurance policy may become the claimant for coverage under that policy e.g., if injured in an automobile accident and there is no liable third party. In the case of a named insured making a claim, a role type code INSCLM (insured claimant) subtypes the class to indicate that a named insured has filed a claim for a loss.Example:The named insured under a comprehensive automobile, disability, or property and casualty policy that is the named insured and may or may not be the policy holder.

An individual designated for notification as the next of kin for a given entity.

An Entity (player) for which someone (scoper) is granted by law the right to call the material (player) his own. This entitles the scoper to make decisions about the disposition of that material.

Definition:an association between two Entities where the playing Entity (the part) is a component of the whole (scoper) in the sense of an integral structural component, that is distinct from other parts in the same whole, has a distinct function in the whole, and, as an effect, the full integrity of the whole depends (to some degree) on the presence of this part, even though the part may often be separable from the whole.Discussion:Part is defined in opposition to (a) ingredient (not separable), (b) content (not a functional component), and (c) member (not functionally distinct from other members).

A Role of a LivingSubject (player) as an actual or potential recipient of health care services from a healthcare provider organization (scoper).

Usage Note:Communication about relationships between patients and specific healthcare practitioners (people) is not done via scoper. Instead this is generally done using the CareProvision act. This allows linkage between patient and a particular healthcare practitioner role and also allows description of the type of care involved in the relationship.

The role of an organization or individual designated to receive payment for a claim against a particular coverage. The scoping entity is the organization that is the submitter of the invoice in question.

The role of an organization that undertakes to accept claims invoices, assess the coverage or payments due for those invoices and pay to the designated payees for those invoices. This role may be either the underwriter or a third-party organization authorized by the underwriter. The scoping entity is the organization that underwrites the claimed coverage.

A role played by a person or organization that holds an insurance policy. The underwriter of that policy is the scoping entity.

*Discussion:*The identifier of the policy is captured in 'Role.id' when the Role is a policy holder.

A particular policy may cover several individuals one of whom may be, but need not be, the policy holder. Thus the notion of covered party is a role that is distinct from that of the policy holder.

Description:A role played by a party that meets the eligibility criteria for coverage under a program. A program eligible may be either a person, non-person living subject, or an organization, or a group of persons, non-person living subjects, or organizations.Discussion:A program as typically government administered coverage for parties determined eligible under the terms of the program.Note:The party playing a program eligible is not a claimant in the sense conveyed by the RoleClassCoveredParty CLAIM (claimant). However a program eligible may make a claim under program, e.g., an unemployed worker may claim benefits under an unemployment insurance program, but parties playing these covered party role classes are not, for purposes of this vocabulary and in an effort to clearly distinguish role classes, considered claimants.

In the case of a program eligible, a role type code INJWKR (injured worker) subtypes the class to indicate that the covered party in a workers compensation program is an injured worker, and as such, has filed a "claim" under the program for benefits. Likewise, a covered role type code UNEMP (unemployed worker) subtypes the program eligible class to indicate that the covered party in an unemployment insurance program has filed a claim for unemployment benefits.

Example:A party meeting eligibility criteria related to health or financial status, e.g., in the U.S., persons meeting health, demographic, or financial criteria established by state and federal law are eligible for Medicaid.

An Entity (player) that is authorized to provide health care services by some authorizing agency (scoper).

Links two entities with classCode PSN (person) in a personal relationship. The character of the relationship must be defined by a PersonalRelationshipRoleType code. The player and scoper are determined by PersonalRelationshipRoleType code as well.

A substance (player) added to a mixture (scoper) to prevent microorganisms (fungi, bacteria) to spoil the mixture.

An entity (player) that has been recognized as having certain training/experience or other characteristics that would make said entity an appropriate performer for a certain activity. The scoper is an organization that educates or qualifies entities.

**Definition:**Specifies the administrative functionality within a formal experimental design for which the ResearchSubject role was established.

Examples:Screening - role is used for pre-enrollment evaluation portion of the design; enrolled - role is used for subjects admitted to the experimental portion of the design.

Material (player) sold by a retailer (scoper), who also give advice to prospective buyers.

A product regulated by some governmentatl orgnization. The role is played by Material and scoped by Organization.

Rationale: To support an entity clone used to identify the NDC number for a drug product.

Corresponds to the Role class

The "same" role asserts an identity between playing and scoping entities, i.e., that they are in fact two records of the same entity instance, and, in the case of discrepancies (e.g different DOB, gender), that one or both are in error.

Usage:

playing and scoping entities must have same classCode, but need not have identical attributes or values.

Example:

a provider registry maintains sets of conflicting demographic data for what is reported to be the same individual.

A role played by a place at which services may be provided.

The "same" roleclass asserts an identity between playing and scoping entities: that they are in fact instances of the same entity and, in the case of discrepancies (e.g different DOB, gender), that one or both are in error.

Usage:

playing and scoping entities must have same classcode, but need not have identical attributes or values.

Example:

a provider registry maintains sets of conflicting demographic data for what is reported to be the same individual.

The role of a person (player) who is the officer or signature authority for of a scoping entity, usually an organization (scoper).

A role played by a material entity that is a specimen for an act. It is scoped by the source of the specimen.

A role played by an entity, usually an organization that is the sponsor of an insurance plan or a health program. A sponsor is the party that is ultimately accountable for the coverage by employment contract or by law. A sponsor can be an employer, union, government agency, or association. Fully insured sponsors establish the terms of the plan and contract with health insurance plans to assume the risk and to administer the plan. Self-insured sponsors delegate coverage administration, but not risk, to third-party administrators. Program sponsors designate services to be covered in accordance with statute. Program sponsors may administer the coverage themselves, delegate coverage administration, but not risk to third-party administrators, or contract with health insurance plans to assume the risk and administrator a program. Sponsors qualify individuals who may become

  • a policy holder of the plan;

  • where the sponsor is the policy holder, who may become a subscriber or a dependent to a policy under the plan; or

  • where the sponsor is a government agency, who may become program eligibles under a program.

The sponsor role may be further qualified by the SponsorRole.code. Entities playing the sponsor role may also play the role of a Coverage Administrator.

Example:An employer, union, government agency, or association.

A stabilizer (player) added to a mixture (scoper) in order to prevent the molecular disintegration of the main substance.

A role played by an individual who is a student of a school, which is the scoping entity.

Relates an entity (player) (e.g. a device) to a location (scoper) at which it is normally found or stored when not used.

An entity that subsumes the identity of another. Used in the context of merging documented entity instances. Both the player and scoper must have the same classCode.

The use of this code isdeprecatedin favor of the term SUBY which is its inverse and is more ontologically correct.
Description:A role played by a person covered under a policy based on association with a sponsor who is the policy holder, and whose association may provide for the eligibility of dependents for coverage.Discussion:The policy holder holds the contract with the policy or program underwriter. The subscriber holds a certificate of coverage under the contract. In legal proceedings concerning the policy or program, the terms of the contract takes precedence over the terms of the certificate of coverage if there are any inconsistencies.Note:The party playing the role of a subscriber is not a claimant in the sense conveyed by the RoleClassCoveredParty CLAIM (claimant). However, a subscriber may make a claim under a policy, e.g., a subscriber under a health insurance policy may become the claimant for coverage under that policy for wellness examines or if injured and there is no liable third party. In the case of a subscriber making a claim, a role type code INSCLM (insured claimant) subtypes the class to indicate that the subscriber has filed a claim for services covered under the health insurance policy.Example:An employee or a member of an association.

Relates a prevailing record of an Entity (scoper) with another record (player) that it subsumes.

Examples:Show a correct new Person object (scoper) that subsumes one or more duplicate Person objects that had accidentally been created for the same physical person.Constraints:Both the player and scoper must have the same classCode.

Relates a place entity (player) as the region over which the scoper (typically an Organization) has certain authority (jurisdiction). For example, the Calgary Regional Health Authority (scoper) has authority over the territory "Region 4 of Alberta" (player) in matters of health.

A manufactured material (player) that is used for its therapeutic properties. The manufacturer is the scoper.

A role played by a person or an organization. It is the party that

  • accepts fiscal responsibility for insurance plans and the policies created under those plans;

  • administers and accepts fiscal responsibility for a program that provides coverage for services to eligible individuals; and/or

  • has the responsibility to assess the merits of each risk and decide a suitable premium for accepting all or part of the risk. If played by an organization, this role may be further specified by an appropriate RoleCode.

Example:
  • A health insurer;

  • Medicaid Program;

  • Lloyd's of London

**Description:**An entity (player) that is used by another entity (scoper)

A role a product plays when a guarantee is given to the purchaser by the seller (scoping entity) stating that the product is reliable and free from known defects and that the seller will repair or replace defective parts within a given time limit and under certain conditions.

A general association between two entities that is neither partitive nor ontological.

A relationship that is based on mutual behavior of the two Entities as being related. The basis of such relationship may be agreements (e.g., spouses, contract parties) or they may bede factobehavior (e.g. friends) or may be an incidental involvement with each other (e.g. parties over a dispute, siblings, children).

A relationship in which the scoping Entity defines or specifies what the playing Entity is. Thus, the player's "being" (Greek: ontos) is specified.

An association between two Entities where the playing Entity is considered in some way "part" of the scoping Entity, e.g., as a member, component, ingredient, or content. Being "part" in the broadest sense of the word can mean anything from being an integral structural component to a mere incidental temporary association of a playing Entity with a (generally larger) scoping Entity.

An association for a playing Entity that is used, known, treated, handled, built, or destroyed, etc. under the auspices of the scoping Entity. The playing Entity is passive in these roles (even though it may be active in other roles), in the sense that the kinds of things done to it in this role happen without an agreement from the playing Entity.

A relationship between two entities that is formally recognized, frequently by a contract or similar agreement.

UPDATE:

A set of codes further specifying the kind of Role; specific classification codes for further qualifying RoleClass codes.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The child code is a classification of the particular class group identified by the 'classCode' in a RIM class as the parent code. Used only in RIM backbone classes to link the code and classCode values. The internal identifier for the concept in the HL7 Access database repository. An additional concept code that was also attributed to a concept A property that indicates the status of the concept. One of active, experimental, deprecated, or retired.

Location of an accident where healthcare service was delivered, such as a roadside.

**Description:**Identifier assigned to a location by the organization responsible for accrediting the location.

Description:A person playing the role of program eligible under a program based on active military status.Discussion:This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the persons status as active duty military meets jurisdictional or program criteria.

A child taken into one's family through legal means and raised as one's own child.

The player of the role (father) is a male who has taken the scoper (child) into their family through legal means and raises them as his own child.

The player of the role (father) is a female who has taken the scoper (child) into their family through legal means and raises them as her own child.

The player of the role (parent) has taken the scoper (child) into their family through legal means and raises them as his or her own child.

Location (mobile) where healthcare service was delivered, identified specifically as an ambulance.

An entity which corrected, edited, or amended pre-existing information.

**Description:**Non-person living subject used as antibiotic.

**Examples:**Bacteriophage, is a virus that infects bacteria.

**Description:**Dogs trained to assist the ill or physically challenged.

The player of the role is a sister of the scoping person's mother or father.

Quality Control specimen submitted to the lab whose identity and composition is not known to the lab.

Cattle used for meat production

A contact role used to identify a person within a Provider organization that can be contacted for billing purposes (e.g. about the content of the Invoice).

**Description:**Animals, including fish and insects, and microorganisms which may participate as assigned entities in biotherapies.

Chickens raised for meat

Breeding/genetic stock

The player of the role is a male sharing one or both parents in common with the scoping entity.

The player of the role is: (1) a brother of the scoping person's spouse, or (2) the husband of the scoping person's sister, or (3) the husband of a sister of the scoping person's spouse.

A specimen used for initial calibration settings of an instrument

A person who has fled his or her home country to find a safe place elsewhere.

A person who is someone of below legal age who has fled his or her home country, *without his or her parents*, to find a safe place elsewhere at time of categorization.

**Description:**Companion animals, such as dogs, cats, and rabbits, which may be provided to patients to improve general mood, decrease depression and loneliness, and distract from stress-inducing concerns to improve quality of life.

A specialty unit in hospital that focuses on chronic respirator patients and pulmonary failure

The player of the role is a child of the scoping entity.

The player of the role is a child taken into a family through legal means and raised by the scoping person (parent) as his or her own child.

The player of the role is a child receiving parental care and nurture from the scoping person (parent) but not related to him or her through legal or blood ties.

The player of the role is the spouse of scoping person's child.

(1) A hospital including a physical plant and personnel that provides multidisciplinary diagnosis and treatment for diseases that have one or more of the following characteristics: is permanent; leaves residual disability; is caused by nonreversible pathological alteration; requires special training of the patient for rehabilitation; and/or may be expected to require a long period of supervision or care. In addition, patients require the safety, security, and shelter of these specialized inpatient or partial hospitalization settings. (2) A hospital that provides medical and skilled nursing services to patients with long-term illnesses who are not in an acute phase but who require an intensity of services not available in nursing homes

A party that makes a claim for coverage under a policy.

An individual authorized to assign an original classification to information, including compilations of unclassified information, based on a determination that the information requires protection against unauthorized disclosure. The individual marks the information with immutable, computable, and human readable security labels in accordance with applicable security labeling policies. The labeling policies provide instructions on whether and if so how the security labels may be later reclassified \[i.e., upgraded, downgraded, used in derivative classification, or declassified\] in a manner that preserves the overridden original classification binding and provenance.

A person who is legally recognized as a member of a nation or country, with associated rights and obligations.

A foreigner who is present in a country (which is foreign to him/her) unlawfully or without the country's authorization (may be called an illegal alien).

A person who is below legal age present in a country, *without his or her parents*, (which is foreign to him/her) unlawfully or without the country's authorization.

Companion animals

Description:A person playing the role of an individual insured with continuity of coverage under a policy which is being terminated based on loss of original status that was the basis for coverage. Criteria for qualifying for continuity of coverage may be set by law.Discussion:This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the person's status as a continuity of coverage beneficiary meets jurisdictional or policy criteria.

Community location where healthcare is delivered.

An entity or an entity's delegatee who is the grantee in an agreement such as a consent for services, advanced directive, or a privacy consent directive in accordance with jurisdictional, organizational, or patient policy.

An entity which has witnessed and attests to observing another entity being counseled about an agreement such as a consent for services, advanced directive, or a privacy consent directive.

An entity which participates in the generation of and attest to veracity of content, but is not an author or coauthor. For example a surgeon who is required by institutional, regulatory, or legal rules to sign an operative report, but who was not involved in the authorship of that report.

The player of the role is a relative of the scoping person descended from a common ancestor, such as a grandparent, by two or more steps in a diverging line.

A non-country member admitted to the territory of a nation or country as a non-resident for an explicit purpose.

Description:A person playing the role of program eligible under a program based on allegations of being the victim of a crime.Discussion:This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is "program eligible" and the person's status as a crime victim meets jurisdictional or program criteria.

A foreigner who is a resident of the country but does not have citizenship.

A person who is a resident below legal age of the countrywithout his or her parentsand does not have citizenship. Description:A location that plays the role of delivering services which may include providing front-line services to the population of a defined geographic area such as: healthcare services and social services, preventive or curative, rehabilitation or reintegration.

A practice setting where cardiovascular diagnostic procedures or therapeutic interventions are performed (e.g., cardiac catheterization lab, echocardiography suite)

Milk production

Location address where medical supplies were transported to for use.

The player of the role is a female offspring of the scoping entity (parent).

The player of the role is a female child taken into a family through legal means and raised by the scoping person (parent) as his or her own child.

Description:The player of the role is a female child (of any type) of scoping entity (parent)

The player of the role is a female child receiving parental care and nurture from the scoping person (parent) but not related to him or her through legal or blood ties.

The player of the role is the wife of scoping person's son.

**Description:**A categorization of medicinal products by their therapeutic properties and/or main therapeutic use.

**Description:**Maggots raised for biodebridement.

Discussion:Maggot Debridement Therapy is the medical use of live maggots for cleaning non-healing wounds.

**Examples:**Removal of burnt skin.

An individual which is authorized to declassify information based on a determination that the information no longer requires protection against unauthorized disclosure. The individual marks the information being declassified using computable and human readable security labels indicating that this is copy of previously classified information is unclassified in accordance with applicable security labeling policies. The labeling policies provide instructions on whether and if so how the security labels may be later reclassified \[i.e., upgraded or used in derivative classification\] in a manner that preserves the overridden original classification binding and provenance.

A party to whom some right or authority is granted by a delegator.

A party that grants all or some portion its right or authority to another party.

A party covered under a policy based on association with a subscriber.

Description:A person playing the role of program eligible under a program based on meeting criteria for health or functional limitation set by law or by the program.Discussion:This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible", "named insured", "individual insured", or "dependent", and the person's status as differently abled meets jurisdictional, policy, or program criteria.

The player of the role cohabits with the scoping person but is not the scoping person's spouse.

An individual authorized to lower the classification level of labeled content and provide rationale for doing so as directed by a classification guide.

A relationship between two people in which one person authorizes another, usually a family member or relative, to act for him or her in a manner which is a legally binding upon the person giving such authority as if he or she personally were to do the acts that is often limited in the kinds of powers that can be assigned. Unlike ordinary powers of attorney, durable powers can survive for long periods of time, and again, unlike standard powers of attorney, durable powers can continue after incompetency.

Draft animals

An individual who is only authorized to classify reproduced, extracted, or summarized classified information, or compile classified and unclassified information by applying classification markings derived from source material or as directed by a classification guide.

Dual purpose. Defined purposes based on species and breed

A practice setting where diagnostic procedures or therapeutic interventions are performed

An electronically simulated QC specimen

A contact designated for contact in emergent situations.

(X12N 261QD0000N)

**Description:**A payor that is responsible for functions related to the enrollment of covered parties.

The section of a health care facility for providing rapid treatment to victims of sudden illness or trauma.

**Definition:**The specific role being played by a research subject participating in the active treatment or primary data collection portion of a research study.

The role played by a person acting as the estate executor for a deceased subscriber or policyholder who was the responsible party

Description:A family member not having an immediate genetic or legal relationship e.g. Aunt, cousin, great grandparent, grandchild, grandparent, niece, nephew or uncle.

Specimen used for testing proficiency of an organization performing testing (how does this differ from O?)

The player of the role is dependent of the scoping entity.

A relationship between two people characterizing their "familial" relationship

Animals raised for their fur, hair or skins

A member of the covered party's family. This could be the spouse, a parent, a grand parent, a sibling, etc.

Player of the role was previously joined to the scoping person in marriage and this marriage is now dissolved and inactive.

Usage Note:This is significant to indicate as some jurisdictions have different legal requirements for former spouse to access the patient's record, from a general friend.

The player of the role is a person who is known, liked, and trusted by the scoping person.

Covered party to an insurance policy has coverage through full-time attendance at a recognized educational institution as defined by a particular insurance policy.

The player of the role is a male who begets or raises or nurtures the scoping entity (child).

The player of the role (parent) who is a male state-certified caregiver responsible for the scoper (child) who has been placed in the parent's care. The placement of the child is usually arranged through the government or a social-service agency, and temporary.

The state, via a jurisdiction recognized child protection agency, stands as in loco parentis to the child, making all legal decisions while the foster parent is responsible for the day-to-day care of the specified child.

The player of the role is the father of the scoping person's husband or wife.

The scoper and player were carried in the same womb and share common biological parents but are the product of distinct egg/sperm pairs.

The scoper was carried in the same womb as the male player and shares common biological parents but is the product of a distinct egg/sperm pair.

The scoper was carried in the same womb as the female player and shares common biological parents but is the product of a distinct egg/sperm pair.

**Description:**An employer or organization that contracts with an underwriter to assumes the financial risk and administrative responsibility for coverage of health services for covered parties.

A set of patient samples in which the individuals of the group may or may not be identified.

(X12N 282N00000N)

A child of one's son or daughter.

Relates a manufactured drug product to the non-proprietary (generic) representation of its ingredients independent of strength, and form.

The scoping entity identifies a unique combination of medicine ingredients; sometimes referred to as "ingredient set".

Relates a manufactured drug product to the non-proprietary (generic) representation of its ingredients and dose form, independent of strength of the ingredients. The scoping entity identifies a unique combination of medicine ingredients in a specific dose form.

Relates a manufactured drug product to the non-proprietary (generic) representation of is ingredients with their strength. The scoping entity identifies a unique combination of medicine ingredients with their strength.

Relates a manufactured drug product to the non-proprietary (generic) representation of its ingredients with their strength in a specific dose form. The scoping entity identifies a unique combination of medicine ingredients with their strength in a single dose form.

The player is a female whose womb carries the fetus of the scoper. Generally used when the gestational mother and natural mother are not the same.

The player of the role is the father of the scoping person's grandparent.

The player of the role is the mother of the scoping person's grandparent.

The player of the role is a parent of the scoping person's grandparent.

A practice setting where GI procedures (such as endoscopies) are performed

parent of a parent of the subject.

An entity which accepts certain rights or authority from a grantor.

An entity which agrees to confer certain rights or authority to a grantee.

The player of the role is the father of the scoping person's mother or father.

The player of the role is the mother of the scoping person's mother or father.

The player of the role is a child of the scoping person's son or daughter.

The player of the role is a daughter of the scoping person's son or daughter.

The player of the role is a son of the scoping person's son or daughter.

The player of the role is a parent of the scoping person's mother or father.

An individual or organization that makes or gives a promise, assurance, pledge to pay or has paid the healthcare service provider.

The role played by a person appointed by the court to look out for the best interests of a minor child during the course of legal proceedings.

The role played by a person or institution legally empowered with responsibility for the care of a ward.

Covered party is a dependent of the policy holder with a physical or mental disability causing a disadvantage that makes independent achievement unusually difficult.

The player of the role is a male related to the scoping entity by sharing only one biological parent.

Description:A location that plays the role of delivering services which may include tests done based on clinical specimens to get health information about a patient as pertaining to the diagnosis, treatment and prevention of disease. Hospital laboratories may be further divided into specialized units such as Anatomic Pathology, Microbiology, and Biochemistry.

An acute care institution that provides medical, surgical, or psychiatric care and treatment for the sick or the injured.

A relationship between two people in which one person authorizes another to act for him or her in a manner which is a legally binding upon the person giving such authority as if he or she personally were to do the acts that continues (by its terms) to be effective even though the grantor has become mentally incompetent after signing the document.

Description:A location that plays the role of delivering services which may include the branch of medicine that uses ionizing and non-ionizing radiation to diagnose and treat diseases. The radiology unit may be further divided into subspecialties such as Imaging, Cardiovascular, Thoracic, and Ultrasound.

The player of the role is related to the scoping entity by sharing only one biological parent.

The player of the role is a female related to the scoping entity by sharing only one biological parent.

The player of the role is a man joined to a woman (scoping person) in marriage.

Description:A location that plays the role of delivering services which may include collecting specimens and/or samples from patients for laboratory testing purposes, but does not perform any tests or analysis functions.

Focuses on assessing disability

Description:A person playing the role of program eligible under a program based on aboriginal ancestry or as a member of an aboriginal community.Discussion:This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is "program eligible" and the person's status as a member of an indigenous people meets jurisdictional or program criteria.

A party covered under a policy as the policyholder.

Covered party is an injured party with a legal claim for compensation against a policy holder under an insurance policy.

Description:A person playing the role of program eligible under a workers compensation program based on the filing of work-related injury claim.Discussion:This CoveredPartyRoleType.code is used when the CoveredPartyRole class code is either "program eligible", a "named insured", and "individual insured", or "dependent", and the person's status as differently abled or "handicapped" meets jurisdictional, policy, or program criteria. Description:A location that plays the role of delivering services which may include tests are done on clinical specimens to get health information about a patient pertaining to the diagnosis, treatment, and prevention of disease for a hospital visit longer than one day.

A relationship between an individual and a member of their spousal partner's immediate family.

Description:A location that plays the role of delivering services which may include providing judicious, safe, efficacious, appropriate and cost effective use of medicines for treatment of patients for visits longer than one day. The distinction between inpatient pharmacies and retail (or outpatient) pharmacies is that they are part of a patient's continuity of care while staying in the hospital.

An entity which converts spoken or written language into the language of key participants in an event such as when a provider is obtaining a patient's consent to treatment or permission to disclose information.

The scoper and player are offspring of the same egg-sperm pair.

The male scoper is an offspring of the same egg-sperm pair as the male player.

The female scoper is an offspring of the same egg-sperm pair as the female player.

**Description:**Identifier assigned to a location by a jurisdiction.

Aliquots of individual specimens combined to form a single specimen representing all of the included individuals.

**Description:**Identifier assigned to a location by a local party (which could be the facility itself or organization overseeing a group of facilities).

Chickens raised for egg production

**Description:**The player of the role is a biological sister of the scoping person's biological mother.

Description:A location that plays the role of delivering services which include biochemistry, hematology, microbiology, immunochemistry, and toxicology.

**Description:**The player of the role is a biological relative of the scoping person descended from a common ancestor on the player's mother's side, such as a grandparent, by two or more steps in a diverging line.

Relates a manufactured drug product to the non-proprietary (generic) representation of its ingredients with their strength in a specific dose form. The scoping entity identifies a unique combination of medicine ingredients with their strength in a single dose form.

**Description:**The player of the role is the biological father of the scoping person's biological mother's parent.

**Description:**The player of the role is the biological mother of the scoping person's biological mother's parent.

**Description:**The player of the role is a biological parent of the scoping person's biological mother's parent.

**Description:**The player of the role is the biological father of the scoping person's biological mother.

**Description:**The player of the role is the biological mother of the scoping person's biological mother.

**Description:**The player of the role is the biological parent of the scoping person's biological mother.

A health care facility operated by the Department of Defense or other military operation.

Definition:A person playing the role of program eligible under a program based on military status.Discussion:This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the person's status as a member of the military meets jurisdictional or program criteria

Location (mobile) where healthcare service was delivered.

Animals raised for meat production

The player of the role is a female who conceives, gives birth to, or raises and nurtures the scoping entity (child).

The player of the role (parent) who is a female state-certified caregiver responsible for the scoper (child) who has been placed in the parent's care. The placement of the child is usually arranged through the government or a social-service agency, and temporary.

The state, via a jurisdiction recognized child protection agency, stands as in loco parentis to the child, making all legal decisions while the foster parent is responsible for the day-to-day care of the specified child.

The player of the role is the mother of the scoping person's husband or wife.

Poultry flocks used for chick/poult production

**Description:**The player of the role is a biological brother of the scoping person's biological mother.

A party to an insurance policy to whom the insurer agrees to indemnify for losses, provides benefits for, or renders services.

A child as determined by birth.

The player of the role lives near or next to the scoping person.

The player of the role is a male having the same biological parents as the scoping entity.

The player of the role is an offspring of the scoping entity as determined by birth.

The player of the role is a son of the scoping person's brother or sister or of the brother or sister of the scoping person's spouse.

The player of the role is a male who begets the scoping entity (child).

Indicates the biologic male parent of a fetus.

The player of the role is a daughter of the scoping person's brother or sister or of the brother or sister of the scoping person's spouse.

A child of one's brother or sister or of the brother or sister of one's spouse.

The player of the role is a child of scoping person's brother or sister or of the brother or sister of the scoping person's spouse.

The player of the role is a female who conceives or gives birth to the scoping entity (child).

The player is the biologic female parent of the scoping fetus.

Played by an individual who is designated as the next of kin for another individual which scopes the role.

The player of the role has both biological parents in common with the scoping entity.

The player of the role is a female having the same biological parents as the scoping entity.

A specimen used for evaluation of operator proficiency (operator in what context?)

The relationship that a person has with his or her self.

Description:A location that plays the role of delivering services which may include examination, diagnosis, treatment, management, and prevention of diseases and disorders of the eye as well as prescribing and fitting appropriate corrective lenses (glasses or contact lenses) as needed. Optometry clinics may also provide tests for visual field screening, measuring intra-ocular pressure and ophthalmoscopy, as and when required.

A contact for an organization for administrative purposes. Contact role specifies a person acting as a liason for the organization.

Example: HR Department representative.

Description:A location that plays the role of delivering services which may include tests are done on clinical specimens to get health information about a patient pertaining to the diagnosis, treatment, and prevention of disease for same day visits. Description:A location that plays the role of delivering services which may include providing judicious, safe, efficacious, appropriate and cost effective use of medicines for treatment of patients for outpatient visits and may also be used for discharge prescriptions.

A specimen that has been collected from a patient.

(X12N 261QP3300N)

One that begets or brings forth offspring or a person who brings up and cares for for another (Webster's Collegiate Dictionary)

**Description:**The player of the role is a biological sister of the scoping person's biological father.

A contact role used to identify a person within a Payor organization to whom this communication is addressed.

(X12N 261QP2300N)

**Description:**The player of the role is a biological relative of the scoping person descended from a common ancestor on the player's father's side, such as a grandparent, by two or more steps in a diverging line.

**Description:**The player of the role is the biological father of the scoping person's biological father's parent.

**Description:**The player of the role is the biological mother of the scoping person's biological father's parent.

**Description:**The player of the role is a biological parent of the scoping person's biological father's parent.

**Description:**The player of the role is the biological father of the scoping person's biological father.

**Description:**The player of the role is the biological mother of the scoping person's biological father.

**Description:**The player of the role is the biological parent of the scoping person's biological father.

Policy holder for the insurance policy.

Location where healthcare service was delivered, identified as a pharmacy.

(X12N 273R00000N)

Animals rasied for recreation

(X12N 261QP1100N)

A relationship between two people in which one person authorizes another to act for him in a manner which is a legally binding upon the person giving such authority as if he or she personally were to do the acts.

The player of the role is one who begets, gives birth to, or nurtures and raises the scoping entity (child).

The player of the role (parent) who is a state-certified caregiver responsible for the scoper (child) who has been placed in the parent's care. The placement of the child is usually arranged through the government or a social-service agency, and temporary.

The state, via a jurisdiction recognized child protection agency, stands as in loco parentis to the child, making all legal decisions while the foster parent is responsible for the day-to-day care of the specified child.

The player of the role is the parent of scoping person's husband or wife.

Location where healthcare service was delivered, identified as the healthcare provider's practice office.

A party that meets the eligibility criteria for coverage under a program.

Covered party to an insurance policy has coverage through part-time attendance at a recognized educational institution as defined by a particular insurance policy.

Healthcare facility that cares for patients with psychiatric illness(s).

The recipient for the service(s) and/or product(s) when they are not the covered party.

location where healthcare was delivered which is the residence of the Patient.

**Description:**The player of the role is a biological brother of the scoping person's biological father.

A specimen specifically used to verify the sensitivity, specificity, accuracy or other perfomance parameter of a diagnostic test.

A portion of an original patent sample that is tested at the same time as the original sample

A practice setting where radiology services (diagnostic or therapeutic) are provided (X12N 261QR0200N)

(X12N 261QX0203N)

Animals raised for racing perfomance

The role played by a party who has legal responsibility for another party.

Description:A person playing the role of an individual insured under a policy based on meeting criteria for the employment status of retired set by law or the policy.Discussion:This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the person's status as a retiree meets jurisdictional or policy criteria. Description:A person playing the role of program eligible under a program based on retired military status.Discussion:This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the persons status as retired military meets jurisdictional or program criteria.

An entity authorized to filter information according to approved criteria.

(X12N 283X00000N)

Description:A location that plays the role of delivering services which may include life training and/or social support to people with addictions. Description:A location that plays the role of delivering services which may include adaptation, rehabilitation and social integration services for people with intellectual and/or pervasive development disorders such as autism or severe behaviour disorder. Description:A location that plays the role of delivering services which may social support services for adolescents who are pregnant or have child and are experiencing adaptation issues/difficulties in their current or eventual parenting role. Description:A location that plays the role of delivering services which may include adaptation, rehabilitation and social integration services for people with physical impairments. Description:A location that plays the role of delivering services for people with hearing impairments. Description:A location that plays the role of delivering services for people with motor skill impairments. Description:A location that plays the role of delivering services for people with visual skill impairments. Description:A location that plays the role of delivering services which may include life training and/or social support services for the adaption, rehabilitation and social integration of youths with adjustment difficulties.

One who shares living quarters with the subject.

Location where healthcare service was delivered, identified as a school or educational facility.

**Definition:**The specific role being played by a research subject participating in the pre-enrollment evaluation portion of a research study.

**Description:**Dogs trained to assist persons who are seeing impaired or blind.

Covered party is the policy holder. Also known as the subscriber.

**Description:**An employer or organization that assumes the financial risk and administrative responsibility for coverage of health services for covered parties.

Animals raised for shows

The player of the role shares one or both parents in common with the scoping entity.

The player of the role is: (1) a sibling of the scoping person's spouse, or (2) the spouse of the scoping person's sibling, or (3) the spouse of a sibling of the scoping person's spouse.

A person who is important to one's well being; especially a spouse or one in a similar relationship. (The player is the one who is important)

The player of the role is a female sharing one or both parents in common with the scoping entity.

The player of the role is: (1) a sister of the scoping person's spouse, or (2) the wife of the scoping person's brother, or (3) the wife of a brother of the scoping person's spouse.

(X12N 261QA1200N)

(X12N 314000000N)

**Description:**Dogs trained or having the ability to detect imminent seizures or cancers in humans, probably as a result of volatile chemical (odors) given off by the malignancy of the host.

The player of the role is a male offspring of the scoping entity (parent).

The player of the role is a male child taken into a family through legal means and raised by the scoping person (parent) as his or her own child.

Description:The player of the role is a male child (of any type) of scoping entity (parent)

The player of the role is a male child receiving parental care and nurture from the scoping person (parent) but not related to him or her through legal or blood ties.

The player of the role is the husband of scoping person's daughter.

Covered party is an individual that the policy holder has assumed responsibility for, such as foster child or legal ward.

A relationship between two people in which one person authorizes another to act for him or her in a manner which is a legally binding upon the person giving such authority as if he or she personally were to do the acts that is often limited in the kinds of powers that can be assigned.

The player of the role is a marriage partner of the scoping person.

A marriage partner; a husband or wife.

A child receiving parental care and nurture from a person who is related to them through marriage to their parent.

The player of the role is a son of the scoping person's stepparent.

The player of the role is a child of the scoping person's spouse by a previous union.

The player of the role is a daughter of the scoping person's spouse by a previous union.

The player of the role is the husband of scoping person's mother and not the scoping person's natural father.

The player of the role is the wife of scoping person's father and not the scoping person's natural mother.

The player of the role is the spouse of the scoping person's parent and not the scoping person's natural parent.

The player of the role is a child of the scoping person's stepparent.

The player of the role is a daughter of the scoping person's stepparent.

The player of the role is a son of the scoping person's spouse by a previous union.

Covered party to an insurance policy has coverage through full-time or part-time attendance at a recognized educational institution as defined by a particular insurance policy.

A party covered under a policy based on association with a sponsor who is the policy holder, and whose association may provide for the eligibility of dependents for coverage

(X12N 324500000N)

**Description:**Third party administrator (TPA) is a payor organization that processes health care claims without carrying insurance risk. Third party administrators are prominent players in the managed care industry and have the expertise and capability to administer all or a portion of the claims process. They are normally contracted by a health insurer or self-insuring companies to administer services, including claims administration, premium collection, enrollment and other administrative activities.

Self-insured employers often contract with third party administrator to handle their insurance functions. Insurance companies oftentimes outsource the claims, utilization review or membership functions to a TPA. Sometimes TPAs only manage provider networks, only claims or only utilization review.

While some third-party administrators may operate as units of insurance companies, they are often independent. However, hospitals or provider organizations desiring to set up their own health plans will often outsource certain responsibilities to TPAs. TPAs may perform one or several payor functions, specified by the PayorParticipationFunction value set, such as provider management, enrollment, utilization management, and fee for service claims adjudication management.

A person who is a member of a tribe.

The scoper and player were carried in the same womb and shared common biological parents.

The scoper was carried in the same womb as the male player and shares common biological parents.

The scoper was carried in the same womb as the female player and shares common biological parents.

**Description:**A payor that is responsible for review and case management of health services covered under a policy or program.

The player of the role is a brother of the scoping person's mother or father.

Description:A location that plays the role of delivering services which may include: social emergency services required for a young person as required under any jurisdictional youth laws, child placement, and family mediation in the defined geographical area the SDL is responsible for. It may provide expertise in a judiciary setting on child custody, adoption and biological history research.

An individual authorized to raise the classification level of labeled content and provide rationale for doing so as directed by a classification guide.

A specimen used for periodic calibration checks of instruments

An entity authorized to validate information for inclusion in a record.

Description:A person playing the role of program eligible under a program based on status as a military veteran.Discussion:This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the persons status as a veteran meets jurisdictional or program criteria.

Cattle raised for veal meat production. Implicit is the husbandry method.

Description:A person, who is a minor or is deemed incompetent, who plays the role of a program eligible where eligibility for coverage is based on meeting program eligibility criteria for status as a ward of a court or jurisdiction.Discussion:This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is a "claimant", "program eligible", a "named insured", an "individual Insured" or a "dependent", and the person's status as a ward meets program or policy criteria. In the case of a ward covered under a program providing financial or health benefits, a governmental agency may take temporary custody of a minor or incompetent for his/her protection and care, e.g., if the ward is suffering from neglect or abuse, or has been in trouble with the law.

The player of the role is a woman joined to a man (scoping person) in marriage.

Sheep, goats and other mammals raised for their fiber

Animals used to perform work

Location where healthcare service was delivered, identified as a work place.

A contact role used for business and/or administrative purposes.

Concepts characterizing the type of association formed by player and scoper when there is a recognized Affiliate role by which the two parties are related.

Examples:Business Partner, Business Associate, Colleague

Parties that may or should contribute or have contributed to an Act.

**Description:**A role type that is used to further qualify a non-person subject playing a role where the role class attribute is set to RoleClass AssignedEntity

Defines types of certifications for all entities

A role type used to qualify a person's legal status within a country or nation.

**Description**A role recognized through the eligibility of a party play a claimant for benefits covered or provided under an insurance policy.

A role of an organization that further classifies the clincial responsibility for the healthcare care delivered during an encounter. E.g. cardiology service, pediatric service, nursing services.

Types of contact for Role code "CON"

Role recognized through the issuance of insurance coverage to an identified covered party who has this relationship with the policy holder such as the policy holder themselves (self), spouse, child, etc

**Description:**Codes that indicate a specific type of sponsor. Used when the sponsor's role is only either as a fully insured sponsor or only as a self-insured sponsor. NOTE: Where a sponsor may be either, use the SponsorParticipationFunction.code (fully insured or self insured) to indicate the type of responsibility. (CO6-0057)

A role recognized through the eligibility of an identified living subject for benefits covered under an insurance policy or a program. Eligibility as a covered party may be conditioned on a relationship with (1) the policy holder such as the policy holder who is covered as an individual under a poliy or as a party sponsored for coverage by the policy holder.

**Example:**An employee as a subscriber; or (2) on being scoped another covered party such as the subscriber, as in the case of a dependent.

Discussion:The Abstract Value Set "CoverageRoleType", which was developed for use in the Canadian realm "pre-coordinate" coverage roles with other roles that a covered party must play in order to be eligible for coverage, e.g., "handicapped dependent". Other codes in the Abstract Value Set CoveredPartyRoleType domain can be "post-coordinated" with the EligiblePartyRoleType codes to denote comparable concepts. Decoupling the concepts is intended to support a wider range of concepts and semantic comparability of coded concepts.

A role of a place that further classifies the clinical setting (e.g., cardiology clinic, primary care clinic, rehabilitation hospital, skilled nursing facility) in which care is delivered during an encounter.

A role of a place that further classifies a setting that is intended to house the provision of non-clinical services.

A role of a place that further classifies a setting that is intended to house the provision of services.

Description:A role recognized through the eligibility of a party to play a dependent for benefits covered or provided under a health insurance policy because of an association with the subscriber that is recognized by the policy underwriter.

Indicates the type of person that is responsible for operating the device related to the incident reported in ICSR.

Examples include: Physician, Nurse, Medical Technician, Respiratory Technician.

Definition:A code representing the type of identifier that has been assigned to the identified entity (IDENT).Examples:Example values include Social Insurance Number, Product Catalog ID, Product Model Number.

A role recognized through the eligibility of a party to play an individual insured for benefits covered or provided under an insurance policy where the party is also the policy holder.

Code indicating the primary use for which a living subject is bred or grown

**Description:**Describes types of identifiers other than the primary location registry identifier for a service delivery location. Identifiers may be assigned by a local service delivery organization, a formal body capable of accrediting the location for the capability to provide specific services or the identifier may be assigned at a jurisdictional level.

Identifies the specific hierarchical relationship between the playing and scoping medications.

Examples:Generic, Generic Formulation, Therapeutic Class, etc.

Types of membership for Role code "MBR"

NDC Regulated Drug Entity Type

**Description:**PayorRoleType for a particular type of policy or program benefit package or plan where more detail about the coverage administration role of the Payor is required. The functions performed by a Payor qualified by a PayorRoleType may be specified by the PayorParticpationFunction value set.

**Examples:**A Payor that is a TPA may administer a managed care plan without underwriting the risk.

Description:A role recognized through the eligibility of an identified party for benefits covered under an insurance policy or a program based on meeting eligibility criteria.

Eligibility as a covered party may be conditioned on the party meeting criteria to qualify for coverage under a policy or program, which may be mandated by law. These criteria may be:

  • The sole basis for coverage, e.g., being differently abled may qualify a person for disability coverage

  • May more fully qualify a covered party role e.g, being differently abled may qualify an adult child as a dependent

  • May impact the level of coverage for a covered party under a policy or program, e.g., being differently abled may qualify a program eligible for additional benefits.

Discussion:The Abstract Value Set "CoverageRoleType", which was developed for use in the Canadian realm "pre-coordinate" coverage roles with other roles that a covered party must play in order to be eligible for coverage, e.g., "handicapped dependent". These role.codes may only be used with COVPTY to avoid overlapping concepts that would result from using them to specify the specializations of COVPTY, e.g., the role.class DEPEN should not be used with the role.code family dependent because that relationship has overlapping concepts due to the role.code precoodination and is conveyed in FICO with the personal relationship role that has a PART role link to the covered party role. For the same reasons, the role.class DEPEN should not be used with the role.code HANDIC (handicapped dependent); the role.code DIFFABLE (differently abled) should be used instead.

In summary, the coded concepts in the Abstract Value Set "CoveredPartyRoleType" can be "post-coordinated" with the "RoleClassCoveredParty" Abstract Value Set. Decoupling these concepts is intended to support an expansive range of covered party concepts and their semantic comparability.

Defines types of certifications for practitioners

Description:Indicates the role that an organization takes in the process by which a product goes from an original manufacturer to the eventual consumer.

**Examples:**Manufacturer, re-processor

**Note:**These two values are currently used in adverse event and product problem reporting.

**Description:**Captures the different roles that are recorded to characterize the qualifications or stations in life of persons or organizations who participate as senders or as receivers of adverse event or product problem reports.

**Example:**Example values may include: physician, healthcare facility, attorney, family member, regulatory agency. Initial effort to find defined concepts for this value set will focus on the HIPAA provider taxonomy.

**Description:**A role recognized through the eligibility of a party to play a program eligible for benefits covered or provided under a program.

Specifies the administrative functionality within a formal experimental design for which the ResearchSubject role was established. Examples: screening - role is used for pre-enrollment evaluation portion of the design; enrolled - role is used for subjects admitted to the active treatment portion of the design.

A role of a place that further classifies the setting (e.g., accident site, road side, work site, community location) in which services are delivered.

Description:A role recognized through the eligibility of a party to play a subscriber for benefits covered or provided under a health insurance policy.
UPDATE:

**Description:**Codes representing possible states of a RoleLink, as defined by the RoleLink class state machine.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. Description:The state indicates the RoleLink is in progress. Description:The terminal state resulting from abandoning the RoleLink prior to or after activation. Description:The terminal state representing the successful completion of the RoleLink. Description:The 'typical' state. Excludes "nullified" which represents the termination state of a RoleLink instance that was created in error. Description:The state representing the termination of a RoleLink instance that was created in error. Description:The state indicates the RoleLink has not yet become active.
UPDATE:

A code specifying the meaning and purpose of every RoleLink instance. Each of its values implies specific constraints to what kinds of Role objects can be related and in which way.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Name of inboundLink relationship from Role to RoleLink Name of outboundLink relationship from Role to RoleLink Sort key for inboundLink relationship from Role to RoleLink Sort key for outboundLink relationship from Role to RoleLink Designation of a concept's state. Normally is not populated unless the state is retired.

This relationship indicates the source Role is available to the target Role as a backup. An entity in a backup role will be available as a substitute or replacement in the event that the entity assigned the role is unavailable. In medical roles where it is critical that the function be performed and there is a possibility that the individual assigned may be ill or otherwise indisposed, another individual is assigned to cover for the individual originally assigned the role. A backup may be required to be identified, but unless the backup is actually used, he/she would not assume the assigned entity role.

This relationship indicates the target Role provides or receives information regarding the target role. For example, AssignedEntity is a contact for a ServiceDeliveryLocation.

The source Role has direct authority over the target role in a chain of authority.

Description:The source role provides identification for the target role. The source role must be IDENT. The player entity of the source role is constrained to be the same as (i.e. the equivalent of, or equal to) the player of the target role if present. If the player is absent from the source role, then it is assumed to be the same as the player of the target role.

The source Role has indirect authority over the target role in a chain of authority.

The target Role is part of the Source Role.

An action taken with respect to a subject Entity by a regulatory or authoritative body with supervisory capacity over that entity. The action is taken in response to behavior by the subject Entity that body finds to be undesirable.

Suspension, license restrictions, monetary fine, letter of reprimand, mandated training, mandated supervision, etc.*Examples:*

This relationship indicates that the source Role replaces (or subsumes) the target Role. Allows for new identifiers and/or new effective time for a registry entry or a certification, etc.

UPDATE:

Codes representing the defined possible states of an Role, as defined by the Role class state machine.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

The state representing the fact that the Entity is currently active in the Role.

The terminal state resulting from cancellation of the role prior to activation.

The 'typical' state. Excludes "nullified" which represents the termination state of a Role instance that was created in error.

The state representing the termination of a Role instance that was created in error.

The state representing that fact that the role has not yet become active.

The state that represents a suspension of the Entity playing the Role. This state is arrived at from the "active" state.

The state representing the successful termination of the Role.

UPDATE:

The path the administered medication takes to get into the body or into contact with the body.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.. An additional concept code that was also attributed to a concept

Injection, amniotic fluid

Injection, biliary tract

Injection, urinary bladder

Instillation, urinary catheter

Irrigation, urinary bladder

Irrigation, urinary bladder, continuous

Irrigation, urinary bladder, tidal

Topical application, buccal

Instillation, continuous ambulatory peritoneal dialysis port

Instillation, cecostomy

Topical application, cervical

Injection, cervical

Insertion, cervical (uterine)

Chew, oral

Injection, for cholangiography

Instillation, chest tube

Topical application, dental

Rinse, dental

Dissolve, oral

Douche, vaginal

Topical application, soaked dressing

Instillation, enteral feeding tube

Electro-osmosis

Injection, endosinusial

Enema, rectal

Instillation, enteral

Infusion, epidural

Injection, epidural

Injection, epidural, push

Injection, epidural, slow push

Instillation, endotracheal tube

Nebulization, endotracheal tube

Diffusion, extracorporeal

Injection, extracorporeal

Injection, extra-amniotic

Gargle

Injection, gastric button

Topical application, gingival

Injection, gingival

Instillation, gastro-jejunostomy tube

Instillation, gastrostomy tube

Irrigation, genitourinary

Topical application, hair

Diffusion, hemodialysis

Injection, hemodialysis port

Infusion, intraarterial catheter

Injection, intra-abdominal

Injection, intraarterial

Injection, intraarterial, push

Injection, intraarterial, slow push

Injection, intraarticular

Instillation, intrabronchial

Injection, intrabursal

Infusion, intracardiac

Injection, intracardiac

Injection, intracardiac, rapid push

Injection, intracardiac, slow push

Injection, intracardiac, push

Injection, intracartilaginous

Injection, intracaudal

Injection, intracavernous

Injection, intracavitary

Injection, intracerebral

Injection, intracisternal

Infusion, intracoronary

Topical application, intracorneal

Injection, intracoronary

Injection, intracoronary, push

Topical application, intracoronal (dental)

Injection, intracorpus cavernosum

Implantation, intradermal

Injection, intradermal

Injection, intradiscal

Mucosal absorption, intraduodenal

Injection, intraductal

Instillation, intraduodenal

Injection, intradural

Injection, intraepidermal

Injection, intraepithelial

Instillation, intraesophageal

Topical application, intraesophageal

Instillation, intragastric

Irrigation, intragastric

Lavage, intragastric

Instillation, intraileal

Topical application, intraileal

Injection, intralesional

Irrigation, intralesional

Topical application, intralesional

Injection, intraluminal

Topical application, intraluminal

Injection, intralymphatic

Injection, intramuscular

Injection, intramuscular, deep

Injection, intramedullary

Injection, intramuscular, z track

Insufflation

Injection, interameningeal

Injection, interstitial

Injection, intraocular

Instillation, intraocular

Irrigation, intraocular

Topical application, iontophoresis

Infusion, intraosseous, continuous

Injection, intraosseous

Insertion, intraocular, surgical

Topical application, intraocular

Injection, intraovarian

Injection, intrapericardial

Injection, intraperitoneal

Inhalation, oral

Injection, intrapulmonary

Injection, intrapleural

Inhalation, intermittent positive pressure breathing (ippb)

Injection, intraprostatic

Injection, insulin pump

Instillation, intrasinal

Injection, intraspinal

Injection, intrasternal

Injection, intrasynovial

Infusion, intrathecal

Injection, intratendinous

Injection, intratesticular

Injection, intrathoracic

Injection, intrathecal

Instillation, intratracheal

Mucosal absorption, intratracheal

Injection, intratubular

Injection, intratumor

Injection, intratympanic

Insertion, intrauterine

Injection, intracervical (uterus)

Injection, intracervical (uterus)

Instillation, intrauterine

Injection, intraureteral, retrograde

Infusion, intravenous

Infusion, intravascular

Injection, intravascular

Infusion, intravenous catheter

Infusion, intravenous catheter, continuous

Infusion, intravenous catheter, intermittent

Injection, intraventricular (heart)

Injection, intravesicle

Flush, intravenous catheter

Injection, intravenous

Injection, intravenous, bolus

Implantation, intravitreal

Injection, intravitreal

Injection, intravenous, push

Injection, intravenous, rapid push

Injection, intravenous, slow push

Instillation, jejunostomy tube

Instillation, laryngeal

Topical application, laryngeal

Insertion, lacrimal puncta

Topical application, mucous membrane

Topical application, nail

Topical application, nasal

Instillation, nasal

Inhalation, nasal

Inhalation, nasal, prongs

Inhalation, nebulization, nasal

Instillation, nasogastric

Inhalation, nebulization

Instillation, nasogastric tube

Instillation, nasotracheal tube

Occlusive dressing technique

Instillation, orogastric tube

Instillation, orojejunum tube

Topical application, ophthalmic

Topical application, oral

Inhalation, oral intermittent flow

Topical application, oromucosal

Inhalation, nebulization, oral

Topical application, oropharyngeal

Rinse, oral

Instillation, otic

Injection, periarticular

Injection, parenteral

Infusion, intravenous catheter, pca pump

Injection, periodontal

Topical application, periodontal

Injection, peritoneal dialysis port

Instillation, peritoneal dialysis port

Injection, peridural

Topical application, perianal

Topical application, perineal

Injection, perineural

Injection, paranasal sinuses

Instillation, paranasal sinuses

Swallow, oral

Insertion, rectal

Injection, retrobulbar

Inhalation, oral rebreather mask

Instillation, rectal

Irrigation, rectal

Topical application, rectal

Instillation, rectal tube

Enema, rectal retention

Topical application, scalp

Injection, subconjunctival

Shampoo

Instillation, sinus, unspecified

Topical application, skin

Dissolve, sublingual

Injection, sublesional

Mucosal absorption, submucosal

Immersion (soak)

Injection, soft tissue

Instillation, soft tissue

Injection, subcutaneous

Implantation, subcutaneous

Infusion, subcutaneous

Insertion, subcutaneous, surgical

Injection, subarachnoid

Subconjunctival

Injection, submucosal

Suck, oromucosal

Topical application, swab

Swish and spit out, oromucosal

Swish and swallow, oromucosal

Topical application, transmucosal

Topical

Inhalation, tracheostomy

Instillation, tracheostomy

Transdermal

Diffusion, transdermal

Translingual

Injection, transplacental

Injection, transtracheal

Instillation, transtympanic

Topical absorption, transtympanic

Injection, urethral

Insertion, urethral

Instillation, urethral

Suppository, urethral

Injection, ureteral

Insertion, vaginal

Insertion, vaginal

Inhalation, ventilator

Inhalation, ventimask

Amniotic fluid sac

Biliary tract

Body surface

Buccal mucosa

Cecostomy

Cervix of the uterus

Chew

Dental

Diffusion

Dissolve

Douche

Electro-osmosis

Endocervical

Enema

Enteral

Epidural

Extra-amniotic

Extracorporeal circulation

Flush

Gastric

Genitourinary

Gingival

Hair

Implantation

Infiltration

Infusion

Inhalation

Injection

Insertion

Instillation

Interameningeal

Interstitial

Intra-abdominal

Intra-arterial

Intraarticular

Intrabronchial

Intrabursal

Intracardiac

Intracartilaginous

Intracaudal

Intracavernosal

Intracavitary

Intracerebral

Intracervical

Intracisternal

Intracorneal

Intracoronal (dental)

Intracoronary

Intracorpus cavernosum

Intradermal

Intradiscal

Intraductal

Intraduodenal

Intradural

Intraepidermal

Intraepithelial

Intraesophageal

Intragastric

Intraileal

Intralesional

Intraluminal

Intralymphatic

Intramedullary

Intramuscular

Intraocular

Intraosseous

Intraovarian

Intrapericardial

Intraperitoneal

Intrapleural

Intraprostatic

Intrapulmonary

Intrasinal

Intraspinal

Intrasternal

Intrasynovial

Intratendinous

Intratesticular

Intrathecal

Intrathoracic

Intratracheal

Intratubular

Intratumor

Intratympanic

Intrauterine

Intravascular

Intravenous

Intraventricular

Intravesicle

Intravitreal

Iontophoresis

Irrigation

Jejunum

Lacrimal puncta

Laryngeal

Lavage

Lingual

Mucosal absorption

Mucous membrane

Nail

Nasal

Nebulization

Ophthalmic

Oral

Oromucosal

Oropharyngeal

Otic

Paranasal sinuses

Parenteral

Perianal

Periarticular

Peridural

Perineal

Perineural

Periodontal

Pulmonary

Rectal

Respiratory tract

Retrobulbar

Rinse

Route of substance administration classified by administration method.

Route of substance administration classified by site.

Scalp

Sinus, unspecified

Skin

Soft tissue

Subarachnoid

Subconjunctival

Subcutaneous

Sublesional

Sublingual

Submucosal

Suppository

Swish

Topical absorption

Topical application

Tracheostomy

Transmucosal

Transplacental

Transtracheal

Transtympanic

Ureteral

Urethral

Urinary bladder

Urinary tract

Vaginal

Vitreous humour

Description:The South Carolina Department of Health and Environmental Control GIS Spatial Data Accuracy Tiers have been derived from the National Standard for Spatial Data Accuracy as a means to categorize the accuracy of spatial data assignment utilizing a variety of tools for capturing coordinates including digitizers, geocoding software and global positioning system devices.

This code system contains the list of provider types used in the pan-Canadian specifications.

These pan-Canadian codes are maintained in circumstances where the desired code is not yet available in another code system (HL7 code systems, LOINC, SNOMED, etc.) In general, the codes will be deprecated once an equivalent code is available in the preferred code system.

SNOMED-DICOM Microglossary

UPDATE:

Specifies sequence of sort order.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Ascending sequence order.

Descending sequence order.

No enforced sequence order.

UPDATE:

**** MISSING DESCRIPTION ****

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Form the intersection with the value.

Form the set-difference with this value, i.e., exclude this element or set from the resulting set.

Form the convex hull with the value. The convex hull is defined over ordered domains and is the smallest contiguous superset (interval) that of all the operand sets.

Form the union with this value, i.e., include this element or set in the resulting set.

Form the periodic hull with the value. The periodic hull is defined over ordered domains and is the periodic set that contains all contiguous supersets of pairs of intervals generated by the operand periodic intervals.

Operations that can be used to associate concepts in a terminology.

The Standard Industrial Classification Codes that appear in a company's disseminated EDGAR filings indicate the company's type of business. These codes are also used in the Division of Corporation Finance as a basis for assigning review responsibility for the company's filings. For example, a company whose business was Metal Mining (SIC 1000) would have its filings reviewed by staffers in A/D Office 4. Note that this code system is published both by the US Bureau of Labor Statistics (BLS) at http://www.sec.gov/info/edgar/siccodes.htm, and by the US Occupational & Safety Health Administration (OSHA) at http://www.osha.gov/pls/imis/sic\_manual.html.

Systemized Nomenclature in Medicine (SNOMED)

SNOMED International

SNOMED topology codes (anatomic sites)

The Standard Occupational Classification (SOC) system is used by Federal statistical agencies to classify workers into occupational categories for the purpose of collecting, calculating, or disseminating data. All workers are classified into one of over 820 occupations according to their occupational definition. To facilitate classification, occupations are combined to form 23 major groups, 96 minor groups, and 449 broad occupations. Each broad occupation includes detailed occupation(s) requiring similar job duties, skills, education, or experience. This code system replaced the older FIPSPUB92, which was withdrawn in February 2005.

UPDATE:

**** MISSING DESCRIPTION ****

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. An additional concept code that was also attributed to a concept
UPDATE: Description:This code system contains all HL7 artifacts of type TE (Trigger Event) that are created by HL7 or its affiliates or their designates using the realm namespacing rules approved by HL7. Local implementations who create trigger events outside of these namespacing rules, (e.g. using the ZZ realm code) must register their own code system. The specific list of legal codes can be found by consulting the HL7 publications (editions, ballots, implementation guides, etc.) published by HL7 Inc. and by the various HL7 affiliates and their designates. Codes shall be expressed in upper case, with separator as shown in HL7 publications with no version id. E.g. PORX\_TE123456UV. en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. Description: Description: Description: Description: Description: Description: Description: Description: Description: Description: Description: UPDATE:

<ns1:p>The style code is used within the CDA/SPL narrative block to give the instance author some control over various aspects of style</ns1:p>

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. An additional concept code that was also attributed to a concept

List is ordered using Arabic numerals: 1, 2, 3

List is ordered using big alpha characters: A, B, C

List is ordered using big Roman numerals: I, II, III

Render cell with rule on bottom

List bullets are hollow discs

List bullets are simple solid discs

List is order using little alpha characters: a, b, c

List is ordered using little Roman numerals: i, ii, iii

Render cell with left-sided rule

Render cell with right-sided rule

List bullets are solid squares

Render cell with rule on top

Defines font rendering characteristics

Defines list rendering characteristics

Defines rendering characteristics for ordered lists

Defines table cell rendering characteristics

Defines rendering characteristics for unordered lists

Render with a bold font

Render with with some type of emphasis

Render italicized

Render with an underline font

UPDATE:

Identifies what sort of change is permitted or has occurred between the therapy that was ordered and the therapy that was/will be provided.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Substitution occurred or is permitted between equivalent Brands but not Generics

Examples:

* Zestril for Prinivil * Coumadin for Jantoven

Substitution occurred or is permitted with another bioequivalent and therapeutically equivalent product.

Substitution occurred or is permitted with another product that is a:

* pharmaceutical alternative containing the same active ingredient but is formulated with different salt, ester * pharmaceutical equivalent that has the same active ingredient, strength, dosage form and route of administration

Examples:

* *Pharmaceutical alternative:* Erythromycin Ethylsuccinate for Erythromycin Stearate * *Pharmaceutical equivalent:* Lisonpril for Zestril

This substitution was performed or is permitted based on formulary guidelines.

Substitution occurred or is permitted between equivalent Generics but not Brands

Examples:

* Lisnopril (Lupin Corp) for Lisnopril (Wockhardt Corp)

No substitution occurred or is permitted.

Substitution occurred or is permitted between therapeutically equivalent Brands but not Generics

>

Examples:

* Zantac for Tagamet

Substitution occurred or is permitted with another product having the same therapeutic objective and safety profile.

Examples:

* ranitidine for Tagamet

Substitution occurred or is permitted between therapeutically equivalent Generics but not Brands

>

Examples:

* Ranitidine for cimetidine

Substitution occurred or is permitted with another product that may potentially have different ingredients, but having the same biological and therapeutic effects.

UPDATE:

Identifies what sort of change is permitted or has occurred between the item that was ordered/requested and the one that was/will be provided.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Confirmation with Contact Person prior to making any substitutions has or will occur.

Substitution is not permitted.

Notification to the Contact Person, prior to substitution and through normal institutional procedures, has or will be made.

No conditions are required.

Some conditions may be attached to an allowable substitution. An allowable substitution is based on a match to any other attributes that may be specified.

UPDATE:

These values are defined within the XHTML 4.0 Table Model

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.
UPDATE:

These values are defined within the XHTML 4.0 Table Model

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.
UPDATE:

These values are defined within the XHTML 4.0 Table Model

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.
UPDATE:

These values are defined within the XHTML 4.0 Table Model

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.
UPDATE:

These values are defined within the XHTML 4.0 Table Model

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.
UPDATE:

A code specifying the extent to which the Entity playing the participating Role (usually as a target Participation) is aware of the associated Act.

Examples:For diagnostic observations, is the patient, family member or other participant aware of his terminal illness?Discussion:If the awareness, denial, unconsciousness, etc. is the subject of medical considerations (e.g., part of the problem list), one should use explicit observations in these matters as well, and should not solely rely on this simple attribute in the Participation.
en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Target person has been informed about the issue but currently denies it.

Target person is fully aware of the issue.

Target person is not capable of comprehending the issue.

Target person is marginally aware of the issue.

Target person is partially aware of the issue.

Target person has not yet been informed of the issue.

UPDATE: Deprecation Comment:This code system was deprecated as of the November 2007 harmonization meeting. The content was folded into AddressUse (2.16.840.1.113883.5.1119), which replaces this code system. en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

An automated answering machine used for less urgent cases and if the main purpose of contact is to leave a message or access an automated announcement.

A contact specifically designated to be used for emergencies. This is the first choice in emergencies, independent of any other use codes.

A telecommunication device that moves and stays with its owner. May have characteristics of all other use codes, suitable for urgent matters, not the first choice for routine business.

A paging device suitable to solicit a callback or to leave a very short message.

UPDATE: Description:Concepts that define the telecommunication capabilities of a particular device. Used to identify the expected capabilities to be found at a particular telecommunication address. en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired. Description:This device can receive data calls (i.e. modem). Description:This device can receive faxes. Description:This device can receive SMS messages. Description:This device is a text telephone. Description:This device can receive voice calls (i.e. talking to another person, or a recording device, or a voice activated computer). UPDATE:

**** MISSING DESCRIPTION ****

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

before meal (from lat. ante cibus)

before lunch (from lat. ante cibus diurnus)

before breakfast (from lat. ante cibus matutinus)

before dinner (from lat. ante cibus vespertinus)

Description:meal (from lat. ante cibus) Description:lunch (from lat. cibus diurnus) Description:breakfast (from lat. cibus matutinus) Description:dinner (from lat. cibus vespertinus) Description:Prior to beginning a regular period of extended sleep (this would exclude naps). Note that this might occur at different times of day depending on a person's regular sleep schedule.

between meals (from lat. inter cibus)

between lunch and dinner

between breakfast and lunch

between dinner and the hour of sleep

after meal (from lat. post cibus)

after lunch (from lat. post cibus diurnus)

after breakfast (from lat. post cibus matutinus)

after dinner (from lat. post cibus vespertinus)

Description:Upon waking up from a regular period of sleep, in order to start regular activities (this would exclude waking up from a nap or temporarily waking up during a period of sleep)Usage Notes:e.g.

Take pulse rate on waking in management of thyrotoxicosis.

Take BP on waking in management of hypertension

Take basal body temperature on waking in establishing date of ovulation

e.g. Take pulse rate on waking in management of thyrotoxicosis. Take BP on waking in management of hypertension Take basal body temperature on waking in establishing date of ovulation
UPDATE:

**Description:**A code specifying the meaning and purpose of every TransmissionRelationship instance. Each of its values implies specific constraints to what kinds of Transmission objects can be related and in which way.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

**Description:**A transmission relationship indicating that the source transmission follows the target transmission.

UPDATE:

INDIAN ENTITIES RECOGNIZED AND ELIGIBLE TO RECEIVE SERVICES FROM THE UNITED STATES BUREAU OF INDIAN AFFAIRS

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Capitan Grande Band of Diegueno Mission Indians of California (Barona Group of Capitan Grande Band of Mission Indians of the Barona Reservation, California; Viejas (Baron Long) Group of Capitan Grande Band of Mission Indians of the Viejas Reservation, California)

NATIVE ENTITIES WITHIN THE STATE OF ALASKA RECOGNIZED AND ELIGIBLE TO RECEIVE SERVICES FROM THE UNITED STATES BUREAU OF INDIAN AFFAIRS

NATIVE ENTITIES WITHIN THE CONTIGUOUS 48 STATES

UCDS

MDNS

Unified Medical Language

UMLS codes as CUIs making up the values in a coding system. More information may be found at http://www.nlm.nih.gov/research/umls/

Universal Product Code

Universal Resource Locator (URL) schemes Currently there is no single authority for URL schemes. The authority for URL scheme assignments clearly lies within IANA or W3C and it is likely that a formal URL/URI assigning authority will be formed soon.

UPDATE:

A Universal Resource Locator (URL) is a type of telecommunications address specified as Internet standard RFC 1738 \[http://www.isi.edu/in-notes/rfc1738.txt\]. The URL specifies the protocol and the contact point defined by that protocol for the resource.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.. Description:cid: is the most common mechanism used in webservices. A cid: reference points from the SOAP body to other content in the mime package in which the SOAP envelope is wrapped

A telephone number served by a fax device \[http://www.ietf.org/rfc/rfc3966.txt and http://www.ietf.org/rfc/rfc2806.txt\].

Host-specific local file names \[RCF 1738\]. Note that the file scheme works only for local files. There is little use for exchanging local file names between systems, since the receiving system likely will not be able to access the file.

The File Transfer Protocol (FTP) \[RFC 1738\].

Description:A reference to an HL7 attachment by it's identifier, which takes the form hl7-att:\[II.literal\], such as hl7-att:2.1.16.3.9.12345.2.39.3:ABC123

Hypertext Transfer Protocol \[RFC 2068\].

http://www.ietf.org/rfc/rfc2068.txt

Electronic mail address \[RFC 2368\]

http://www.ietf.org/rfc/rfc2368.txt

Description:Mimimal Lower Layer Protocol. See Transport Specification: MLLP, Release 2 (HL7 V3 Transport specification).

A telephone number served by a modem device \[http://www.ietf.org/rfc/rfc3966.txt and http://www.ietf.org/rfc/rfc2806.txt\].

Network File System protocol \[RFC 2224\]. Some sites use NFS servers to share data files.

http://www.ietf.org/rfc/rfc2224.txt

A voice telephone number \[http://www.ietf.org/rfc/rfc3966.txt and http://www.ietf.org/rfc/rfc2806.txt\].

Reference to interactive sessions \[RFC 1738\]. Some sites, (e.g., laboratories) have TTY based remote query sessions that can be accessed through telnet.

http://www.ietf.org/rfc/rfc1738.txt

Description:A telephone number served by a fax device \[http://www.ietf.org/rfc/rfc3966.txt and http://www.ietf.org/rfc/rfc2806.txt\] Description:A text telephone - a telephone which is designed for use by the hearing-impairedNotes:

* x-text-fax is required to replace fax, since this has been deprecated by W3C. * hl7-att is associated with a series of rules that must be followed. These rules are documented in Datatypes R2 * This domain is external and extensible, so documenting this simply clarifies consistent usage for these use cases.

Coding system of United States Census Occupation Codes, published by the US Governmetn Bureau of the Census. Doucmentation and Crosswalk mapping between the COC and the SOC and NAICS code systems available at http://www.census.gov/hhes/www/ioindex/view.html

The United States Environmental Protection Agency's (US EPA) Substance Registry System (SRS) provides information on substances and how they are represented in US environmental statutes, in US EPA information systems, and in information systems owned by other organizations. The SRS provides standardized identification for each substance to improve data quality in US EPA systems and elsewhere.

Coding system of defined postal zip codes for the United States of America.

UPDATE:

The manufacturer of a vaccine.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

Abbott Laboratories (includes Ross Products Division)

Adams Laboratories

Alpha Therapeutic Corporation

Armour \[Inactive-use CEN\]

Aviron

Baxter Healthcare Corporation

Bayer Corporation (includes Miles, Inc. and Cutter Laboratories)

Berna Products \[Inactive-use BPC\]

Berna Products Corporation (includes Swiss Serum and Vaccine Institute Berne)

Centeon L.L.C. (includes Armour Pharmaceutical Company)

Chiron Corporation

Connaught \[Inactive-use PMC\]

Evans Medical Limited (an affiliate of Medeva Pharmaceuticals, Inc.)

Greer Laboratories, Inc.

Immuno International AG

Merieux \[Inactive-use PMC\]

Immuno-U.S., Inc.

The Research Foundation for Microbial Diseases of Osaka University (BIKEN)

Korea Green Cross Corporation

Lederle \[Inactive-use WAL\]

Massachusetts Public Health Biologic Laboratories

MedImmune, Inc.

Miles \[Inactive-use BAY\]

Bioport Corporation (formerly Michigan Biologic Products Institute)

Merck & Co., Inc.

NABI (formerly North American Biologicals, Inc.)

North American Vaccine, Inc.

Novartis Pharmaceutical Corporation (includes Ciba-Geigy Limited and Sandoz Limited)

New York Blood Center

Ortho Diagnostic Systems, Inc.

Organon Teknika Corporation

Parkedale Pharmaceuticals (formerly Parke-Davis)

Aventis Pasteur Inc. (formerly Pasteur Merieux Connaught; includes Connaught Laboratories and Pasteur Merieux)

Praxis Biologics \[Inactive-use WAL\]

Sclavo, Inc.

Swiss Serum and Vaccine Inst. \[Inactive-use BPC\]

SmithKline Beecham

United States Army Medical Research and Materiel Command

Wyeth-Ayerst \[Inactive-use WAL\]

Wyeth-Ayerst (includes Wyeth-Lederle Vaccines and Pediatrics, Wyeth Laboratories, Lederle Laboratories, and Praxis Biologics)

UPDATE:

The kind of vaccine.

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

diphtheria, tetanus toxoids and pertussis vaccine

poliovirus vaccine, inactivated

pneumococcal conjugate vaccine, polyvalent

Typhoid Vi capsular polysaccharide vaccine

pertussis vaccine

diphtheria antitoxin

tetanus immune globulin

immune globulin, NOS

influenza virus vaccine, split virus (incl. purified surface antigen)

influenza virus vaccine, whole virus

Haemophilus influenzae type b vaccine, conjugate NOS

rabies vaccine, for intramuscular injection

Bacillus Calmette-Guerin vaccine

poliovirus vaccine, live, oral

diphtheria, tetanus toxoids and acellular pertussis vaccine

varicella virus vaccine

DTP-Haemophilus influenzae type b conjugate vaccine

plague vaccine

anthrax vaccine

typhoid vaccine, live, oral

cholera vaccine

botulinum antitoxin

diphtheria and tetanus toxoids, adsorbed for pediatric use

cytomegalovirus immune globulin, intravenous

measles, mumps and rubella virus vaccine

hepatitis B immune globulin

hepatitis A vaccine, pediatric dosage, NOS

meningococcal polysaccharide vaccine

pneumococcal polysaccharide vaccine

rabies immune globulin

tetanus toxoid

varicella zoster immune globulin

yellow fever vaccine

rubella and mumps virus vaccine

Japanese encephalitis vaccine

measles and rubella virus vaccine

rabies vaccine, for intradermal injection

typhoid vaccine, parenteral, other than acetone-killed, dried

hepatitis B vaccine, adolescent/high risk infant dosage

hepatitis B vaccine, adult dosage

hepatitis B vaccine, dialysis patient dosage

hepatitis B vaccine, NOS

Haemophilus influenzae type b vaccine, PRP-D conjugate

Haemophilus influenzae type b vaccine, HbOC conjugate

Haemophilus influenzae type b vaccine, PRP-T conjugate

Haemophilus influenzae type b vaccine, PRP-OMP conjugate

measles virus vaccine

DTaP-Haemophilus influenzae type b conjugate vaccine

Haemophilus influenzae type b conjugate and Hepatitis B vaccine

hepatitis A vaccine, adult dosage

typhoid vaccine, parenteral, acetone-killed, dried (U.S. military)

adenovirus vaccine, type 4, live, oral

adenovirus vaccine, type 7, live, oral

dengue fever vaccine

hantavirus vaccine

hepatitis C vaccine

hepatitis E vaccine

rubella virus vaccine

herpes simplex virus, type 2 vaccine

human immunodeficiency virus vaccine

human papilloma virus vaccine

Junin virus vaccine

leishmaniasis vaccine

leprosy vaccine

Lyme disease vaccine

malaria vaccine

melanoma vaccine

parainfluenza-3 virus vaccine

mumps virus vaccine

Q fever vaccine

respiratory syncytial virus immune globulin, intravenous

rheumatic fever vaccine

Rift Valley fever vaccine

rotavirus vaccine, tetravalent, live, oral

smallpox vaccine

Staphylococcus bacteriophage lysate

tick-borne encephalitis vaccine

tularemia vaccine

vaccinia immune globulin

hepatitis B vaccine, pediatric or pediatric/adolescent dosage

Venezuelan equine encephalitis, live, attenuated

Venezuelan equine encephalitis, inactivated

adenovirus vaccine, NOS

hepatitis A vaccine, pediatric/adolescent dosage, 2 dose schedule

hepatitis A vaccine, pediatric/adolescent dosage, 3 dose schedule

hepatitis A vaccine, NOS

immune globulin, intramuscular

immune globulin, intravenous

influenza virus vaccine, NOS

poliovirus vaccine, NOS

tetanus and diphtheria toxoids, adsorbed for adult use

rabies vaccine, NOS

typhoid vaccine, NOS

Venezuelan equine encephalitis vaccine, NOS

respiratory syncytial virus monoclonal antibody (palivizumab), intramuscular

measles, mumps, rubella, and varicella virus vaccine

tuberculin skin test; old tuberculin, multipuncture device

tuberculin skin test; purified protein derivative solution, intradermal

tuberculin skin test; purified protein derivative, multipuncture device

tuberculin skin test; NOS

VHA Enterprise Reference Terminology is based on CHI standard terminologies (e.g., SNOMED-CT, LOINC, HL7, NDF-RT, etc.) when available and on VHA own code sets when necessary (e.g., allergens). All concepts used within the VHA clinical environment receive a VHA Unique IDentifier or VUID. VHA Enterprise Reference Terminology complies with the semantics of the HL7 message structure

WHO rec\# drug codes

WHO rec\# code with ASTM extension

WHO Adverse Drug Reaction Terminology (WHOART). Uppsala (Sweden): WHO Collaborating Centre for International Drug Monitoring, 1997. This branch node OID contains identifiers for the different foreign language versions of this terminology. For more information, see http://www.umc-products.com/graphics/3149.pdf

WHO Adverse Drug Reaction Terminology (WHOART). French Translation. Uppsala (Sweden): WHO Collaborating Centre for International Drug Monitoring, 1997. For more information, see http://www.umc-products.com/graphics/3149.pdf

WHO Adverse Drug Reaction Terminology (WHOART). German Translation. Uppsala (Sweden): WHO Collaborating Centre for International Drug Monitoring, 1997. For more information, see http://www.umc-products.com/graphics/3149.pdf

WHO Adverse Drug Reaction Terminology (WHOART). Portuguese Translation. Uppsala (Sweden): WHO Collaborating Centre for International Drug Monitoring, 1997. For more information, see http://www.umc-products.com/graphics/3149.pdf

WHO Adverse Drug Reaction Terminology (WHOART). Spanish Translation. Uppsala (Sweden): WHO Collaborating Centre for International Drug Monitoring, 1997. For more information, see http://www.umc-products.com/graphics/3149.pdf

UPDATE:

Code system of concepts representing a person's job type as defined by compensation and sector (e.g. paid vs. unpaid, self-employed vs. not self-employed, government vs. private, etc.).

en The child code is a more narrow version of the concept represented by the parent code. I.e. Every child concept is also a valid parent concept. Used to allow determination of subsumption. Must be transitive, irreflexive, antisymmetric. Inverse of Specializes. Only included as a derived relationship. The internal identifier for the concept in the HL7 Access database repository. Designation of a concept's state. Normally is not populated unless the state is retired.

A situation in which an individual serves in a government-sponsored military force.

A situation in which an individual works for a national government organization, not including armed forces, and receives a paid salary or wage.

A situation in which an individual works for a government organization with jurisdiction below the level of state/provincial/territorial/tribal government (e.g., city, town, township), not armed forces, and receives a paid salary or wage.

A situation in which an individual works for a business (not government) that they do not own and receives a paid salary or wage.

A situation in which an individual earns a salary or wage working for himself or herself instead of working for an employer.

A situation in which an individual works for a government organization with jurisdiction immediately below the level of national government (between national government and local government), not armed forces and receives a paid salary or wage. Often called a state, provincial, territorial, or tribal government.

A situation in which an individual works for a business (not government) that they do not own without receiving a paid salary or wage.

A situation in which an individual works for himself or herself without receiving a paid salary or wage.

A situation in which an individual chooses to do something, especially for other people or for an organization, willingly and without being forced or compensated to do it. This can include formal activity undertaken through public, private and voluntary organizations as well as informal community participation.

A situation in which an individual chooses to donate their time to perform activities (work) in disaster response or as a first responder, without being forced and with no expectation of compensation. This can include formal activity undertaken through a government agency or a public or private organization, as well as informal community participation.

SNOMED CT is a core clinical healthcare terminology that contains concepts with unique meanings and formal logic based definitions organized into hierarchies.

en

RxNorm provides normalized names for clinical drugs and links its names to many of the drug vocabularies commonly used in pharmacy management and drug interaction software, including those of First Databank, Micromedex, and Gold Standard Drug Database. By providing links between these vocabularies, RxNorm can mediate messages between systems not using the same software and vocabulary. RxNorm now includes the United States Pharmacopeia (USP) Compendial Nomenclature from the United States Pharmacopeial Convention. USP is a cumulative data set of all Active Pharmaceutical Ingredients (API).

en

The Unified Code for Units of Measure (UCUM) is a code system intended to include all units of measures being contemporarily used in international science, engineering, and business. The purpose is to facilitate unambiguous electronic communication of quantities together with their units. The focus is on electronic communication, as opposed to communication between humans. A typical application of The Unified Code for Units of Measure are electronic data interchange (EDI) protocols, but there is nothing that prevents it from being used in other types of machine communication.

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LOINC provides a set of universal names and ID codes for identifying laboratory and clinical test results.1,2 LOINC facilitates the exchange and pooling of results, such as blood hemoglobin, serum potassium, or vital signs, for clinical care, outcomes management, and research. LOINC's universal identifiers (names and codes) can be used in the context of order and observation exchanges between information systems that use syntax standards such as HL73, CEN TC251, ISO TC215, ASTM4, and DICOM. Specifically, the identifier can be used as the coded value for an observation in any other standard that uses the observation/observation value paradigm, whether messages, documents, application programming interface (API), etc. For example, LOINC codes are used widely in the OBX segment Observation Identifier field (OBX-3) of an ORU HL7 (HL7 version 2.x or ASTM 1238-9410) message that may be sent between a Clinical Laboratory Information Management Systems (LIMS) and Electronic Health Record Systems (EHR).5, 6 In this way, LOINC codes provide universal identifiers that allow the exchange of clinical data between heterogeneous computing environments.

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X12.3 Data Elementary Dictionary

This is the root OID for vocabulary defined internally by X12N. OIDS for each vocabulary will be assigned underneath this oid by appending the X12N data element id to the root OID. Data Element 1336 is Insurance Type Code, so the OID for the X12N Insurance Type Code vocabulary will be 2.16.840.1.113883.6.255.1336

UPDATE:

The gender of a person used for adminstrative purposes (as opposed to clinical gender)

2.16.840.1.113883.5.1 en
UPDATE:

The possible modes of updating that occur when an attribute is received by a system that already contains values for that attribute.

2.16.840.1.113883.5.57 en
UPDATE: No description 2.16.840.1.113883.5.93 en UPDATE:

Institution

2.16.840.1.113883.5.63 en
UPDATE:

A code distinguishing whether an Act is conceived of as a factual statement or in some other manner as a command, possibility, goal, etc.

Constraints:An Act-instance must have one and only one moodCode value.

The moodCode of a single Act-instance never changes. Mood is not state.

To describe the progression of a business activity from defined to planned to executed, etc. one must instantiate different Act-instances in the different moods and link them using ActRelationship of general type "sequel". (See ActRelationship.type.)

2.16.840.1.113883.5.1001 en
UPDATE:

These are moods describing activities as they progress in the business cycle, from defined, through planned and ordered to completed.

2.16.840.1.113883.5.1001 en
UPDATE:

An intention or plan to perform a service. Historical note: in previous RIM versions, the intent mood was captured as a separate class hierarchy, called Service\_intent\_or\_order.

2.16.840.1.113883.5.1001 en
UPDATE:

Any of the above service moods (e.g., event, intent, or goal) can be turned into a predicate used as a criterion to express conditionals (or queries.) However, currently we allow only criteria on service events.

2.16.840.1.113883.5.1001 en
UPDATE:

Interpretation of normality or degree of abnormality (including critical or "alert" level). Concepts in this category are mutually exclusive, i.e., at most one is allowed.

2.16.840.1.113883.5.83 en
UPDATE:

Interpretation of degree of abnormality (including critical or "alert" level). Concepts in this category are mutually exclusive, i.e., at most one is allowed.

2.16.840.1.113883.5.83 en
UPDATE:

Interpretation for a quantitative observation of degree of abnormality (including critical or "alert" level) below the lower limit of the reference range.

2.16.840.1.113883.5.83 en
UPDATE:

Interpretation for a quantitative observation of degree of abnormality (including critical or "alert" level) above the upper limit of the reference range.

2.16.840.1.113883.5.83 en
UPDATE:

Interpretation of a critical (or "alert") degree of abnormality. Concepts in this category are mutually exclusive, i.e., at most one is allowed.

2.16.840.1.113883.5.83 en
UPDATE:

Interpretations of change of quantity and/or severity, such as "better", "worse", "increased", etc. At most one of B or W and one of U or D allowed.

2.16.840.1.113883.5.83 en
UPDATE:

Interpretations of anti-microbial susceptibility testing results (microbiology). At most one allowed.

2.16.840.1.113883.5.83 en
UPDATE:

Technical exceptions resulting in the inability to provide an interpretation. At most one allowed. Does not imply normality or severity.

2.16.840.1.113883.5.83 en
UPDATE:

Set of codes used to value Act.Confidentiality and Role.Confidentiality attribute in accordance with the definition for concept domain "Confidentiality".

2.16.840.1.113883.5.25 en
UPDATE:

Modifiers of role based access rights (multiple allowed)

Usage Note:All codes that are referenced by this value set were retired as of the November 2013 Harmonization cycle. Guidance for what to use instead of the v:ConfidentialityModifers leaf concepts: celebrity, sensitive, and taboo: These codes have been revised and are now included under v:ActCode at:

* V:ActInformationSensitivityPolicy:2.16.840.1.113883.1.11.20429 - taboo * V:InformationSensitivityPolicy:2.16.840.1.113883.1.11.20428 - celebrity/VIP and patient requested sensitivity

2.16.840.1.113883.5.25 en
UPDATE:

Participations related, but not primary to an act. The Referring, Admitting, and Discharging practitioners must be the same person as those authoring the ControlAct event for their respective trigger events.

2.16.840.1.113883.5.90 en
UPDATE:

A person who actually and principally carries out the action. Need not be the principal responsible actor, e.g. a surgery resident operating under supervision of attending surgeon, and may be the patient in self-care, e.g. fingerstick blood sugar. The traditional order filler is a performer. This information should accompany every service event.

2.16.840.1.113883.5.90 en
UPDATE:

Parties that may or should contribute or have contributed information to the Act. Such information includes information leading to the decision to perform the Act and how to perform the Act (e.g., consultant), information that the Act itself seeks to reveal (e.g., informant of clinical history), or information about what Act was performed (e.g., informant witness).

2.16.840.1.113883.5.90 en
UPDATE:

A person who verifies the correctness and appropriateness of the service (plan, order, event, etc.) and hence takes on accountability.

2.16.840.1.113883.5.90 en
UPDATE:

A party, who may or should receive or who has recieved the Act or subsequent or derivative information of that Act. Information recipient is inert, i.e., independent of mood." Rationale: this is a generalization of a too diverse family that the definition can't be any more specific, and the concept is abstract so one of the specializations should be used.

2.16.840.1.113883.5.90 en
UPDATE:

This code is used to specify the exact function an actor had in a service in all necessary detail. This domain may include local extensions (CWE).

2.16.840.1.113883.5.88 en
UPDATE:

A code specifying whether and how the participant has attested his participation through a signature and or whether such a signature is needed.

Examples:A surgical Procedure act object (representing a procedure report) requires a signature of the performing and responsible surgeon, and possibly other participants. (See also: Participation.signatureText.)
2.16.840.1.113883.5.89 en
UPDATE:

Target that is substantially present in the service and which is directly affected by the service action (includes consumed material, devices, etc.).

2.16.840.1.113883.5.90 en
UPDATE:

Something used in delivering the service without being substantially affected by the service (i.e. durable or inert with respect to that particular service.) Examples are: monitoring equipment, tools, but also access/drainage lines, prostheses, pace maker, etc.

2.16.840.1.113883.5.90 en
UPDATE:

This attribute defines whether the message is part of a production, training, or debugging system.

2.16.840.1.113883.5.100 en
UPDATE:

The facility where the service is done. May be a static building (or room therein) or a moving location (e.g., ambulance, helicopter, aircraft, train, truck, ship, etc.)

2.16.840.1.113883.5.90 en
UPDATE:

A code specifying the extent to which the Entity playing the participating Role (usually as a target Participation) is aware of the associated Act.

Examples:For diagnostic observations, is the patient, family member or other participant aware of his terminal illness?Discussion:If the awareness, denial, unconsciousness, etc. is the subject of medical considerations (e.g., part of the problem list), one should use explicit observations in these matters as well, and should not solely rely on this simple attribute in the Participation.
2.16.840.1.113883.5.137 en
UPDATE:

A code specifying the meaning and purpose of every ActRelationship instance. Each of its values implies specific constraints to what kinds of Act objects can be related and in which way.

Discussion:The types of act relationships fall under one of 5 categories:

1.) (De)-composition, with composite (source) and component (target)

2.) Sequel which includes follow-up, fulfillment, instantiation, replacement, transformation, etc. that all have in common that source and target are Acts of essentially the same kind but with variances in mood and other attributes, and where the target exists before the source and the source refers to the target that it links back to.

3.) Pre-condition, trigger, reason, contraindication, with the conditioned Act at the source and the condition or reason at the target.

4.) Post-condition, outcome, goal and risk, with the Act at the source having the outcome or goal at the target.

5.) A host of functional relationships including support, cause, derivation, etc. generalized under the notion of "pertinence".

2.16.840.1.113883.5.1002 en
UPDATE:

A collection of sub-services as steps or subtasks performed for the source service. Services may be performed sequentially or concurrently.

2.16.840.1.113883.5.1002 en
UPDATE:

An observation that should follow or does actually follow as a result or consequence of a condition or action (sometimes called "post-condition".) Target must be an observation as a goal, risk or any criterion. For complex outcomes a conjunction attribute

2.16.840.1.113883.5.1002 en
UPDATE:

This is a very unspecific relationship from one item of clinical information to another. It does not judge about the role the pertinent information plays.

2.16.840.1.113883.5.1002 en
UPDATE:

Used to indicate that an existing service is suggesting evidence for a new observation. The assumption of support is attributed to the same actor who asserts the observation. Source must be an observation, target may be any service (e.g., to indicate a status post.)

2.16.840.1.113883.5.1002 en
UPDATE:

An act relationship indicating that the source act follows the target act. The source act should in principle represent the same kind of act as the target. Source and target need not have the same mood code (mood will often differ). The target of a sequel is called antecedent. Examples for sequel relationships are: revision, transformation, derivation from a prototype (as a specialization is a derivation of a generalization), followup, realization, instantiation.

2.16.840.1.113883.5.1002 en
UPDATE:

The source act fulfills (in whole or in part) the target act. Source act must be in a mood equal or more actual than the target act.

2.16.840.1.113883.5.1002 en
UPDATE:

A code specifying when in the course of an Act a precondition for the Act is evaluated (e.g., before the Act starts for the first time, before every repetition, after each repetition but not before the first, or throughout the entire time of the Act.)

Discussion:This attribute is part of the workflow control suite of attributes. An action plan is a composite Act with component Acts. In a sequential plan, each component has a sequenceNumber that specifies the ordering of the plan steps. Before each step is executed and has preconditions these conditions are tested and if the test is positive, the Act has clearance for execution. The repeatNumber may indicate that an Act may be repeatedly executed. The checkpointCode is specifies when the precondition is checked and is analogous to the various conditional statements and loop constructs in programming languages "while-do" vs. "do-while" or "repeat-until" vs. "loop-exit".

For all checkpointCodes, except "end", preconditions are being checked at the time when the preceding step of the plan has terminated and this step would be next in the sequence established by the sequenceNumber attribute.

When the checkpointCode for a criterion of a repeatable Act is "end", the criterion is tested only at the end of each repetition of that Act. When the condition holds true, the next repetition is ready for execution.

When the checkpointCode is "entry" the criterion is checked at the beginning of each repetition (if any) whereas "beginning" means the criterion is checked only once before the repetition "loop" starts.

The checkpointCode "through" is special in that it requires the condition to hold throughout the execution of the Act, even throughout a single execution. As soon as the condition turns false, the Act should receive an interrupt event (see interruptibleInd) and will eventually terminate.

The checkpointCode "exit" is only used on a special plan step that represents a loop exit step. This allows an action plan to exit due to a condition tested inside the execution of this plan. Such exit criteria are sequenced with the other plan components using the ActRelationship.sequenceNumber.

2.16.840.1.113883.5.10 en
UPDATE:

A code specifying how branches in an action plan are selected among other branches.

Discussion:This attribute is part of the workflow control suite of attributes. An action plan is a composite Act with component Acts. In a sequential plan, each component has a sequenceNumber that specifies the ordering of the plan steps. Branches exist when multiple components have the same sequenceNumber. The splitCode specifies whether a branch is executed exclusively (case-switch) or inclusively, i.e., in parallel with other branches.

In addition to exlusive and inclusive split the splitCode specifies how the pre-condition (also known as "guard conditions" on the branch) are evaluated. A guard condition may be evaluated once when the branching step is entered and if the conditions do not hold at that time, the branch is abandoned. Conversely execution of a branch may wait until the guard condition turns true.

In exclusive wait branches, the first branch whose guard conditions turn true will be executed and all other branches abandoned. In inclusive wait branches some branches may already be executed while other branches still wait for their guard conditions to turn true.

2.16.840.1.113883.5.13 en
UPDATE:

A code specifying how concurrent Acts are resynchronized in a parallel branch construct.

Discussion:This attribute is part of the workflow control suite of attributes. An action plan is a composite Act with component Acts. In a sequential plan, each component has a sequenceNumber that specifies the ordering of the plan steps. Branches exist when multiple components have the same sequenceNumber. Branches are parallel if the splitCode specifies that more than one branch can be executed at the same time. The joinCode then specifies if and how the braches are resynchronized.

The principal re-synchronization actions are (1) the control flow waits for a branch to terminate (wait-branch), (2) the branch that is not yet terminated is aborted (kill-branch), (3) the branch is not re-synchronized at all and continues in parallel (detached branch).

A kill branch is only executed if there is at least one active wait (or exclusive wait) branch. If there is no other wait branch active, a kill branch is not started at all (rather than being aborted shortly after it is started.) Since a detached branch is unrelated to all other branches, active detached branches do not protect a kill-branch from being aborted.

2.16.840.1.113883.5.12 en
UPDATE:

A code specifying the logical conjunction of the criteria among all the condition-links of Acts (e.g., and, or, exclusive-or.)

Constraints:All AND criteria must be true. If OR and AND criteria occur together, one criterion out of the OR-group must be true and all AND criteria must be true also. If XOR criteria occur together with OR and AND criteria, exactly one of the XOR criteria must be true, and at least one of the OR criteria and all AND criteria must be true. In other words, the sets of AND, OR, and XOR criteria are in turn combined by a logical AND operator (all AND criteria and at least one OR criterion and exactly one XOR criterion.) To overcome this ordering, Act criteria can be nested in any way necessary.
2.16.840.1.113883.5.106 en
UPDATE:

Code set to define specialized/allowed diets

2.16.840.1.113883.5.4 en
UPDATE:

The vocabulary table for the Entity.riskCode attribute

2.16.840.1.113883.5.46 en
UPDATE:

Material known to be infectious with human pathogenic microorganisms. Those who handle this material must take precautions for their protection.

2.16.840.1.113883.5.46 en
UPDATE:

Material is highly inflammable and in certain mixtures (with air) may lead to explosions. Keep away from fire, sparks and excessive heat.

2.16.840.1.113883.5.46 en
UPDATE:

A relationship between two entities that is formally recognized, frequently by a contract or similar agreement.

2.16.840.1.113883.5.110 en
UPDATE:

A material (player) distributed by a distributor (scoper) who functions between a manufacturer and a buyer or retailer.

2.16.840.1.113883.5.110 en
UPDATE:

A relationship in which the scoping Entity defines or specifies what the playing Entity is. Thus, the player's "being" (Greek: ontos) is specified.

2.16.840.1.113883.5.110 en
UPDATE:

An association between two Entities where the playing Entity is considered in some way "part" of the scoping Entity, e.g., as a member, component, ingredient, or content. Being "part" in the broadest sense of the word can mean anything from being an integral structural component to a mere incidental temporary association of a playing Entity with a (generally larger) scoping Entity.

2.16.840.1.113883.5.110 en
UPDATE:

Relates a component (player) to a mixture (scoper). E.g., Glucose and Water are ingredients of D5W, latex may be an ingredient in a tracheal tube.

2.16.840.1.113883.5.110 en
UPDATE:

Relates a specialized material concept (player) to its generalization (scoper).

2.16.840.1.113883.5.110 en
UPDATE:

A storage status in which a document is available on-line.

2.16.840.1.113883.5.34 en
UPDATE:

A role of a place that further classifies the clinical setting (e.g., cardiology clinic, primary care clinic, rehabilitation hospital, skilled nursing facility) in which care is delivered during an encounter.

2.16.840.1.113883.5.111 en
UPDATE: No description 2.16.840.1.113883.5.111 en UPDATE: No description 2.16.840.1.113883.5.111 en UPDATE: No description 2.16.840.1.113883.5.111 en UPDATE: No description 2.16.840.1.113883.5.111 en UPDATE:

The section of a health care facility for providing rapid treatment to victims of sudden illness or trauma.

2.16.840.1.113883.5.111 en
UPDATE: No description 2.16.840.1.113883.5.111 en UPDATE:

An acute care institution that provides medical, surgical, or psychiatric care and treatment for the sick or the injured.

2.16.840.1.113883.5.111 en
UPDATE:

(X12N 282N00000N)

2.16.840.1.113883.5.111 en
UPDATE:

(X12N 283X00000N)

2.16.840.1.113883.5.111 en
UPDATE: No description 2.16.840.1.113883.5.111 en UPDATE: No description 2.16.840.1.113883.5.111 en UPDATE: No description 2.16.840.1.113883.5.1008 en UPDATE:

**Description:**The value is exceptional (missing, omitted, incomplete, improper). No information as to the reason for being an exceptional value is provided. This is the most general exceptional value. It is also the default exceptional value.

2.16.840.1.113883.5.1008 en
UPDATE:

A proper value is applicable, but not known.

2.16.840.1.113883.5.1008 en
UPDATE:

Information was sought but not found (e.g., patient was asked but didn't know)

2.16.840.1.113883.5.1008 en
UPDATE:

The actual value is not an element in the value domain of a variable. (e.g., concept not provided by required code system).

2.16.840.1.113883.5.1008 en
UPDATE: No description 2.16.840.1.113883.5.1009 en UPDATE: No description 2.16.840.1.113883.5.1119 2.16.840.1.113883.5.45 en UPDATE:

Discussion: The hierarchical nature of these concepts shows composition. E.g. "Street Name" is part of "Street Address Line"

2.16.840.1.113883.5.16 en
UPDATE: No description 2.16.840.1.113883.5.16 en UPDATE:

The number of a building, house or lot alongside the street. Also known as "primary street number". This does not number the street but rather the building.

2.16.840.1.113883.5.16 en
UPDATE:

This can be a unit designator, such as apartment number, suite number, or floor. There may be several unit designators in an address (e.g., "3rd floor, Appt. 342".) This can also be a designator pointing away from the location (e.g. Across the street from).

2.16.840.1.113883.5.16 en
UPDATE: No description 2.16.840.1.113883.5.44 en UPDATE: No description 2.16.840.1.113883.5.1017 en UPDATE: No description 2.16.840.1.113883.5.9 en UPDATE:

Two letter calendar cycle abbreviations (Temporary - remove when RoseTree is fixed)

2.16.840.1.113883.5.9 en
UPDATE:

One letter calendar cycle abbreviations (Temporary - remove when RoseTree is fixed)

2.16.840.1.113883.5.9 en
UPDATE: No description 2.16.840.1.113883.5.139 en UPDATE: No description 2.16.840.1.113883.5.1022 en UPDATE:

Holidays

2.16.840.1.113883.5.1022 en
UPDATE:

Christian Holidays (Roman/Gregorian "Western" Tradition.)

2.16.840.1.113883.5.1022 en
UPDATE:

United States National Holidays (public holidays for federal employees established by U.S. Federal law 5 U.S.C. 6103.)

2.16.840.1.113883.5.1022 en
UPDATE: No description 2.16.840.1.113883.5.1020 en UPDATE: No description 2.16.840.1.113883.5.9 en UPDATE:

The type of document section. Possible values: review of systems, medical history, family history, microscopic findings, etc.

2.16.840.1.113883.6.1 en
UPDATE:

EntityDeterminer in natural language grammar is the class of words that comprises articles, demonstrative pronouns, and quantifiers. In the RIM, determiner is a structural code in the Entity class to distinguish whether any given Entity object stands for some, any one, or a specific thing.

2.16.840.1.113883.5.30 en
UPDATE:

The described determiner is used to indicate that the given Entity is taken as a general description of a kind of thing that can be taken in whole, in part, or in multiples.

2.16.840.1.113883.5.30 en
UPDATE:

Classifies the Entity class and all of its subclasses. The terminology is hierarchical. At the top is this HL7-defined domain of high-level categories (such as represented by the Entity subclasses). Each of these terms must be harmonized and is specializable.

The value sets beneath are encoded in Entity.code and are drawn from multiple, frequently external, domains that reflect much more fine-grained typing.

2.16.840.1.113883.5.41 en
UPDATE:

Any thing that has extension in space and mass, may be of living or non-living origin.

2.16.840.1.113883.5.41 en
UPDATE:

Anything that essentially has the property of life, independent of current state (a dead human corpse is still essentially a living subject.)

2.16.840.1.113883.5.41 en
UPDATE:

A social or legal structure formed by human beings.

2.16.840.1.113883.5.41 en
UPDATE:

A physicial place or site with its containing structure. May be natural or man-made. The geographic position of a place may or may not be constant.

2.16.840.1.113883.5.41 en
UPDATE:

A value representing the current state of control associated with the device.

Examples:A device can either work autonomously (localRemoteControlStateCode="Local") or it can be controlled by another system (localRemoteControlStateCode="Remote").Rationale:The control status of a device must be communicated between devices prior to remote commands being transmitted. If the device is not in "Remote" status then external commands will be ignored.
2.16.840.1.113883.5.66 en
UPDATE: No description 2.16.840.1.113883.5.49 en UPDATE:

A code specifying the meaning and purpose of every Participation instance. Each of its values implies specific constraints on the Roles undertaking the participation.

2.16.840.1.113883.5.90 en
UPDATE:

A practice setting where diagnostic procedures or therapeutic interventions are performed

2.16.840.1.113883.5.111 en
UPDATE:

A practice setting where cardiovascular diagnostic procedures or therapeutic interventions are performed (e.g., cardiac catheterization lab, echocardiography suite)

2.16.840.1.113883.5.111 en
UPDATE:

A practice setting where GI procedures (such as endoscopies) are performed

2.16.840.1.113883.5.111 en
UPDATE:

A practice setting where radiology services (diagnostic or therapeutic) are provided (X12N 261QR0200N)

2.16.840.1.113883.5.111 en
UPDATE: No description 2.16.840.1.113883.5.111 en UPDATE: No description 2.16.840.1.113883.5.111 en UPDATE: No description 2.16.840.1.113883.5.111 en UPDATE: No description 2.16.840.1.113883.5.111 en UPDATE: No description 2.16.840.1.113883.5.111 en UPDATE: No description 2.16.840.1.113883.5.111 en UPDATE: No description 2.16.840.1.113883.5.111 en UPDATE: No description 2.16.840.1.113883.5.111 en UPDATE: No description 2.16.840.1.113883.5.111 en UPDATE: No description 2.16.840.1.113883.5.111 en UPDATE: No description 2.16.840.1.113883.5.111 en UPDATE:

Tells a receiver to ignore just the local markup tags (local\_markup, local\_header, local\_attr) when value="markup", or to ignore the local markup tags and all contained content when value="all"

2.16.840.1.113883.5.65 en
UPDATE:

These values are defined within the XHTML 4.0 Table Model

2.16.840.1.113883.5.131 en
UPDATE:

These values are defined within the XHTML 4.0 Table Model

2.16.840.1.113883.5.133 en
UPDATE:

These values are defined within the XHTML 4.0 Table Model

2.16.840.1.113883.5.134 en
UPDATE:

These values are defined within the XHTML 4.0 Table Model

2.16.840.1.113883.5.136 en
UPDATE:

These values are defined within the XHTML 4.0 Table Model

2.16.840.1.113883.5.132 en
UPDATE:

HtmlLinkType values are drawn from HTML 4.0 and describe the relationship between the current document and the anchor that is the target of the link

2.16.840.1.113883.5.58 en
UPDATE:

The closeness or quality of the mapping between the HL7 concept (as represented by the HL7 concept identifier) and the source coding system. The values are patterned after the similar relationships used in the UMLS Metathesaurus. Because the HL7 coding sy

2.16.840.1.113883.5.67 en
UPDATE:

A value representing whether the primary reproductive organs of NonPersonLivingSubject are present.

2.16.840.1.113883.5.51 en
UPDATE:

Codes for the representation of the names of human languages.

2.16.840.1.113883.6.121 en
UPDATE:

A code specifying the major type of Act that this Act-instance represents.

Constraints:The classCode domain is a tightly controlled vocabulary, not an external or user-defined vocabulary.

Every Act-instance must have a classCode. If the act class is not further specified, the most general Act.classCode (ACT) is used.

The Act.classCode must be a generalization of the specific Act concept (e.g., as expressed in Act.code), in other words, the Act concepts conveyed in an Act must be specializations of the Act.classCode. Especially, Act.code is not a "modifier" that can alter the meaning of a class code. (See Act.code for contrast.)

2.16.840.1.113883.5.6 en
UPDATE: **Description:**An act that is intended to result in new information about a subject. The main difference between Observations and other Acts is that Observations have a value attribute. Thecodeattribute of Observation and thevalueattribute of Observation must be considered in combination to determine the semantics of the observation.Discussion:

Structurally, many observations are name-value-pairs, where the Observation.code (inherited from Act) is the name and the Observation.value is the value of the property. Such a construct is also known as a variable (a named feature that can assume a value) hence, the Observation class is always used to hold generic name-value-pairs or variables, even though the variable valuation may not be the result of an elaborate observation method. It may be a simple answer to a question or it may be an assertion or setting of a parameter.

As with all Act statements, Observation statements describe what was done, and in the case of Observations, this includes a description of what was actually observed (results or answers); and those results or answers are part of the observation and not split off into other objects.

The method of action is asserted by the Observation classCode or its subclasses at the least granular level, by the Observation.code attribute value at the medium level of granularity, and by the attribute value of observation.methodCode when a finer level of granularity is required. The method in whole or in part may also appear in the attribute value of Observation.value when using coded data types to express the value of the attribute. Relevant aspects of methodology may also be restated in value when the results themselves imply or state a methodology.

An observation may consist of component observations each having their own Observation.code and Observation.value. In this case, the composite observation may not have an Observation.value for itself. For instance, a white blood cell count consists of the sub-observations for the counts of the various granulocytes, lymphocytes and other normal or abnormal blood cells (e.g., blasts). The overall white blood cell count Observation itself may therefore not have a value by itself (even though it could have one, e.g., the sum total of white blood cells). Thus, as long as an Act is essentially an Act of recognizing and noting information about a subject, it is an Observation, regardless of whether it has a simple value by itself or whether it has sub-observations.

Even though observations are professional acts (see Act) and as such are intentional actions, this does not require that every possible outcome of an observation be pondered in advance of it being actually made. For instance, differential white blood cell counts (WBC) rarely show blasts, but if they do, this is part of the WBC observation even though blasts might not be predefined in the structure of a normal WBC.

Clinical documents commonly have Subjective and Objective findings, both of which are kinds of Observations. In addition, clinical documents commonly contain Assessments, which are also kinds of Observations. Thus, the establishment of a diagnosis is an Observation.

Examples:

* Recording the results of a Family History Assessment * Laboratory test and associated result * Physical exam test and associated result * Device temperature * Soil lead level

2.16.840.1.113883.5.6 en
UPDATE:

A public health case is an Observation representing a condition or event that has a specific significance for public health. Typically it involves an instance or instances of a reportable infectious disease or other condition. The public health case can include a health-related event concerning a single individual or it may refer to multiple health-related events that are occurrences of the same disease or condition of interest to public health. An outbreak involving multiple individuals may be considered as a type of public health case. A public health case definition (Act.moodCode = "definition") includes the description of the clinical, laboratory, and epidemiologic indicators associated with a disease or condition of interest to public health. There are case definitions for conditions that are reportable, as well as for those that are not. There are also case definitions for outbreaks. A public health case definition is a construct used by public health for the purpose of counting cases, and should not be used as clinical indications for treatment. Examples include AIDS, toxic-shock syndrome, and salmonellosis and their associated indicators that are used to define a case.

2.16.840.1.113883.5.6 en
UPDATE:

An act representing a system action such as the change of state of another act or the initiation of a query. All control acts represent trigger events in the HL7 context. ControlActs may occur in different moods.

2.16.840.1.113883.5.6 en
UPDATE:

Supply orders and deliveries are simple Acts that focus on the delivered product. The product is associated with the Supply Act via Participation.typeCode="product". With general Supply Acts, the precise identification of the Material (manufacturer, serial numbers, etc.) is important. Most of the detailed information about the Supply should be represented using the Material class. If delivery needs to be scheduled, tracked, and billed separately, one can associate a Transportation Act with the Supply Act. Pharmacy dispense services are represented as Supply Acts, associated with a SubstanceAdministration Act. The SubstanceAdministration class represents the administration of medication, while dispensing is supply.

2.16.840.1.113883.5.6 en
UPDATE:

This table includes codes for the Role class hierarchy. The values in this hierarchy, represent a Role which is an association or relationship between two entities - the entity that plays the role and the entity that scopes the role. Roles names are derived from the name of the playing entity in that role.

The role hierarchy stems from three core concepts, or abstract domains:

* **RoleClassOntological** is an abstract domain that collects roles in which the playing entity is defined or specified by the scoping entity. * **RoleClassPartitive** collects roles in which the playing entity is in some sense a "part" of the scoping entity. * **RoleClassAssociative** collects all of the remaining forms of association between the playing entity and the scoping entity. This set of roles is further partitioned between: * **RoleClassPassive** which are roles in which the playing entity is used, known, treated, handled, built, or destroyed, etc. under the auspices of the scoping entity. The playing entity is passive in these roles in that the role exists without an agreement from the playing entity. * **RoleClassMutualRelationship** which are relationships based on mutual behavior of the two entities. The basis of these relationship may be formal agreements or they may be *de facto* behavior. Thus, this sub-domain is further divided into: * **RoleClassRelationshipFormal** in which the relationship is formally defined, frequently by a contract or agreement. * **Personal relationship** which inks two people in a personal relationship.

The hierarchy discussed above is represented In the current vocabulary tables as a set of abstract domains, with the exception of the "Personal relationship" which is a leaf concept.

2.16.840.1.113883.5.110 en
UPDATE:

One person who shares a parent or parents with another.

2.16.840.1.113883.5.111 en
UPDATE:

A relationship between a person or organization and a person or organization formed for the purpose of exchanging work for compensation. The purpose of the role is to identify the type of relationship the employee has to the employer, rather than the nature of the work actually performed. (Contrast with AssignedEntity.)

2.16.840.1.113883.5.110 en
UPDATE:

Scoped by the manufacturer

2.16.840.1.113883.5.110 en
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A role played by a material entity that is a specimen for an act. It is scoped by the source of the specimen.

2.16.840.1.113883.5.110 en
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An agent role in which the agent is an Entity acting in the employ of an organization. The focus is on functional role on behalf of the organization, unlike the Employee role where the focus is on the 'Human Resources' relationship between the employee and the organization.

2.16.840.1.113883.5.110 en
UPDATE:

A code specifying the meaning and purpose of every RoleLink instance. Each of its values implies specific constraints to what kinds of Role objects can be related and in which way.

2.16.840.1.113883.5.107 en
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Used to enumerate the relationships between two clinical documents for document management.

2.16.840.1.113883.5.1002 en
UPDATE: No description 2.16.840.1.113883.5.41 en UPDATE:

A container of other entities.

2.16.840.1.113883.5.41 en
UPDATE:

A subtype of ManufacturedMaterial used in an activity, without being substantially changed through that activity. The kind of device is identified by the code attribute inherited from Entity.

Usage:This includes durable (reusable) medical equipment as well as disposable equipment.
2.16.840.1.113883.5.41 en
UPDATE:

INDIAN ENTITIES RECOGNIZED AND ELIGIBLE TO RECEIVE SERVICES FROM THE UNITED STATES BUREAU OF INDIAN AFFAIRS

2.16.840.1.113883.5.140 en
UPDATE:

NATIVE ENTITIES WITHIN THE STATE OF ALASKA RECOGNIZED AND ELIGIBLE TO RECEIVE SERVICES FROM THE UNITED STATES BUREAU OF INDIAN AFFAIRS

2.16.840.1.113883.5.140 en
UPDATE:

A value representing the level of proficiency in a language.

*Example:*Excellent, good, fair, poor.

2.16.840.1.113883.5.61 en
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A person or an organization (player) which provides or receives information regarding another entity (scoper). Examples; patient NOK and emergency contacts; guarantor contact; employer contact.

2.16.840.1.113883.5.110 en
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The domestic partnership status of a person.

*Example:*Married, separated, divorced, widowed, common-law marriage.

2.16.840.1.113883.5.2 en
UPDATE: No description 2.16.840.1.113883.5.37 en UPDATE:

A code identifying special courtesies extended to the patient. For example, no courtesies, extended courtesies, professional courtesy, VIP courtesies.

2.16.840.1.113883.5.40 en
UPDATE:

A value representing the method of expression of the language.

*Example:*Expressed spoken, expressed written, expressed signed, received spoken, received written, received signed.

2.16.840.1.113883.5.60 en
UPDATE:

NATIVE ENTITIES WITHIN THE CONTIGUOUS 48 STATES

2.16.840.1.113883.5.140 en
UPDATE: Description:All units of measure. 2.16.840.1.113883.6.8 en UPDATE:

(1) A hospital including a physical plant and personnel that provides multidisciplinary diagnosis and treatment for diseases that have one or more of the following characteristics: is permanent; leaves residual disability; is caused by nonreversible pathological alteration; requires special training of the patient for rehabilitation; and/or may be expected to require a long period of supervision or care. In addition, patients require the safety, security, and shelter of these specialized inpatient or partial hospitalization settings. (2) A hospital that provides medical and skilled nursing services to patients with long-term illnesses who are not in an acute phase but who require an intensity of services not available in nursing homes

2.16.840.1.113883.5.111 en
UPDATE:

A health care facility operated by the Department of Defense or other military operation.

2.16.840.1.113883.5.111 en
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A record of something that is being done, has been done, can be done, or is intended or requested to be done.

*Examples:*The kinds of acts that are common in health care are (1) a clinical observation, (2) an assessment of health condition (such as problems and diagnoses), (3) healthcare goals, (4) treatment services (such as medication, surgery, physical and psychological therapy), (5) assisting, monitoring or attending, (6) training and education services to patients and their next of kin, (7) and notary services (such as advanced directives or living will), (8) editing and maintaining documents, and many others.

Discussion and Rationale:Acts are the pivot of the RIM; all domain information and processes are represented primarily in Acts. Any profession or business, including healthcare, is primarily constituted of intentional and occasionally non-intentional actions, performed and recorded by responsible actors. An Act-instance is a record of such an action.

Acts connect to Entities in their Roles through Participations and connect to other Acts through ActRelationships. Participations are the authors, performers and other responsible parties as well as subjects and beneficiaries (which includes tools and material used in the performance of the act, which are also subjects). The moodCode distinguishes between Acts that are meant as factual records, vs. records of intended or ordered services, and the other modalities in which act can appear.

One of the Participations that all acts have (at least implicitly) is a primary author, who is responsible of the Act and who "owns" the act. Responsibility for the act means responsibility for what is being stated in the Act and as what it is stated. Ownership of the act is assumed in the sense of who may operationally modify the same act. Ownership and responsibility of the Act is not the same as ownership or responsibility of what the Act-object refers to in the real world. The same real world activity can be described by two people, each being the author of their Act, describing the same real world activity. Yet one can be a witness while the other can be a principal performer. The performer has responsibilities for the physical actions; the witness only has responsibility for making a true statement to the best of his or her ability. The two Act-instances may even disagree, but because each is properly attributed to its author, such disagreements can exist side by side and left to arbitration by a recipient of these Act-instances.

In this sense, an Act-instance represents a "statement" according to Rector and Nowlan (1991) \[Foundations for an electronic medical record. Methods Inf Med. 30.\] Rector and Nowlan have emphasized the importance of understanding the medical record not as a collection of facts, but "a faithful record of what clinicians have heard, seen, thought, and done." Rector and Nowlan go on saying that "the other requirements for a medical record, e.g., that it be attributable and permanent, follow naturally from this view." Indeed the Act class is this attributable statement, and the rules of updating acts (discussed in the state-transition model, see Act.statusCode) versus generating new Act-instances are designed according to this principle of permanent attributable statements.

Rector and Nolan focus on the electronic medical record as a collection of statements, while attributed statements, these are still mostly factual statements. However, the Act class goes beyond this limitation to attributed factual statements, representing what is known as "speech-acts" in linguistics and philosophy. The notion of speech-act includes that there is pragmatic meaning in language utterances, aside from just factual statements; and that these utterances interact with the real world to change the state of affairs, even directly cause physical activities to happen. For example, an order is a speech act that (provided it is issued adequately) will cause the ordered action to be physically performed. The speech act theory has culminated in the seminal work by Austin (1962) \[How to do things with words. Oxford University Press\].

An activity in the real world may progress from defined, through planned and ordered to executed, which is represented as the mood of the Act. Even though one might think of a single activity as progressing from planned to executed, this progression is reflected by multiple Act-instances, each having one and only one mood that will not change along the Act-instance life cycle. This is because the attribution and content of speech acts along this progression of an activity may be different, and it is often critical that a permanent and faithful record be maintained of this progression. The specification of orders or promises or plans must not be overwritten by the specification of what was actually done, so as to allow comparing actions with their earlier specifications. Act-instances that describe this progression of the same real world activity are linked through the ActRelationships (of the relationship category "sequel").

Act as statements or speech-acts are the only representation of real world facts or processes in the HL7 RIM. The truth about the real world is constructed through a combination (and arbitration) of such attributed statements only, and there is no class in the RIM whose objects represent "objective state of affairs" or "real processes" independent from attributed statements. As such, there is no distinction between an activity and its documentation. Every Act includes both to varying degrees. For example, a factual statement made about recent (but past) activities, authored (and signed) by the performer of such activities, is commonly known as a procedure report or original documentation (e.g., surgical procedure report, clinic note etc.). Conversely, a status update on an activity that is presently in progress, authored by the performer (or a close observer) is considered to capture that activity (and is later superceded by a full procedure report). However, both status update and procedure report are acts of the same kind, only distinguished by mood and state (see statusCode) and completeness of the information.

2.16.840.1.113883.5.6 en
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Corresponds to the Entity class

2.16.840.1.113883.5.41 en
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Corresponds to the ManufacturedMaterial class

2.16.840.1.113883.5.41 en
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Corresponds to the Role class

2.16.840.1.113883.5.110 en
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A clinical document is a documentation of clinical observations and services, with the following characteristics: (1) Persistence - A clinical document continues to exist in an unaltered state, for a time period defined by local and regulatory requirements; (2) Stewardship - A clinical document is maintained by a person or organization entrusted with its care; (3) Potential for authentication - A clinical document is an assemblage of information that is intended to be legally authenticated; (4) Wholeness - Authentication of a clinical document applies to the whole and does not apply to portions of the document without the full context of the document; (5) Human readability - A clinical document is human readable."

2.16.840.1.113883.5.6 en
UPDATE:

Domain provides codes that qualify the ActEncounterClass (ENC)

2.16.840.1.113883.5.4 en
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Identifies the type of observation that is made about a specimen that may affect its processing, analysis or further result interpretation

2.16.840.1.113883.5.4 en
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Special handling requirements for an Entity.

*Example:*Keep at room temperature; Keep frozen below 0 C; Keep in a dry environment; Keep upright, do not turn upside down.

2.16.840.1.113883.5.42 en
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An agreement of obligation between two or more parties that is subject to contractual law and enforcement.

2.16.840.1.113883.5.6 en
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A contract whose value is measured in monetary terms.

2.16.840.1.113883.5.6 en
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An entity (player) that acts or is authorized to act on behalf of another entity (scoper).

2.16.840.1.113883.5.110 en
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An abstract domain that encompasses the roles that arise in the context of providing, purchasing, and managing health care coverage and insurance.

2.16.840.1.113883.5.110 en
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An abstract domain that encompasses the roles involved in submitting, responding to and managing invoices or claims for health care coverage.

2.16.840.1.113883.5.110 en
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Set of codes related to specimen treatments

2.16.840.1.113883.5.4 en
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The type of cap associated with a container

2.16.840.1.113883.5.26 en
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A material in a blood collection container that facilites the separation of of blood cells from serum or plasma

2.16.840.1.113883.5.27 en
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Constrains the ActCode to the domain of Container Registration

2.16.840.1.113883.5.4 en
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Domain values for the Device.Alert\_levelCode

2.16.840.1.113883.5.31 en
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A code that provides additional detail about the means or technique used to ascertain the observation.

Examples:Blood pressure measurement method: arterial puncture vs. sphygmomanometer (Riva-Rocci), sitting vs. supine position, etc.Constraints:In all observations the method is already partially specified by the Act.code. In this case, the methodCode NEED NOT be used at all. The methodCode MAY still be used to identify this method more clearly in addition to what is implied from the Act.code. However, an information consumer system or process SHOULD NOT depend on this methodCode information for method detail that is implied by the Act.code.

If the methodCode is used to express method detail that is also implied by the Act.code, the methodCode MUST NOT be in conflict with the implied method of the Act.code.

2.16.840.1.113883.5.84 en
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An observation that reports the dilution of a sample.

2.16.840.1.113883.5.4 en
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An observation that reports the volume of a sample.

2.16.840.1.113883.5.4 en
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An observation that relates to factors that may potentially cause interference with the observation

2.16.840.1.113883.5.4 en
UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE:

A state of substance that is an intermediate one entered into as matter goes from solid to gas; liquids are also intermediate in that they have neither the orderliness of a crystal nor the randomness of a gas. (Note: This term should not be used to describe solutions, only pure chemicals in their liquid state.)

2.16.840.1.113883.5.85 en
UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE:

An unctuous, combustible substance which is liquid, or easily liquefiable, on warming, and is soluble in ether but insoluble in water. Such substances, depending on their origin, are classified as animal, mineral, or vegetable oils.

2.16.840.1.113883.5.85 en
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A liquid preparation that contains one or more chemical substances dissolved, i.e., molecularly dispersed, in a suitable solvent or mixture of mutually miscible solvents.

2.16.840.1.113883.5.85 en
UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE:

A sterile solution intended to bathe or flush open wounds or body cavities; they're used topically, never parenterally.

2.16.840.1.113883.5.85 en
UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE:

A liquid preparation which consists of solid particles dispersed throughout a liquid phase in which the particles are not soluble.

2.16.840.1.113883.5.85 en
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A semisolid system consisting of either suspensions made up of small inorganic particles or large organic molecules interpenetrated by a liquid.

2.16.840.1.113883.5.85 en
UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE:

A semisolid dosage form that contains one or more drug substances intended for topical application.

2.16.840.1.113883.5.85 en
UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE:

A two-phase system in which one liquid is dispersed throughout another liquid in the form of small droplets.

2.16.840.1.113883.5.85 en
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The term "lotion" has been used to categorize many topical suspensions, solutions and emulsions intended for application to the skin.

2.16.840.1.113883.5.85 en
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A semisolid dosage form containing one or more drug substances dissolved or dispersed in a suitable base; more recently, the term has been restricted to products consisting of oil-in-water emulsions or aqueous microcrystalline dispersions of long chain fatty acids or alcohols that are water washable and more cosmetically and aesthetically acceptable.

2.16.840.1.113883.5.85 en
UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE:

A semisolid preparation intended for external application to the skin or mucous membranes.

2.16.840.1.113883.5.85 en
UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE:

A drug delivery system that contains an adhesived backing and that permits its ingredients to diffuse from some portion of it (e.g., the backing itself, a reservoir, the adhesive, or some other component) into the body from the external site where it is applied.

2.16.840.1.113883.5.85 en
UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE:

A small, round solid dosage form containing a medicinal agent intended for oral administration.

2.16.840.1.113883.5.85 en
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A solid dosage form in which the drug is enclosed within either a hard or soft soluble container or "shell" made from a suitable form of gelatin.

2.16.840.1.113883.5.85 en
UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE:

A solid dosage form in which the drug is enclosed within either a hard or soft soluble container made from a suitable form of gelatin, and which releases a drug (or drugs) in such a manner to allow a reduction in dosing frequency as compared to that drug (or drugs) presented as a conventional dosage form.

2.16.840.1.113883.5.85 en
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A solid dosage form containing medicinal substances with or without suitable diluents.

2.16.840.1.113883.5.85 en
UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE:

A solid dosage form containing a drug which allows at least a reduction in dosing frequency as compared to that drug presented in conventional dosage form.

2.16.840.1.113883.5.85 en
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An intimate mixture of dry, finely divided drugs and/or chemicals that may be intended for internal or external use.

2.16.840.1.113883.5.85 en
UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE:

A solid body of various weights and shapes, adapted for introduction into the rectal, vaginal, or urethral orifice of the human body; they usually melt, soften, or dissolve at body temperature.

2.16.840.1.113883.5.85 en
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A wad of absorbent material usually wound around one end of a small stick and used for applying medication or for removing material from an area.

2.16.840.1.113883.5.85 en
UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE: No description 2.16.840.1.113883.5.85 en UPDATE:

Any elastic aeriform fluid in which the molecules are separated from one another and have free paths.

2.16.840.1.113883.5.85 en
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Indicates the form in which the drug product should be administered.

This element only needs to be specified when (a) the form in which the drug is measured for dispensing differs from the form in which the drug is administered; and (b) the form in which the quantity of the administered drug being administered is not expressed as a discrete measured mass or volume.*Usage:*

2.16.840.1.113883.5.85 en
UPDATE:

The path the administered medication takes to get into the body or into contact with the body.

2.16.840.1.113883.5.112 en
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Chew

2.16.840.1.113883.5.112 en
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Diffusion

2.16.840.1.113883.5.112 en
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Dissolve

2.16.840.1.113883.5.112 en
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Douche

2.16.840.1.113883.5.112 en
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Enema

2.16.840.1.113883.5.112 en
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Flush

2.16.840.1.113883.5.112 en
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Implantation

2.16.840.1.113883.5.112 en
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Infusion

2.16.840.1.113883.5.112 en
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Infusion, intravenous

2.16.840.1.113883.5.112 en
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Inhalation

2.16.840.1.113883.5.112 en
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Inhalation, nasal

2.16.840.1.113883.5.112 en
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Inhalation, nebulization

2.16.840.1.113883.5.112 en
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Inhalation, oral

2.16.840.1.113883.5.112 en
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Injection

2.16.840.1.113883.5.112 en
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Injection, intraarterial

2.16.840.1.113883.5.112 en
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Injection, intracardiac

2.16.840.1.113883.5.112 en
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Injection, intracoronary

2.16.840.1.113883.5.112 en
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Injection, intramuscular

2.16.840.1.113883.5.112 en
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Injection, intravenous

2.16.840.1.113883.5.112 en
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Insertion

2.16.840.1.113883.5.112 en
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Instillation

2.16.840.1.113883.5.112 en
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Instillation, rectal

2.16.840.1.113883.5.112 en
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Irrigation

2.16.840.1.113883.5.112 en
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Irrigation, urinary bladder

2.16.840.1.113883.5.112 en
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Nebulization

2.16.840.1.113883.5.112 en
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Rinse

2.16.840.1.113883.5.112 en
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Swish

2.16.840.1.113883.5.112 en
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Topical application

2.16.840.1.113883.5.112 en
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Specifies whether a response is expected from the addressee of this interaction and what level of detail that response should include

2.16.840.1.113883.5.108 en
UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE:

An account represents a grouping of financial transactions that are tracked and reported together with a single balance. Examples of account codes (types) are Patient billing accounts (collection of charges), Cost centers; Cash.

2.16.840.1.113883.5.4 en
UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE: No description 2.16.840.1.113883.5.16 en UPDATE:

Internet Assigned Numbers Authority (IANA) Mime Media Types

2.16.840.1.113883.5.79 en
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For any text

2.16.840.1.113883.5.79 en
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Application specific media type.

2.16.840.1.113883.5.79 en
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Audio media type.

2.16.840.1.113883.5.79 en
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Image media type.

2.16.840.1.113883.5.79 en
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Video media type.

2.16.840.1.113883.5.79 en
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Model media type.

2.16.840.1.113883.5.79 en
UPDATE:

Multipart Media Type

2.16.840.1.113883.5.79 en
UPDATE:

Internet Assigned Numbers Authority (IANA) Charset Types

2.16.840.1.113883.5.21 en
UPDATE:

A Universal Resource Locator (URL) is a type of telecommunications address specified as Internet standard RFC 1738 \[http://www.ietf.org/rfc/rfc1738.txt\]. The URL specifies the protocol and the contact point defined by that protocol for the resource.

2.16.840.1.113883.5.143 en
UPDATE:

Reasons for cancelling or rescheduling an Appointment

2.16.840.1.113883.5.8 en
UPDATE:

Codes that describe the relationship between an Act and a financial instrument such as a financial transaction, account or invoice element.

2.16.840.1.113883.5.1002 en
UPDATE:

Describes payment terms for a financial transaction, used in an invoice.

This is typically expressed as a responsibility of the acceptor or payor of an invoice.

2.16.840.1.113883.5.91 en
UPDATE:

In the United States, federal standards for classifying data on race determine the categories used by federal agencies and exert a strong influence on categorization by state and local agencies and private sector organizations. The federal standards do not conceptually define race, and they recognize the absence of an anthropological or scientific basis for racial classification. Instead, the federal standards acknowledge that race is a social-political construct in which an individual's own identification with one more race categories is preferred to observer identification. The standards use a variety of features to define five minimum race categories. Among these features are descent from "the original peoples" of a specified region or nation. The minimum race categories are American Indian or Alaska Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander, and White. The federal standards stipulate that race data need not be limited to the five minimum categories, but any expansion must be collapsible to those categories.

2.16.840.1.113883.5.104 en
UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE:

Acknowledgement Condition codes describe the conditions under which accept or application level acknowledgements are required to be returned in response to the message send operation.

2.16.840.1.113883.5.1050 en
UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE:

In the United States, federal standards for classifying data on ethnicity determine the categories used by federal agencies and exert a strong influence on categorization by state and local agencies and private sector organizations. The federal standards do not conceptually define ethnicity, and they recognize the absence of an anthropological or scientific basis for ethnicity classification. Instead, the federal standards acknowledge that ethnicity is a social-political construct in which an individual's own identification with a particular ethnicity is preferred to observer identification. The standards specify two minimum ethnicity categories: Hispanic or Latino, and Not Hispanic or Latino. The standards define a Hispanic or Latino as a person of "Mexican, Puerto Rican, Cuban, South or Central America, or other Spanish culture or origin, regardless of race." The standards stipulate that ethnicity data need not be limited to the two minimum categories, but any expansion must be collapsible to those categories. In addition, the standards stipulate that an individual can be Hispanic or Latino or can be Not Hispanic or Latino, but cannot be both.

2.16.840.1.113883.5.50 en
UPDATE: No description 2.16.840.1.113883.5.50 en UPDATE: No description 2.16.840.1.113883.5.50 en UPDATE: No description 2.16.840.1.113883.5.50 en UPDATE: No description 2.16.840.1.113883.5.50 en UPDATE: No description 2.16.840.1.113883.5.50 en UPDATE: No description 2.16.840.1.113883.5.44 en UPDATE:

A name for an organization, such as "Health Level Seven, Inc." An organization name consists only of untyped name parts, prefixes, suffixes, and delimiters.

2.16.840.1.113883.5.44 en
UPDATE: No description 2.16.840.1.113883.5.43 en UPDATE: No description 2.16.840.1.113883.5.43 en UPDATE: No description 2.16.840.1.113883.5.45 en UPDATE: No description 2.16.840.1.113883.5.45 en UPDATE:

Types of contact for Role code "CON"

2.16.840.1.113883.5.111 2.16.840.1.113883.5.110 en
UPDATE:

A role type that is used to further qualify an entity playing a role where the role class attribute is set to RoleClassMember.

2.16.840.1.113883.5.111 en
UPDATE: No description 2.16.840.1.113883.6.21 en UPDATE: No description 2.16.840.1.113883.6.2 en UPDATE:

Contains the names (codes) for each of the states in the state-machine of the RIM Act class.

2.16.840.1.113883.5.14 en
UPDATE:

Encompasses the expected states of an Act, but excludes "nullified" and "obsolete" which represent unusual terminal states for the life-cycle.

2.16.840.1.113883.5.14 en
UPDATE:

The explanation for why a patient is moved from one location to another within the organization

2.16.840.1.113883.5.8 en
UPDATE:

Codes representing the defined possible states of a Managed Participation, as defined by the Managed Participation class state machine.

2.16.840.1.113883.5.1062 en
UPDATE:

The 'typical' state. Excludes "nullified" which represents the termination state of a participation instance that was created in error.

2.16.840.1.113883.5.1062 en
UPDATE:

Codes representing the defined possible states of an Role, as defined by the Role class state machine.

2.16.840.1.113883.5.1068 en
UPDATE:

The 'typical' state. Excludes "nullified" which represents the termination state of a Role instance that was created in error.

2.16.840.1.113883.5.1068 en
UPDATE:

Codes representing the defined possible states of an Entity, as defined by the Entity class state machine.

2.16.840.1.113883.5.1061 en
UPDATE:

The 'typical' state. Excludes "nullified" which represents the termination state of an Entity record instance that was created in error.

2.16.840.1.113883.5.1061 en
UPDATE:

Describes the type of communication function that the associated entity plays in the associated transmission.

2.16.840.1.113883.5.1056 en
UPDATE:

A code qualifying the employment in various ways, such as, full-time vs. part time, etc.

2.16.840.1.113883.5.1059 en
UPDATE: No description 2.16.840.1.113883.6.85 en UPDATE:

A value representing the specific kind of Entity the instance represents.

Examples:A medical building, a Doberman Pinscher, a blood collection tube, a tissue biopsy.Rationale:For each Entity, the value for this attribute is drawn from one of several coding systems depending on the Entity classCode, such as living subjects (animal and plant taxonomies), chemical substance (e.g., IUPAC code), organizations, insurance company, government agency, hospital, park, lake, syringe, etc. It is possible that Entity.code may be so fine grained that it represents a single instance. An example is the CDC vaccine manufacturer code, modeled as a concept vocabulary, when in fact each concept refers to a single instance.
2.16.840.1.113883.5.1060 2.16.840.1.113883.5.129 1.0.3166.1 en
UPDATE:

Types of Material for EntityClass "MAT"

2.16.840.1.113883.5.1060 2.16.840.1.113883.5.129 en
UPDATE:

Set of codes related to specimen additives

2.16.840.1.113883.5.1060 en
UPDATE:

Types of places for EntityClass "PLC"

2.16.840.1.113883.5.1060 1.0.3166.1 en
UPDATE:

Shape of the region on the object being referenced

2.16.840.1.113883.5.4 en
UPDATE:

Identifies types of detected issues for Act class "ALRT"

2.16.840.1.113883.5.4 en
UPDATE:

Accommodation type. In Intent mood, represents the accommodation type requested. In Event mood, represents accommodation assigned/used. In Definition mood, represents the available accommodation type.

2.16.840.1.113883.5.4 en
UPDATE:

Material intended to hold another material for purpose of storage or transport.

2.16.840.1.113883.5.1060 en
UPDATE:

A material intended to hold other materials for purposes of storage or transportation

2.16.840.1.113883.5.1060 en
UPDATE:

A container for a diverse collection of products intended to be used together for some purpose (e.g. Medicinal kits often contain a syringe, a needle and the injectable medication).

2.16.840.1.113883.5.1060 en
UPDATE:

A container having dimensions that adjust somewhat based on the amount and shape of the material placed within it.

2.16.840.1.113883.5.1060 en
UPDATE:

A container having a fixed and inflexible dimensions and volume

2.16.840.1.113883.5.1060 en
UPDATE:

A container intended to contain sufficient material for more than one use. (I.e. Material is intended to be removed from the container at more than one discrete time period.)

2.16.840.1.113883.5.1060 en
UPDATE:

A container, typically rounded, either glass or plastic with a narrow neck and capable of storing liquid.

2.16.840.1.113883.5.1060 en
UPDATE:

A bottle made of plastic

2.16.840.1.113883.5.1060 en
UPDATE:

A container intended to contain sufficient material for more than one use, but grouped or organized to provide individual access to sufficient material for a single use. Often used to ensure that the proper type and amount of material is consumed/expended for each use.

2.16.840.1.113883.5.1060 en
UPDATE:

A bubblepack. Medications sealed individually, separated into doses.

2.16.840.1.113883.5.1060 en
UPDATE:

Container intended to contain sufficient material for only one use.

2.16.840.1.113883.5.1060 en
UPDATE:

Cap types for medication containers

2.16.840.1.113883.5.26 en
UPDATE:

A device with direct or indirect therapeutic purpose. Values for EntityCode when EntityClass = "DEV"

2.16.840.1.113883.5.1060 en
UPDATE:

A device intended to administer a substance to a subject

2.16.840.1.113883.5.1060 en
UPDATE:

A device intended to administer liquid into a subject via a

2.16.840.1.113883.5.1060 en
UPDATE:

A small device used for inhaling medicine in the form of a vapour or gas in order to ease a respiratory condition such as asthma or to relieve nasal congestion.

2.16.840.1.113883.5.1060 en
UPDATE:

A device used to allow access to a part of a body

2.16.840.1.113883.5.1060 en
UPDATE:

A hollow tube used to administer a substance into a vein, artery or body cavity

2.16.840.1.113883.5.1060 en
UPDATE:

Identifies types of dispensing events

2.16.840.1.113883.5.4 en
UPDATE:

The initial fill against an order. (This includes initial fills against refill orders.)

2.16.840.1.113883.5.4 en
UPDATE:

A fill against an order that has already been filled (or partially filled) at least once.

2.16.840.1.113883.5.4 en
UPDATE:

A supply action where there is no 'valid' order for the supplied medication. E.g. Emergency vacation supply, weekend supply (when prescriber is unavailable to provide a renewal prescription)

2.16.840.1.113883.5.4 en
UPDATE:

Identifies the kinds of observations that can be performed

2.16.840.1.113883.5.4 2.16.840.1.113883.6.1 en
UPDATE:

An observation about the presence (or absence) of a particular disease state in a subject.

2.16.840.1.113883.5.4 en
UPDATE:

Identifies types of monitoring programs

2.16.840.1.113883.5.4 en
UPDATE:

A monitoring program that focuses on narcotics and/or commonly abused substances that are subject to legal restriction.

2.16.840.1.113883.5.4 en
UPDATE:

one that begets or brings forth offspring or a person who brings up and cares for another (Webster's Collegiate Dictionary)

2.16.840.1.113883.5.111 en
UPDATE:

parent of a parent of the subject

2.16.840.1.113883.5.111 en
UPDATE:

The player of the role is a child of the scoping entity.

2.16.840.1.113883.5.111 en
UPDATE:

Code indicating the primary use for which a living subject is bred or grown

2.16.840.1.113883.5.111 en
UPDATE: No description 2.16.840.1.113883.5.104 en UPDATE:

A code that specifies how an ActRelationship or Participation contributes to the context of an Act, and whether it may be propagated to descendent Acts whose association allows such propagation (see also attributes Participation.contextControlCode, ActRelationship.contextControlCode, ActRelationship.contextConductionInd).

2.16.840.1.113883.5.1057 en
UPDATE:

The LOINC database provides a set of universal names and ID codes for identifying laboratory and clinical test results. The purpose is to facilitate the exchange and pooling of results, such as blood hemoglobin, serum potassium, or vital signs, for clinical care, outcomes management, and research. The LOINC codes are not intended to transmit all possible information about a test or observation. They are only intended to identify the test result or clinical observation. http://www.regenstrief.org/LOINC/LOINC.htm

2.16.840.1.113883.6.1 en
UPDATE:

Set of codes indicating the type of incident or accident.

2.16.840.1.113883.5.4 en
UPDATE: No description 2.16.840.1.113883.5.111 en UPDATE:

A specimen specifically used to verify the sensitivity, specificity, accuracy or other perfomance parameter of a diagnostic test.

2.16.840.1.113883.5.111 en
UPDATE:

An anatomical location on a human which can be the focus of an act.

OpenIssue:This value set was approved fordeletionin November 2008, and was deleted at release \#762. Subsequently, however, it was found that this deletion caused the legacy software embedded in the RMIM Designer in Visio to fail to show appropriate options for concepts in the subject area of this value set. For that reason, the value set wasre-added in releasse 813 and DEPRECATED from general useat the same time. This value set should be deleted as soon as it is no longer required to support of the legacy software.
2.16.840.1.113883.5.1052 2.16.840.1.113883.5.1080 en
UPDATE:

Identifies the primary means by which an Entity participates in an Act.

2.16.840.1.113883.5.1064 en
UPDATE:

Participation by voice communication

2.16.840.1.113883.5.1064 en
UPDATE:

Participation by human language recorded on a physical material

2.16.840.1.113883.5.1064 en
UPDATE:

Participation by non-human-languaged based electronic signal

2.16.840.1.113883.5.1064 en
UPDATE: No description 2.16.840.1.113883.5.1070 en UPDATE:

Substitution occurred or is permitted with another product in the same generic ingredient.

2.16.840.1.113883.5.1070 en
UPDATE:

Potential values for observations of severity.

2.16.840.1.113883.5.1063 en
UPDATE:

Identifies types of detected issues regarding the administration or supply of an item to a patient.

2.16.840.1.113883.5.4 en
UPDATE:

Administration of the proposed therapy may be inappropriate or contraindicated as proposed

2.16.840.1.113883.5.4 en
UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE:

Proposed therapy may be inappropriate or contraindicated due to conditions or characteristics of the patient

2.16.840.1.113883.5.4 en
UPDATE:

Proposed therapy may be inappropriate or contraindicated due to an existing/recent patient condition or diagnosis

2.16.840.1.113883.5.4 en
UPDATE:

Proposed therapy may be inappropriate or contraindicated due to patient age

2.16.840.1.113883.5.4 en
UPDATE:

Proposed therapy may be inappropriate or contraindicated based on the potential for a patient reaction to the proposed product

2.16.840.1.113883.5.4 en
UPDATE:

Proposed therapy may be inappropriate or contraindicated because of a potential patient reaction to a cross-sensitivity related product.

2.16.840.1.113883.5.4 en
UPDATE:

Proposed dosage instructions for therapy differ from standard practice.

2.16.840.1.113883.5.4 en
UPDATE:

Proposed dosage exceeds standard practice

2.16.840.1.113883.5.4 en
UPDATE:

Proposed dosage is below suggested therapeutic levels

2.16.840.1.113883.5.4 en
UPDATE:

Proposed dosage interval/timing differs from standard practice

2.16.840.1.113883.5.4 en
UPDATE:

Proposed length of therpay differs from standard practice

2.16.840.1.113883.5.4 en
UPDATE:

Proposed length of therapy is shorter than that necessary for therapeutic effect

2.16.840.1.113883.5.4 en
UPDATE:

Proposed length of therapy is longer than standard practice

2.16.840.1.113883.5.4 en
UPDATE:

There may be an issue with the patient complying with the intentions of the proposed therapy

2.16.840.1.113883.5.4 en
UPDATE:

Supplying the product at this time may be inappropriate or indicate compliance issues with the associated therapy

2.16.840.1.113883.5.4 en
UPDATE:

Codes dealing with the management of Detected Issue observations

2.16.840.1.113883.5.4 en
UPDATE:

Confirmed drug therapy appropriate

2.16.840.1.113883.5.4 en
UPDATE:

Consulted prescriber, therapy confirmed

2.16.840.1.113883.5.4 en
UPDATE:

Order is performed as issued, but other action taken to mitigate potential adverse effects

2.16.840.1.113883.5.4 en
UPDATE:

Confirmed supply action appropriate

2.16.840.1.113883.5.4 en
UPDATE:

A grouping of Order, Promise and Event moods.

2.16.840.1.113883.5.1001 en
UPDATE:

A grouping of Order, Promise. These specific moods are used in orders.

2.16.840.1.113883.5.1001 en
UPDATE:

A constraint domain for RMIM design.

2.16.840.1.113883.5.1001 en
UPDATE:

Used to enumerate the ways in which a clinician can directly participate during an encounter which generates a clinical document.

2.16.840.1.113883.5.90 en
UPDATE:

Used to represent the role(s) of those who should receive a copy of a document.

2.16.840.1.113883.5.110 en
UPDATE:

A relationship in which the scoper certifies the player ( e. g. a medical care giver, a medical device or a provider organization) to perform certain activities that fall under the jurisdiction of the scoper (e.g., a health authority licensing healthcare prlviders, a medical quality authority certifying healthcare professionals,)

2.16.840.1.113883.5.110 en
UPDATE:

Relates an entity (player) to a location (scoper) at which it is present in some way. This presence may be limited in time.

2.16.840.1.113883.5.110 en
UPDATE:

An inpatient encounter is an encounter in which the patient is admitted to a hospital or equivalent facility.

2.16.840.1.113883.5.4 en
UPDATE:

An observation form that determines parameters or attributes of an Act. Examples are the settings of a ventilator machine as parameters of a ventilator treatment act; the controls on dillution factors of a chemical analyzer as a parameter of a laboratory observation act; the settings of a physiologic measurement assembly (e.g., time skew) or the position of the body while measuring blood pressure.

Control variables are forms of observations because just as with clinical observations, the Observation.code determines the parameter and the Observation.value assigns the value. While control variables sometimes can be observed (by noting the control settings or an actually measured feedback loop) they are not primary observations, in the sense that a control variable without a primary act is of no use (e.g., it makes no sense to record a blood pressure position without recording a blood pressure, whereas it does make sense to record a systolic blood pressure without a diastolic blood pressure).

2.16.840.1.113883.5.4 en
UPDATE:

A code or set of codes (e.g., for routine, emergency,) specifying the urgency under which the Act happened, can happen, is happening, is intended to happen, or is requested/demanded to happen.

Discussion:This attribute is used in orders to indicate the ordered priority, and in event documentation it indicates the actual priority used to perform the act. In definition mood it indicates the available priorities.
2.16.840.1.113883.5.7 en
UPDATE:

Filler should contact the placer (or target) to schedule the service. (Was "C" in HL7 version 2.3's TQ-priority component.)

2.16.840.1.113883.5.7 en
UPDATE:

A code indicating whether the Act statement as a whole, with its subordinate components has been asserted to be uncertain in any way.

Examples:Patient might have had a cholecystectomy procedure in the past (but isn't sure).Constraints:Uncertainty asserted using this attribute applies to the combined meaning of the Act statement established by all descriptive attributes (e.g., Act.code, Act.effectiveTime, Observation.value, SubstanceAdministration.doseQuantity, etc.), and the meanings of any components.

*Discussion:*This is not intended for use to replace or compete with uncertainty associated with a Observation.values alone or other individual attributes of the class. Such pointed indications of uncertainty should be specified by applying the PPD, UVP or UVN data type extensions to the specific attribute. Particularly if the uncertainty is uncertainty of a quantitative measurement value, this must still be represented by a PPD<PQ> in the value and NOT using the uncertaintyCode. Also, when differential diagnoses are enumerated or weighed for probability, the UVP<CD> or UVN<CD> must be used, not the uncertaintyCode. The use of the uncertaintyCode is appropriate only if the entirety of the Act and its dependent Acts is questioned.

Note that very vague uncertainty may be thought related to negationInd, however, the two concepts are really independent. One may be very uncertain about an event, but that does not mean that one is certain about the negation of the event.

2.16.840.1.113883.5.1053 en
UPDATE:

Status of a clinical document.

2.16.840.1.113883.5.14 en
UPDATE: Description:Used to enumerate the typical confidentiality constraints placed upon a clinical document.

*Usage Note:*x\_BasicConfidentialityKind is a subset of Confidentiality codes that are used as metadata indicating the receiver responsibility to comply with normally applicable jurisdictional privacy law or disclosure authorization; that the receiver may not disclose this information except as directed by the information custodian, who may be the information subject; or that the receiver may not disclose this information except as directed by the information custodian, who may be the information subject.

2.16.840.1.113883.5.25 en
UPDATE:

A role played by a place at which services may be provided.

2.16.840.1.113883.5.110 en
UPDATE:

A role played by an entity that receives credentials from the scoping entity.

2.16.840.1.113883.5.110 en
UPDATE:

Route of substance administration classified by administration method.

2.16.840.1.113883.5.112 en
UPDATE:

Iontophoresis

2.16.840.1.113883.5.112 en
UPDATE:

Lavage

2.16.840.1.113883.5.112 en
UPDATE:

Mucosal absorption

2.16.840.1.113883.5.112 en
UPDATE:

Suppository

2.16.840.1.113883.5.112 en
UPDATE:

Topical absorption

2.16.840.1.113883.5.112 en
UPDATE:

Electro-osmosis

2.16.840.1.113883.5.112 en
UPDATE:

Route of substance administration classified by site.

2.16.840.1.113883.5.112 en
UPDATE:

Amniotic fluid sac

2.16.840.1.113883.5.112 en
UPDATE:

Biliary tract

2.16.840.1.113883.5.112 en
UPDATE:

Body surface

2.16.840.1.113883.5.112 en
UPDATE:

Buccal mucosa

2.16.840.1.113883.5.112 en
UPDATE:

Cecostomy

2.16.840.1.113883.5.112 en
UPDATE:

Cervix of the uterus

2.16.840.1.113883.5.112 en
UPDATE:

Endocervical

2.16.840.1.113883.5.112 en
UPDATE:

Enteral

2.16.840.1.113883.5.112 en
UPDATE:

Epidural

2.16.840.1.113883.5.112 en
UPDATE:

Extracorporeal circulation

2.16.840.1.113883.5.112 en
UPDATE:

Extra-amniotic

2.16.840.1.113883.5.112 en
UPDATE:

Gastric

2.16.840.1.113883.5.112 en
UPDATE:

Genitourinary

2.16.840.1.113883.5.112 en
UPDATE:

Gingival

2.16.840.1.113883.5.112 en
UPDATE:

Hair

2.16.840.1.113883.5.112 en
UPDATE:

Interameningeal

2.16.840.1.113883.5.112 en
UPDATE:

Interstitial

2.16.840.1.113883.5.112 en
UPDATE:

Intra-abdominal

2.16.840.1.113883.5.112 en
UPDATE:

Intra-arterial

2.16.840.1.113883.5.112 en
UPDATE:

Intraarticular

2.16.840.1.113883.5.112 en
UPDATE:

Intrabronchial

2.16.840.1.113883.5.112 en
UPDATE:

Intrabursal

2.16.840.1.113883.5.112 en
UPDATE:

Intracardiac

2.16.840.1.113883.5.112 en
UPDATE:

Intracartilaginous

2.16.840.1.113883.5.112 en
UPDATE:

Intracaudal

2.16.840.1.113883.5.112 en
UPDATE:

Countries of the world. ISO 3166, part 1, alpha-3 set.

1.0.3166.1 en
UPDATE:

Intracavernosal

2.16.840.1.113883.5.112 en
UPDATE:

Intracavitary

2.16.840.1.113883.5.112 en
UPDATE:

Intracerebral

2.16.840.1.113883.5.112 en
UPDATE:

Intracervical

2.16.840.1.113883.5.112 en
UPDATE:

Intracisternal

2.16.840.1.113883.5.112 en
UPDATE:

Intracorneal

2.16.840.1.113883.5.112 en
UPDATE:

Intracoronal (dental)

2.16.840.1.113883.5.112 en
UPDATE:

Intracoronary

2.16.840.1.113883.5.112 en
UPDATE:

Intracorpus cavernosum

2.16.840.1.113883.5.112 en
UPDATE:

Intratendinous

2.16.840.1.113883.5.112 en
UPDATE:

Intradermal

2.16.840.1.113883.5.112 en
UPDATE:

Intradiscal

2.16.840.1.113883.5.112 en
UPDATE:

Intraductal

2.16.840.1.113883.5.112 en
UPDATE:

Intraduodenal

2.16.840.1.113883.5.112 en
UPDATE:

Intradural

2.16.840.1.113883.5.112 en
UPDATE:

Intraepidermal

2.16.840.1.113883.5.112 en
UPDATE:

Intraepithelial

2.16.840.1.113883.5.112 en
UPDATE:

Intraesophageal

2.16.840.1.113883.5.112 en
UPDATE:

Intragastric

2.16.840.1.113883.5.112 en
UPDATE:

Intraileal

2.16.840.1.113883.5.112 en
UPDATE:

Intralesional

2.16.840.1.113883.5.112 en
UPDATE:

Intraluminal

2.16.840.1.113883.5.112 en
UPDATE:

Intralymphatic

2.16.840.1.113883.5.112 en
UPDATE:

Intramedullary

2.16.840.1.113883.5.112 en
UPDATE:

Intramuscular

2.16.840.1.113883.5.112 en
UPDATE:

Intraocular

2.16.840.1.113883.5.112 en
UPDATE:

Intraosseous

2.16.840.1.113883.5.112 en
UPDATE:

Intraovarian

2.16.840.1.113883.5.112 en
UPDATE:

Intrapericardial

2.16.840.1.113883.5.112 en
UPDATE:

Intraperitoneal

2.16.840.1.113883.5.112 en
UPDATE:

Intrapleural

2.16.840.1.113883.5.112 en
UPDATE:

Intraprostatic

2.16.840.1.113883.5.112 en
UPDATE:

Intrapulmonary

2.16.840.1.113883.5.112 en
UPDATE:

Intrasinal

2.16.840.1.113883.5.112 en
UPDATE:

Intraspinal

2.16.840.1.113883.5.112 en
UPDATE:

Intrasternal

2.16.840.1.113883.5.112 en
UPDATE:

Intrasynovial

2.16.840.1.113883.5.112 en
UPDATE:

Intratesticular

2.16.840.1.113883.5.112 en
UPDATE:

Intrathecal

2.16.840.1.113883.5.112 en
UPDATE:

Intrathoracic

2.16.840.1.113883.5.112 en
UPDATE:

Intratracheal

2.16.840.1.113883.5.112 en
UPDATE:

Intratubular

2.16.840.1.113883.5.112 en
UPDATE:

Intratumor

2.16.840.1.113883.5.112 en
UPDATE:

Intratympanic

2.16.840.1.113883.5.112 en
UPDATE:

Intrauterine

2.16.840.1.113883.5.112 en
UPDATE:

Intravascular

2.16.840.1.113883.5.112 en
UPDATE:

Intravenous

2.16.840.1.113883.5.112 en
UPDATE:

Intraventricular

2.16.840.1.113883.5.112 en
UPDATE:

Intravesicle

2.16.840.1.113883.5.112 en
UPDATE:

Intravitreal

2.16.840.1.113883.5.112 en
UPDATE:

Jejunum

2.16.840.1.113883.5.112 en
UPDATE:

Lacrimal puncta

2.16.840.1.113883.5.112 en
UPDATE:

Laryngeal

2.16.840.1.113883.5.112 en
UPDATE:

Lingual

2.16.840.1.113883.5.112 en
UPDATE:

Mucous membrane

2.16.840.1.113883.5.112 en
UPDATE:

Nail

2.16.840.1.113883.5.112 en
UPDATE:

Nasal

2.16.840.1.113883.5.112 en
UPDATE:

Ophthalmic

2.16.840.1.113883.5.112 en
UPDATE:

Oral

2.16.840.1.113883.5.112 en
UPDATE:

Oromucosal

2.16.840.1.113883.5.112 en
UPDATE:

Oropharyngeal

2.16.840.1.113883.5.112 en
UPDATE:

Otic

2.16.840.1.113883.5.112 en
UPDATE:

Paranasal sinuses

2.16.840.1.113883.5.112 en
UPDATE:

Parenteral

2.16.840.1.113883.5.112 en
UPDATE:

Perianal

2.16.840.1.113883.5.112 en
UPDATE:

Periarticular

2.16.840.1.113883.5.112 en
UPDATE:

Periodontal

2.16.840.1.113883.5.112 en
UPDATE:

Peridural

2.16.840.1.113883.5.112 en
UPDATE:

Perineal

2.16.840.1.113883.5.112 en
UPDATE:

Perineural

2.16.840.1.113883.5.112 en
UPDATE:

Pulmonary

2.16.840.1.113883.5.112 en
UPDATE:

Rectal

2.16.840.1.113883.5.112 en
UPDATE:

Respiratory tract

2.16.840.1.113883.5.112 en
UPDATE:

Retrobulbar

2.16.840.1.113883.5.112 en
UPDATE:

Scalp

2.16.840.1.113883.5.112 en
UPDATE:

Sinus, unspecified

2.16.840.1.113883.5.112 en
UPDATE:

Skin

2.16.840.1.113883.5.112 en
UPDATE:

Soft tissue

2.16.840.1.113883.5.112 en
UPDATE:

Subarachnoid

2.16.840.1.113883.5.112 en
UPDATE:

Subconjunctival

2.16.840.1.113883.5.112 en
UPDATE:

Subcutaneous

2.16.840.1.113883.5.112 en
UPDATE:

Sublesional

2.16.840.1.113883.5.112 en
UPDATE:

Sublingual

2.16.840.1.113883.5.112 en
UPDATE:

Submucosal

2.16.840.1.113883.5.112 en
UPDATE:

Tracheostomy

2.16.840.1.113883.5.112 en
UPDATE:

Transdermal

2.16.840.1.113883.5.112 en
UPDATE:

Transmucosal

2.16.840.1.113883.5.112 en
UPDATE:

Transplacental

2.16.840.1.113883.5.112 en
UPDATE:

Transtracheal

2.16.840.1.113883.5.112 en
UPDATE:

Transtympanic

2.16.840.1.113883.5.112 en
UPDATE:

Ureteral

2.16.840.1.113883.5.112 en
UPDATE:

Urethral

2.16.840.1.113883.5.112 en
UPDATE:

Urinary bladder

2.16.840.1.113883.5.112 en
UPDATE:

Urinary tract

2.16.840.1.113883.5.112 en
UPDATE:

Vaginal

2.16.840.1.113883.5.112 en
UPDATE:

Vitreous humour

2.16.840.1.113883.5.112 en
UPDATE: No description 2.16.840.1.113883.5.1010 en UPDATE:

The currency unit as defined in ISO 4217

2.16.840.1.113883.5.1058 en
UPDATE: No description 2.16.840.1.113883.5.1069 en UPDATE: No description 2.16.840.1.113883.5.1055 en UPDATE:

Identifies the reason the patient is assigned to this accommodation type

2.16.840.1.113883.5.8 en
UPDATE:

General category of medical service provided to the patient during their encounter.

2.16.840.1.113883.5.4 en
UPDATE:

Actions to be carried out by the recipient of the Adjudication Result information.

2.16.840.1.113883.5.4 en
UPDATE:

The type of provision(s) made for reimbursing for the deliver of healthcare services and/or goods provided by a Provider, over a specified period.

2.16.840.1.113883.5.4 en
UPDATE:

Response to an insurance coverage eligibility query or authorization request.

2.16.840.1.113883.5.4 en
UPDATE:

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

2.16.840.1.113883.5.4 en
UPDATE:

Criteria that are applicable to the authorized coverage.

2.16.840.1.113883.5.4 en
UPDATE:

Identifies the different types of summary information that can be reported by queries dealing with Statement of Financial Activity (SOFA). The summary information is generally used to help resolve balance discrepancies between providers and payors.

2.16.840.1.113883.5.4 en
UPDATE:

Total counts and total net amounts billed for all Invoice Groupings that were submitted within a time period. Adjudicated invoice elements are included.

2.16.840.1.113883.5.4 en
UPDATE:

Total counts and total net amounts adjudicated for all Invoice Groupings that were adjudicated within a time period based on the adjudication date of the Invoice Grouping.

2.16.840.1.113883.5.4 en
UPDATE:

Total counts and total net amounts paid for all Invoice Groupings that were paid within a time period based on the payment date.

2.16.840.1.113883.5.4 en
UPDATE:

Includes coded responses that will occur as a result of the adjudication of an electronic invoice at a summary level and provides guidance on interpretation of the referenced adjudication results.

2.16.840.1.113883.5.4 en
UPDATE:

Code identifying the method or the movement of payment instructions.

Codes are drawn from X12 data element 591 (PaymentMethodCode)

2.16.840.1.113883.5.4 en
UPDATE:

Includes coded responses that will occur as a result of the adjudication of an electronic invoice at a summary level and provides guidance on interpretation of the referenced adjudication results.

2.16.840.1.113883.5.4 en
UPDATE:

A role type that is used to further qualify an entity playing a role where the role class attribute is set to RoleClassCommissioningParty.

2.16.840.1.113883.5.111 en
UPDATE:

A role of a place that further classifies the setting (e.g., accident site, road side, work site, community location) in which services are delivered.

2.16.840.1.113883.5.111 en
UPDATE:

Processing consideration and clarification codes.

2.16.840.1.113883.5.1051 en
UPDATE:

Identifies what sort of change is permitted or has occurred between the item that was ordered/requested and the one that was/will be provided.

2.16.840.1.113883.5.1071 en
UPDATE:

Some conditions may be attached to an allowable substitution. An allowable substitution is based on a match to any other attributes that may be specified.

2.16.840.1.113883.5.1071 en
UPDATE:

Proposed therapy may be inappropriate based on the patient's weight

2.16.840.1.113883.5.4 en
UPDATE:

Proposed therapy may be inappropriate based on the patient's height or body surface area

2.16.840.1.113883.5.4 en
UPDATE:

Proposed therapy may interact with an existing or recent therapeutic product

2.16.840.1.113883.5.4 en
UPDATE:

**Description:**Identifies the different representations of a Address. The representation may affect how the address is used. (E.g. use of Ideographic for formal communications.)

2.16.840.1.113883.5.45 en
UPDATE:

A delivery address line is frequently used instead of breaking out delivery mode, delivery installation, etc. An address generally has only a delivery address line or a street address line, but not both.

2.16.840.1.113883.5.16 en
UPDATE:

Regions of Interest (ROI) within a subject Act. Primarily used for making secondary observations on a subset of a subject observation. The relationship between a ROI and its referenced Act is specified through an ActRelationship of type "subject" (SUBJ), which must always be present.

2.16.840.1.113883.5.6 en
UPDATE:

Type of bounded ROI.

2.16.840.1.113883.5.4 en
UPDATE:

A child as determined by birth.

2.16.840.1.113883.5.111 en
UPDATE:

The method that a product is obtained for use by the subject of the supply act (e.g. patient). Product examples are consumable or durable goods.

2.16.840.1.113883.5.4 en
UPDATE:

Transfer of ownership for a product.

2.16.840.1.113883.5.4 en
UPDATE:

Temporary supply of a product without transfer of ownership for the product.

2.16.840.1.113883.5.4 en
UPDATE:

The method that a product is obtained for use by the subject of the supply act (e.g. patient), with financial compensation. Product examples are consumable or durable goods.

2.16.840.1.113883.5.4 en
UPDATE:

Catagorization of grouping criteria for the associated transactions and/or summary (totals, subtotals).

2.16.840.1.113883.5.4 en
UPDATE:

The specification of the relationship to the covered party of the payee in the case when an insurer is not directly paying the healthcare provider (as payee) but reimbursing the party that did pay them.

2.16.840.1.113883.5.111 en
UPDATE: No description 2.16.840.1.113883.5.1063 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE: No description 2.16.840.1.113883.5.1054 en UPDATE:

The source is an excerpt from the target.

2.16.840.1.113883.5.1002 en
UPDATE:

Container for Correlated Observation Sequences sharing a common frame of reference. All Observations of the same cd must be comparable and relative to the common frame of reference. For example, a 3-channel ECG device records a 12-lead ECG in 4 steps (3 leads at a time). Each of the separate 3-channel recordings would be in their own "OBSCOR". And, all 4 OBSCOR would be contained in one OBSSER because all the times are relative to the same origin (beginning of the recording) and all the ECG signals were from a fixed set of electrodes.

2.16.840.1.113883.5.6 en
UPDATE:

Role recognized through the issuance of insurance coverage to an identified covered party who has this relationship with the policy holder such as the policy holder themselves (self), spouse, child, etc

2.16.840.1.113883.5.111 en
UPDATE:

A code specifying the state of the Query.

2.16.840.1.113883.5.103 en
UPDATE:

The association adds to the existing context associated with the Act. Both this association and any associations propagated from ancestor Acts are interpreted as being related to this Act.

2.16.840.1.113883.5.1057 en
UPDATE:

The association adds to the existing context associated with the Act, but replaces associations propagated from ancestor Acts whose typeCodes are the same.

2.16.840.1.113883.5.1057 en
UPDATE:

The association propagates to any child Acts that are related via a conducting ActRelationship (refer to contextConductionInd).

2.16.840.1.113883.5.1057 en
UPDATE:

The association applies only to the current Act and will not propagate to any child Acts that are related via a conducting ActRelationship (refer to contextConductionInd).

2.16.840.1.113883.5.1057 en
UPDATE:

Specialization of Act to add the characteristics unique to document management services.

2.16.840.1.113883.5.6 en
UPDATE:

Used to enumerate the moods that an observation can take within the body of a clinical document.

2.16.840.1.113883.5.1001 en
UPDATE: No description 2.16.840.1.113883.5.1001 en UPDATE:

Specifies under what circumstances (target Act) the source-Act may, must, must not or has occurred

2.16.840.1.113883.5.1002 en
UPDATE: No description 2.16.840.1.113883.5.1119 en UPDATE:

Used to enumerate the relationships between a CDA entry and an externally referenced act.

2.16.840.1.113883.5.1002 en
UPDATE:

Relates a patient encounter act (source) to the transportation act (target) representing the patient"s arrival at or departure from the site of a patient encounter.

2.16.840.1.113883.5.1002 en
UPDATE:

Target that is not substantially present in the act and which is not directly affected by the act, but which will be a focus of the record or documentation of the act.

2.16.840.1.113883.5.90 en
UPDATE:

One who initiates the control act event, either as its author or its physical performer.

2.16.840.1.113883.5.90 en
UPDATE:

One who oversees a control act event. Includes either a type of accountability, as in responsible party, verifier (and its children) and witness; or being an assistant to the control act event, as in secondary performer.

2.16.840.1.113883.5.90 en
UPDATE: No description 2.16.840.1.113883.5.110 en UPDATE:

An association for a playing Entity that is used, known, treated, handled, built, or destroyed, etc. under the auspices of the scoping Entity. The playing Entity is passive in these roles (even though it may be active in other roles), in the sense that the kinds of things done to it in this role happen without an agreement from the playing Entity.

2.16.840.1.113883.5.110 en
UPDATE: No description 2.16.840.1.113883.5.1077 en UPDATE:

Assigment of spiritual faith affiliation

2.16.840.1.113883.5.1076 en
UPDATE:

Identifies how to interpret the instance of the code, codeSystem value in a set of translations. Since HL7 (or a government body) may mandate that codes from certain code systems be sent in conformant messages, other synonyms that are sent in the translation set need to be distinguished among the originally captured source, the HL7 specified code, or some future role. When this code is NULL, it indicates that the translation is an undefined type. When valued, this property must contain one of the following values:

SRC - Source (or original) code HL7 - HL7 Specified or Mandated SH - both HL7 mandated and the original code (precoordination)

There may be additional values added to this value set as we work through the use of codes in messages and determine other Use Cases requiring special interpretation of the translations.

2.16.840.1.113883.5.1074 en
UPDATE:

Patient VIP code

2.16.840.1.113883.5.1075 en
UPDATE: No description 2.16.840.1.113883.6.85 en UPDATE:

A general association between two entities that is neither partitive nor ontological.

2.16.840.1.113883.5.110 en
UPDATE: A relationship that is based on mutual behavior of the two Entities as being related. The basis of such relationship may be agreements (e.g., spouses, contract parties) or they may bede factobehavior (e.g. friends) or may be an incidental involvement with each other (e.g. parties over a dispute, siblings, children). 2.16.840.1.113883.5.110 en UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE:

Permanent dentition, the natural teeth of adulthood that replace or are added to the deciduous teeth

2.16.840.1.113883.5.1080 en
UPDATE:

Supernumerary tooth, any tooth in addition to the normal permanent and primary dentition

2.16.840.1.113883.5.1080 en
UPDATE:

Primary dentition, the first teeth to errupt and usually replaced with permanent dentition

2.16.840.1.113883.5.1080 en
UPDATE:

Artificial dentition, artificial subsitutes for the natural dentition

2.16.840.1.113883.5.1080 en
UPDATE: No description 2.16.840.1.113883.5.1080 en UPDATE:

The invoice element has been accepted for payment but one or more adjustment(s) have been made to one or more invoice element line items (component charges).

Also includes the concept 'Adjudicate as zero' and items not covered under a particular Policy.

Invoice element can be reversed (nullified).

Recommend that the invoice element is saved for DUR (Drug Utilization Reporting).

2.16.840.1.113883.5.4 en
No description 2.16.840.1.113883.6.235 en

**** MISSING DESCRIPTION ****

2.16.840.1.113883.6.95 en
UPDATE:

Set of codes indicating the type of insurance policy or other source of funds to cover healthcare costs.

2.16.840.1.113883.5.4 en
UPDATE: No description 2.16.840.1.113883.5.110 en UPDATE:

Identifies the reason or rational for why a person is not eligibile for benefits under an insurance policy.

Examples are client deceased & adopted client has been given a new policy identifier.

2.16.840.1.113883.5.8 en
UPDATE:

A code identifying the specific message to be provided.

A textual value may be specified as the print name, or for non-coded messages, as the original text.*Discussion:*

'Required attribute xxx is missing', 'System will be unavailable March 19 from 0100 to 0300'*Examples:*

2.16.840.1.113883.5.1082 en
UPDATE:

How a code system is maintained by HL7

2.16.840.1.113883.5.1085 en
UPDATE:

Property identifiers for a concept code

2.16.840.1.113883.5.1087 en
UPDATE:

Provides codes associated with ActClass value of LIST (working list)

2.16.840.1.113883.5.4 en
UPDATE:

Used to represent participant(s) who should receive a copy of a document.

2.16.840.1.113883.5.90 en
UPDATE:

Used to represent the role(s) of those who can serve as subjects of the contents of a clinical document.

2.16.840.1.113883.5.110 en
UPDATE: No description 2.16.840.1.113883.5.110 en UPDATE:

List of medications.

2.16.840.1.113883.5.4 en
UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE: No description 2.16.840.1.113883.5.1001 en UPDATE: No description 2.16.840.1.113883.5.1001 en UPDATE:

This is the domain of HL7 version codes for the Version 3 standards. Values are to be determined by HL7 and added with each new version of the HL7 Standard.

2.16.840.1.113883.5.1097 en
UPDATE:

A grouping of Definition, Event. These specific moods are used in control wrapper override acts. The domain is restricted to acts that are possible to occur or have already occurred.

2.16.840.1.113883.5.1001 en
UPDATE:

The reason or rationale for a service. A reason link is weaker than a trigger, it only suggests that some service may be or might have been a reason for some action, but not that this reason requires/required the action to be taken. Also, as opposed to the trigger, there is no strong timely relation between the reason and the action.

Discussion:In prior releases, the code "SUGG" (suggests) was expressed as "an inversion of the reason link." That code has been retired in favor of the inversion indicator that is an attribute of ActRelationship.
2.16.840.1.113883.5.1002 en
UPDATE: No description 2.16.840.1.113883.5.8 en UPDATE:

Provides codes for decision methods, initially for assessing the causality of events.

2.16.840.1.113883.5.84 en
UPDATE:

Reaching a decision through the application of an algorithm designed to weigh the different factors involved.

2.16.840.1.113883.5.84 en
UPDATE:

Value set provides methods used to assess the causality of adverse events. New codes should not be added to the domain without first checking with its steward - the Regulated Clinical Research Information Management (RCRIM) technical committee.

2.16.840.1.113883.5.84 en
UPDATE:

The requestor for the accommodation. Steward is Financial Management Technical Committee

2.16.840.1.113883.5.110 en
UPDATE:

This value set includes all HCPCS Level II codes.

2.16.840.1.113883.6.285 en
UPDATE:

The specification of the relationship of the Payee to the invoice. Can be used in cases when an insurer is not directly paying the healthcare provider (as payee) but reimbursing the party that paid the invoice/claim.

2.16.840.1.113883.5.110 en
UPDATE:

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.

2.16.840.1.113883.5.4 en
UPDATE:

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.

2.16.840.1.113883.5.4 en
UPDATE:

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.

2.16.840.1.113883.5.4 en
UPDATE:

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.

2.16.840.1.113883.5.4 en
UPDATE:

Codes representing a service or product that is being invoiced (billed). The code can represent such concepts as "office visit", "drug X", "wheelchair" and other billable items such as taxes, service charges and discounts.

2.16.840.1.113883.5.4 en
UPDATE:

An identifying data string for A substance used as a medication or in the preparation of medication.

2.16.840.1.113883.5.4 en
UPDATE:

An identifying data string for healthcare products.

2.16.840.1.113883.5.4 en
UPDATE:

An identifying data string for medical facility accommodations.

2.16.840.1.113883.5.4 en
UPDATE:

The detail item codes to identify charges or changes to the total billing of a claim due to insurance rules and payments.

2.16.840.1.113883.5.4 en
UPDATE:

The billable item codes to identify provider supplied charges or changes to the total billing of a claim.

2.16.840.1.113883.5.4 en
UPDATE:

The billable item codes to identify modifications to a billable item charge by a tax factor applied to the amount. As for example 7% provincial sales tax.

2.16.840.1.113883.5.4 en
UPDATE:

The billable item codes to identify modifications to a billable item charge. As for example after hours increase in the office visit fee.

2.16.840.1.113883.5.4 en
UPDATE:

The billable item codes to identify adjudicator specified components to the total billing of a claim.

2.16.840.1.113883.5.4 en
UPDATE:

Codes representing a grouping of invoice elements (totals, sub-totals), reported through a Payment Advice or a Statement of Financial Activity (SOFA). The code can represent summaries by day, location, payee and other cost elements such as bonus, retroactive adjustment and transaction fees.

2.16.840.1.113883.5.4 en
UPDATE:

Codes representing a grouping of invoice elements (totals, sub-totals), reported through a Payment Advice or a Statement of Financial Activity (SOFA). The code can represent summaries by day, location, payee, etc.

2.16.840.1.113883.5.4 en
UPDATE:

Codes representing adjustments to a Payment Advice such as retroactive, clawback, garnishee, etc.

2.16.840.1.113883.5.4 en
UPDATE:

The billable codes selected for use for Pharmacy Invoices. Steward is Financial Management.

2.16.840.1.113883.5.4 en
UPDATE:

The billable codes selected for use for Preferred Accommodation Invoices. Steward is Financial Management.

2.16.840.1.113883.5.4 en
UPDATE:

Specifies the administrative functionality within a formal experimental design for which the ResearchSubject role was established. Examples: screening - role is used for pre-enrollment evaluation portion of the design; enrolled - role is used for subjects admitted to the active treatment portion of the design.

2.16.840.1.113883.5.111 en
UPDATE:

Identifies types of detectyed issues for Act class "ALRT" for the administrative and patient administrative acts domains.

2.16.840.1.113883.5.4 en
UPDATE:

Codes dealing with the management of Detected Issue observations for the administrative and patient administrative acts domains.

2.16.840.1.113883.5.4 en
UPDATE:

This context represents the part of a patient record conveyed in a single communication. It is drawn from a providing system for the purposes of communication to a requesting process (which might be another repository, a client application or a middleware service such as an electronic guideline engine), and supporting the faithful inclusion of the communicated data in the receiving system.

An extract may be the entirety of the patient record as held by the sender or it may be a part of that record (e.g. changes since a specified date).

An extract contains folders or compositions.

An extract cannot contain another extract.

2.16.840.1.113883.5.6 en
UPDATE:

A context representing a grouped commitment of information to the EHR. It is considered the unit of modification of the record, the unit of transmission in record extracts, and the unit of attestation by authorizing clinicians.

A composition represents part of a patient record originating from a single interaction between an authenticator and the record.

Unless otherwise stated all statements within a composition have the same authenticator, apply to the same patient and were recorded in a single session of use of a single application.

A composition contains organizers and entries.

2.16.840.1.113883.5.6 en
UPDATE:

Used to group a set of acts sharing a common context. Container structures can nest within other context structures - such as where a document is contained within a folder, or a folder is contained within an EHR extract.

Open issue:There is a clear conflict between this act and the use of the more general "component" ActRelationship. The question that must be resolved is what should be the class code of the parent (or containing) Act.
2.16.840.1.113883.5.6 en
UPDATE:

Used to enumerate the relationships between a CDA section and its contained entries.

2.16.840.1.113883.5.1002 en
UPDATE:

Used to enumerate the relationships between two CDA entries.

2.16.840.1.113883.5.1002 en
UPDATE:

HL7 implementation technology specification versions. These codes will document the ITS type and version for message encoding. The code will appear in the instances based upon rules expressed in the ITS, and do not appear in the abstract message, either as it is presented to received from the ITS.

2.16.840.1.113883.5.1092 en
UPDATE:

A role of a place that further classifies a setting that is intended to house the provision of services.

2.16.840.1.113883.5.111 en
UPDATE: No description 2.16.840.1.113883.5.111 en UPDATE:

A role of a place that further classifies a setting that is intended to house the provision of non-clinical services.

2.16.840.1.113883.5.111 en
UPDATE: No description 2.16.840.1.113883.6.21 en UPDATE: No description 2.16.840.1.113883.6.21 en UPDATE:

A politically organized body of people bonded by territory, culture, or ethnicity, having sovereignty (to a certain extent) granted by other states (enclosing or neighboring states). This includes countries (nations), provinces (e.g., one of the United States of America or a French departement), counties or municipalities. Refine using, e.g., ISO country codes, FIPS-PUB state codes, etc.

2.16.840.1.113883.5.41 en
UPDATE:

Administrative reasons for patient encounters.

*Example:*Medical necessity, patient request and dependency.

2.16.840.1.113883.5.8 en
UPDATE:

The urgency for starting a patient encounter.

*Example:*Routine, urgent, emergency, and elective.

2.16.840.1.113883.5.7 en
UPDATE:

Used to enumerate the moods that an act can take within the body of a clinical document.

2.16.840.1.113883.5.1001 en
UPDATE:

Used to enumerate the moods that an encounter can take within the body of a clinical document.

2.16.840.1.113883.5.1001 en
UPDATE:

Used to enumerate the moods that a procedure can take within the body of a clinical document.

2.16.840.1.113883.5.1001 en
UPDATE:

Used to enumerate the moods that a substance administration can take within the body of a clinical document.

2.16.840.1.113883.5.1001 en
UPDATE: No description 2.16.840.1.113883.5.41 en UPDATE: No description 2.16.840.1.113883.5.41 en UPDATE: No description 2.16.840.1.113883.5.129 en UPDATE:

In the absence of an all-encompassing Provider Classification System, both X12N and the National Provider System Workgroup from the Centers for Medicare and Medicaid Services (CMS) commenced work on identifying and coding an external provider table that would be able to codify provider type and provider area of specialization for all medical related providers. CMS' intent was to provide a single coding structure to support work on the National Provider System, while X12N needed a single common table for trading partner use. The two projects worked independently to some extent until April 1996 when the lists were coordinated and a single taxonomy was proposed. A sub-group of the X12N TG2 WG 15 was charged with resolving differences in the two proposed taxonomies. Their work resulted in a single taxonomy that both CMS and members of X12N found meaningful, easy to use, and functional for electronic transactions.

The sub-group initially started with the CMS draft taxonomy. This list incorporated all types of providers associated with medical care in various ways. Many of the providers listed, such as technologists or technicians, support or repair equipment/machinery. A number of the providers offer medical services, in concert with others, and do not or cannot bill independently for their portion. The amount of research to validate and classify all providers using the proposed hierarchical structure was enormous. The X12N sub-group focused on medical providers who are licensed practitioners, those who bill for health-related services rendered, and those who appeared on the Medicare CMS Provider Specialty listing. This included providers who were licensed to practice medicine via state licensure agencies. In addition, a very broad definition of "areas of specialization" was used, which included nationally recognized specialties, provider self-designated specialties, areas of practice focus, and any request by any agency or trading partner submitted before the first taxonomy release. This level of detail captured specialty information in categories detailed enough to support those trading credentialing information, yet broad enough to support those wishing to trade directory level specialization information.

In 2001, ANSI ASC X12N asked the NUCC to become the official maintainer of the Health Care Provider Taxonomy List. The NUCC has a formal operating protocol and its membership includes representation from key provider and payer organizations, as well as state and federal agencies, standard development organizations and the National Uniform Billing Committee (NUBC). Criteria for membership includes a national scope and representation of a unique constituency affected by health care electronic commerce, with an emphasis on maintaining a provider/payer balance.

2.16.840.1.113883.6.101 en
UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE:

Types of personal relationships between two living subjects.

*Example:*Parent, sibling, unrelated friend, neighbor

2.16.840.1.113883.5.111 en
UPDATE:

The player of the role is a child taken into a family through legal means and raised by the scoping person (parent) as his or her own child.

2.16.840.1.113883.5.111 en
UPDATE:

The player of the role is a child receiving parental care and nurture from the scoping person (parent) but not related to him or her through legal or blood ties.

2.16.840.1.113883.5.111 en
UPDATE:

The player of the role is the spouse of scoping person's child.

2.16.840.1.113883.5.111 en
UPDATE:

The player of the role is a child of the scoping person's spouse by a previous union.

2.16.840.1.113883.5.111 en
UPDATE: No description 2.16.840.1.113883.5.111 en UPDATE:

The player of the role is the parent of scoping person's husband or wife.

2.16.840.1.113883.5.111 en
UPDATE:

The player of the role is the spouse of the scoping person's parent and not the scoping person's natural parent.

2.16.840.1.113883.5.111 en
UPDATE:

The player of the role is a parent of the scoping person's grandparent.

2.16.840.1.113883.5.111 en
UPDATE:

**Description:**A relationship between two people characterizing their "familial" relationship

2.16.840.1.113883.5.111 en
UPDATE:

The player of the role is a child of the scoping person's son or daughter.

2.16.840.1.113883.5.111 en
UPDATE:

The player of the role is a child of scoping person's brother or sister or of the brother or sister of the scoping person's spouse.

2.16.840.1.113883.5.111 en
UPDATE:

The player of the role has both biological parents in common with the scoping entity.

2.16.840.1.113883.5.111 en
UPDATE:

The player of the role is related to the scoping entity by sharing only one biological parent.

2.16.840.1.113883.5.111 en
UPDATE:

The player of the role is a child of the scoping person's stepparent.

2.16.840.1.113883.5.111 en
UPDATE:

The player of the role is: (1) a sibling of the scoping person's spouse, or (2) the spouse of the scoping person's sibling, or (3) the spouse of a sibling of the scoping person's spouse.

2.16.840.1.113883.5.111 en
UPDATE:

A relationship between two people characterizing their "familial" relationship

2.16.840.1.113883.5.111 en
UPDATE:

An observable finding or state that persists over time and tends to require intervention or management, and, therefore, distinguished from an Observation made at a point in time; may exist before an Observation of the Condition is made or after interventions to manage the Condition are undertaken. Examples: equipment repair status, device recall status, a health risk, a financial risk, public health risk, pregnancy, health maintenance, chronic illness

2.16.840.1.113883.5.6 en
UPDATE:

Indicates the highest importance level of the set of messages the acknowledging application has waiting on a queue for the receiving application.

Discussion:These messages would need to be retrieved via a query. This facilitates receiving applications that cannot receive unsolicited messages (i.e. polling). The specific code specified identifies how important the most important waiting message is (and may govern how soon the receiving application is required to poll for the message).

Priority may be used by local agreement to determine the timeframe in which the receiving application is expected to retrieve the messages from the queue.

2.16.840.1.113883.5.1083 en
UPDATE:

The principle target that the service acts on. E.g. the patient in physical examination, a specimen in a lab observation. May also be a patient's family member (teaching) or a device or room (cleaning, disinfecting, housekeeping). Note: not all direct targets are subjects, consumables, and devices used as tools for a service are not subjects. However, a device may be a subject of a maintenance service.

2.16.840.1.113883.5.90 en
UPDATE:

Location (mobile) where healthcare service was delivered.

2.16.840.1.113883.5.111 en
UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE:

A person that contributed to recording or validating the act.

2.16.840.1.113883.5.90 en
UPDATE:

A person that performed, contributed in recording or validating the act.

2.16.840.1.113883.5.90 en
UPDATE: No description 2.16.840.1.113883.5.6 en UPDATE:

The set of Act class codes allowed for the ACT class clone in the CDA Clinical Statement model. The scope of this value set are those Act class codes not otherwise covered by specific classes in the CDA Clinical Statement model and required to enable representation of Clinical Statement in CDA.

2.16.840.1.113883.5.6 en
UPDATE:

Clones using this x\_domain should have a name "encounterParticipant".

2.16.840.1.113883.5.90 en
UPDATE:

Clones using this x\_domain should have a name "performer".

2.16.840.1.113883.5.90 en
UPDATE:

(abstract) Used within an instance to give the author some control over various aspects of rendering

2.16.840.1.113883.5.1095 en
UPDATE:

(abstract) Defines font rendering characteristics

2.16.840.1.113883.5.1095 en
UPDATE:

(abstract) Defines table cell rendering characteristics

2.16.840.1.113883.5.1095 en
UPDATE:

Defines list rendering characteristics

2.16.840.1.113883.5.1095 en
UPDATE:

Defines rendering characteristics for ordered lists

2.16.840.1.113883.5.1095 en
UPDATE:

Defines rendering characteristics for unordered lists

2.16.840.1.113883.5.1095 en
UPDATE:

Further classifies entities of classCode ORG.

2.16.840.1.113883.5.1060 en
UPDATE:

Expresses values for describing the relationship between a FinancialTransaction and an Account.

2.16.840.1.113883.5.1002 en
UPDATE:

Expresses values for describing the relationship relationship between an InvoiceElement or InvoiceElementGroup and a billable act.

2.16.840.1.113883.5.1002 en
UPDATE:

A person who is important to one's well being; especially a spouse or one in a similar relationship. (The player is the one who is important)

2.16.840.1.113883.5.111 en
UPDATE:

Used to indicate that the target of the relationship will be a filtered subset of the total related set of targets.

Used when there is a need to limit the number of components to the first, the last, the next, the total, the average or some other filtered or calculated subset.

2.16.840.1.113883.5.1099 en
UPDATE:

An occurrence that occurred or was scheduled to occur in the past. An Act whose effective time is less than 'now'. ('now' is the time the instance is authored.)

2.16.840.1.113883.5.1099 en
UPDATE:

An occurrence that is scheduled to occur in the future. An Act whose effective time is greater than 'now', where 'now' is the time the instance is authored.

2.16.840.1.113883.5.1099 en
UPDATE:

The target act is a desired outcome of the source act. Source is any act (typically an intervention). Target must be an observation in criterion mood.

2.16.840.1.113883.5.1002 en
UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE:

A site specific problem code

2.16.840.1.113883.5.1100 en
UPDATE:

Reflects errors in the syntax or structure of the communication.

2.16.840.1.113883.5.1100 en
UPDATE:

Refelects rejections because elements of the communication are not supported in the current context.

2.16.840.1.113883.5.1100 en
UPDATE:

An action taken with respect to a subject Entity by a regulatory or authoritative body with supervisory capacity over that entity. The action is taken in response to behavior by the subject Entity that body finds to be undesirable.

Suspension, license restrictions, monetary fine, letter of reprimand, mandated training, mandated supervision, etc.*Examples:*

2.16.840.1.113883.5.107 en
UPDATE: No description 2.16.840.1.113883.5.1001 en UPDATE: No description 2.16.840.1.113883.5.1001 en UPDATE: No description 2.16.840.1.113883.5.1001 en UPDATE: No description 2.16.840.1.113883.5.1001 en UPDATE: No description 2.16.840.1.113883.5.1001 en UPDATE: No description 2.16.840.1.113883.5.1001 en UPDATE:

Specifies the mode, immediate versus deferred or queued, by which a receiver should communicate its receiver responsibilities.

2.16.840.1.113883.5.1126 en
UPDATE:

A value representing the state (solid, liquid, gas) and nature of the material.

2.16.840.1.113883.5.1127 2.16.840.1.113883.5.85 en
UPDATE:

Codes to characterize a Resource Group using categories that typify its membership and/or function

.

Example:PractitionerGroup
2.16.840.1.113883.5.1060 en
UPDATE: No description 2.16.840.1.113883.5.6 en UPDATE:

The act of putting something away for safe keeping. The "something" may be physical object such as a specimen, or information, such as observations regarding a specimen.

2.16.840.1.113883.5.6 en
UPDATE:

An Act whose immediate and primary outcome (post-condition) is the alteration of the physical condition of the subject.

Examples:: Procedures may involve the disruption of some body surface (e.g. an incision in a surgical procedure), but they also include conservative procedures such as reduction of a luxated join, chiropractic treatment, massage, balneotherapy, acupuncture, shiatsu, etc. Outside of clinical medicine, procedures may be such things as alteration of environments (e.g. straightening rivers, draining swamps, building dams) or the repair or change of machinery etc.
2.16.840.1.113883.5.6 en
UPDATE:

A procedure for obtaining a specimen from a source entity.

2.16.840.1.113883.5.6 en
UPDATE:

A type of Manufactured Material that is administered to a living subject, either by a healthcare professional or auto-administered, within a healthcare context.

2.16.840.1.113883.5.1060 en
UPDATE:

A type of Administered Substance that is manufactured from raw organic or inorganic ingredients and used in the course of a patient's therapy.

2.16.840.1.113883.5.1060 en
UPDATE: No description 2.16.840.1.113883.5.30 en UPDATE:

Covered party to an insurance policy has coverage through full-time or part-time attendance at a recognized educational institution as defined by a particular insurance policy.

2.16.840.1.113883.5.111 en
UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE:

List of condition observations.

2.16.840.1.113883.5.4 en
UPDATE:

A set of codes identifying specific countries.

1.0.3166.1 en
UPDATE:

An entity entering the data into the originating system. The data entry entity is collected optionally for internal quality control purposes. This includes the transcriptionist for dictated text transcribed into electronic form.

2.16.840.1.113883.5.90 en
UPDATE:

An entity that is the subject of an investigation. This role is scoped by the party responsible for the investigation.

2.16.840.1.113883.5.110 en
UPDATE:

Testing to measure the minimum concentration of the antibacterial agent in a given culture medium below which bacterial growth is not inhibited.

2.16.840.1.113883.5.84 en
UPDATE: No description 2.16.840.1.113883.5.84 en UPDATE:

Test methods designed to determine a microorganismaTMs susceptibility to being killed by an antibiotic.

2.16.840.1.113883.5.84 en
UPDATE:

Enumerates the moods that an Act can take when describing privileges.

2.16.840.1.113883.5.1001 en
UPDATE:

Identifies why a specific query, request, or other trigger event occurred.

2.16.840.1.113883.5.8 2.16.840.1.113883.5.4 en
UPDATE:

**Description:**Identifies the reason or rational for why a person is eligible for benefits under an insurance policy or program.

Examples:A new employee is eligible for health insurance as an employment benefit. A person meets eligibility criteria for government program coverage based on financial, age or health status.
2.16.840.1.113883.5.8 en
UPDATE:

Indicates the result of a particular allergy test. E.g. Negative, Mild, Moderate, Severe

2.16.840.1.113883.5.1063 en
UPDATE:

Indicates types of allergy and intolerance agents which are non-drugs. (E.g. foods, latex, etc.)

2.16.840.1.113883.5.1060 en
UPDATE:

Hypersensitivity resulting in an adverse reaction upon exposure to an agent.

2.16.840.1.113883.5.4 en
UPDATE:

Hypersensitivity to an agent caused by an immunologic response to an initial exposure.

2.16.840.1.113883.5.4 en
UPDATE:

Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure

2.16.840.1.113883.5.4 en
UPDATE:

Hypersensitivity resulting in an adverse reaction upon exposure to a drug.

2.16.840.1.113883.5.4 en
UPDATE:

Hypersensitivity resulting in an adverse reaction upon exposure to food.

2.16.840.1.113883.5.4 en
UPDATE:

Hypersensitivity resulting in an adverse reaction upon exposure to environmental conditions.

2.16.840.1.113883.5.4 en
UPDATE: No description 2.16.840.1.113883.5.84 en UPDATE:

Describes the type of substance administration being performed.

2.16.840.1.113883.5.4 en
UPDATE:

The introduction of an immunogen with the intent of stimulating an immune response, aimed at preventing subsequent infections by more viable agents.

2.16.840.1.113883.5.4 en
UPDATE:

Codes used to identify different types of 'duration-based' working lists. Examples include "Continuous/Chronic", "Short-Term" and "As-Needed".

2.16.840.1.113883.5.4 en
UPDATE:

Distinguishes the kinds of coded observations that could be the trigger for clinical issue detection. These are observations that are not measurable, but instead can be defined with codes. Coded observation types include: Allergy, Intolerance, Medical Condition, Pregnancy status, etc.

2.16.840.1.113883.5.4 en
UPDATE:

A coded description of the reason for why a patient did not receive a scheduled immunization.

(important for public health strategy

2.16.840.1.113883.5.8 en
UPDATE:

Indicates why a fulfiller refused to fulfill a supply order, and considered it important to notify other providers of their decision. E.g. "Suspect fraud", "Possible abuse", "Contraindicated".

(used when capturing 'refusal to fill' annotations)

2.16.840.1.113883.5.8 en
UPDATE:

Reasons why substitution of a substance administration request is not permitted.

2.16.840.1.113883.5.8 en
UPDATE:

Identifies the specific hierarchical relationship between the playing and scoping medications.

Examples:Generic, Generic Formulation, Therapeutic Class, etc.
2.16.840.1.113883.5.111 en
UPDATE:

A Type of medicine that creates an immune protection without the recipient experiencing the disease.

2.16.840.1.113883.5.1060 en
UPDATE:

The set of body locations to or through which a drug product may be administered.

2.16.840.1.113883.5.1052 en
UPDATE:

A "helper" vocabulary used to construct complex query filters based on how and whether a prescription has been dispensed.

2.16.840.1.113883.5.1096 en
UPDATE:

Characterizes how a transportation act was or will be carried out.

Examples:Via private transport, via public transit, via courier.
2.16.840.1.113883.5.4 en
UPDATE:

Definition: Characterizes how a patient was or will be transported to the site of a patient encounter.

Examples:Via ambulance, via public transit, on foot.
2.16.840.1.113883.5.4 en
UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE:

**Description:**Identifies the reason or rational for why a person is eligible for benefits under an insurance policy or program.

Examples:A new employee is eligible for health insurance as an employment benefit. A person meets eligibility criteria for government program coverage based on financial, age or health status.
2.16.840.1.113883.5.8 en
UPDATE:

Used to indicate that the participation is a filtered subset of the total participations of the same type owned by the Act.

Used when there is a need to limit the participations to the first, the last, the next or some other filtered subset.

2.16.840.1.113883.5.1099 en
UPDATE:

**Description:**Limits confidentiality to effectively a yes/no decision.

*Usage Note:*x\_VeryBasicConfidentialityKind is a subset of Confidentiality codes that are used as metadata indicating the receiver responsibility to comply with normally applicable jurisdictional privacy law or disclosure authorization or that the receiver may not disclose this information except as directed by the information custodian, who may be the information subject.

2.16.840.1.113883.5.25 en
UPDATE:

Restricts participation to either physical or verbal

2.16.840.1.113883.5.1064 en
UPDATE:

Restricts substitution to effectively a yes/no decision

2.16.840.1.113883.5.1071 en
UPDATE:

Restricts scheme to e-mail or phone numbers at which a human can be reached

2.16.840.1.113883.5.143 en
UPDATE:

Restricts scheme to phone numbers at which a human can be reached

2.16.840.1.113883.5.143 en
UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE:

A non-mandated intent to perform an act. Used to record intents that are explicitly not Orders. Professional responsibility for the 'proposal' may or may not be present.

2.16.840.1.113883.5.1001 en
UPDATE:

Indicates that the target of the participation is involved in some manner in the act, but does not qualify how.

This shouldnotbe used except when no more specific participation type is known or when the participation type is further clarified elsewhere. It should not be used lightly, and should never be used as a "placeholder" when a more appropriate specific type does not yet exist.
2.16.840.1.113883.5.90 en
UPDATE: No description 2.16.840.1.113883.5.111 en UPDATE:

Codes identifying nation states. Allows for finer grained specification of Entity with classcode <= NAT

*Example:*ISO3166 country codes.

2.16.840.1.113883.5.1060 en
UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE:

**Definition:**Indicates the set of information types which may be manipulated or referenced, such as for recommending access restrictions.

2.16.840.1.113883.5.4 en
UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE:

**Definition:**Contains domains for act reasons used in clinical research.

2.16.840.1.113883.5.8 en
UPDATE:

**Definition:**Specifies the reason that an event occurred in a clinical research study.

2.16.840.1.113883.5.8 en
UPDATE:

**Definition:**SSpecifies the reason that a test was performed or observation collected in a clinical research study.

**Note:**This set of codes are not strictly reasons, but are used in the currently Normative standard. Future revisions of the specification will model these as ActRelationships and thes codes may subsequently be retired. Thus, these codes should not be used for new specifications.

2.16.840.1.113883.5.8 en
UPDATE:

**Definition:**The ways the age of an entity involved in an act can be measured, calculated or otherwise expressed in order to provide context for another act.

2.16.840.1.113883.5.4 en
UPDATE:

**Definition:**The set of LOINC codes for the act of determining the period of time that has elapsed since an entity was born or created.

2.16.840.1.113883.5.4 en
UPDATE:

The observation/test result is interpreted as being outside the inclusion range for a particular protocol within which the result is being reported.

Example:A positive result on a Hepatitis screening test.Open Issue:We are not deprecating this value set at this time, but instead are leaving open the consideration of deprecation in the future. \[Note: The concepts included in this value set have also been suggested for future deprecation, and there are no associated concept subdomains or bindings.\]
2.16.840.1.113883.5.83 en
UPDATE:

The observation/test result is interpreted as being outside the inclusion range for a particular protocol within which the result is being reported.

Example:A positive result on a Hepatitis screening test.Open Issue:We are not deprecating this value set at this time, but instead are leaving open the consideration of deprecation in the future. \[Note: The concepts included in this value set have also been suggested for future deprecation, and there are no associated concept subdomains or bindings. Note also that the name of the value set appears to have a typo in it from the old cycle when it was originally added.\]
2.16.840.1.113883.5.83 en
UPDATE: No description 2.16.840.1.113883.5.45 en UPDATE: No description 2.16.840.1.113883.5.1001 en UPDATE: No description 2.16.840.1.113883.5.1001 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: Definition:A new act that carries forward the intention of the original act, but does not completely replace it. The status of the predecessor act must be 'completed'. The original act is the target act and the successor is the source act. 2.16.840.1.113883.5.1002 en UPDATE:

An observation denoting the physical location of a person or thing based on a reference coordinate system.

2.16.840.1.113883.5.6 en
UPDATE: Description:The EPSG (European Petroleum Survey Group) dataset represents all Datums, coordinate references (projected and 2D geographic) and coordinate systems (including Cartesian coordinate systems) used in surveying worldwide. Each record includes a 4-8 digit unique identifier. The current version is available from http://www.epsg.org/. The database contains over 4000 records covering spatial data applications worldwide. 2.16.840.1.113883.6.242 en UPDATE: Description:The South Carolina Department of Health and Environmental Control GIS Spatial Data Accuracy Tiers have been derived from the National Standard for Spatial Data Accuracy as a means to categorize the accuracy of spatial data assignment utilizing a variety of tools for capturing coordinates including digitizers, geocoding software and global positioning system devices. 2.16.840.1.113883.6.241 en UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE:

**Description:**Identifies why a change is being made to a record.

2.16.840.1.113883.5.8 en
UPDATE:

**Description:**Concepts representing indications (reasons for clinical action) other than diagnosis and symptoms.

2.16.840.1.113883.5.4 en
UPDATE:

**Description:**Indicates why the prescription should be suspended.

2.16.840.1.113883.5.8 en
UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE: No description 2.16.840.1.113883.5.8 2.16.840.1.113883.5.4 en UPDATE:

**Definition:**A collection of concepts that indicate why the prescription should be released from suspended state.

2.16.840.1.113883.5.8 en
UPDATE: No description 2.16.840.1.113883.5.8 en UPDATE: No description 2.16.840.1.113883.5.8 en UPDATE:

**Definition:**A collection of concepts that identifies why a renewal prescription has been refused.

2.16.840.1.113883.5.8 en
UPDATE:

**Definition:**A collection of concepts that indicates why the prescription should no longer be allowed to be dispensed (but can still administer what is already being dispensed).

2.16.840.1.113883.5.8 en
UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE:

**Description:**The type and scope of responsibility taken-on by the performer of the Act for a specific subject of care.

2.16.840.1.113883.5.4 en
UPDATE:

**Description:**The type and scope of legal and/or professional responsibility taken-on by the performer of the Act for a specific subject of care as described by a credentialing agency, i.e. government or non-government agency. Failure in executing this Act may result in loss of credential to the person or organization who participates as performer of the Act. Excludes employment agreements.

**Example:**Hospital license; physician license; clinic accreditation.

2.16.840.1.113883.5.4 en
UPDATE:

**Description:**The type and scope of legal and/or professional responsibility taken-on by the performer of the Act for a specific subject of care as described by an agency for credentialing individuals.

2.16.840.1.113883.5.4 en
UPDATE:

**Description:**The type and scope of legal and/or professional responsibility taken-on by the performer of the Act for a specific subject of care as described by an agency for credentialing individuals.

2.16.840.1.113883.5.4 en
UPDATE:

Values for observations of verification act results

Examples:Verified, not verified, verified with warning.
2.16.840.1.113883.5.1063 en
UPDATE:

Identifies the type of verification investigation being undertaken with respect to the subject of the verification activity.

Examples:
  • Verification of eligibility for coverage under a policy or program - aka enrolled/covered by a policy or program

  • Verification of record - e.g., person has record in an immunization registry

  • Verification of enumeration - e.g. NPI

  • Verification of Board Certification - provider specific

  • Verification of Certification - e.g. JAHCO, NCQA, URAC

  • Verification of Conformance - e.g. entity use with HIPAA, conformant to the CCHIT EHR system criteria

  • Verification of Provider Credentials

  • Verification of no adverse findings - e.g. on National Provider Data Bank, Health Integrity Protection Data Base (HIPDB)

2.16.840.1.113883.5.4 en
UPDATE:

Code for the mechanism by which disease was acquired by the living subject involved in the public health case. Includes sexually transmitted, airborne, bloodborne, vectorborne, foodborne, zoonotic, nosocomial, mechanical, dermal, congenital, environmental exposure, indeterminate.

2.16.840.1.113883.5.4 en
UPDATE:

The spatial relationship of a subject whether human, other animal, or plant, to a frame of reference such as gravity or a collection device.

2.16.840.1.113883.5.6 en
UPDATE: Deprecation Comment:This value set has been deprecated because its root code was deprecated in an earlier vocabulary release. 2.16.840.1.113883.5.6 en UPDATE: Deprecation Comment:This value set has been deprecated because its root code was deprecated in an earlier vocabulary release. 2.16.840.1.113883.5.6 en UPDATE:

A role recognized through the eligibility of an identified living subject for benefits covered under an insurance policy or a program. Eligibility as a covered party may be conditioned on a relationship with (1) the policy holder such as the policy holder who is covered as an individual under a poliy or as a party sponsored for coverage by the policy holder.

**Example:**An employee as a subscriber; or (2) on being scoped another covered party such as the subscriber, as in the case of a dependent.

Discussion:The Abstract Value Set "CoverageRoleType", which was developed for use in the Canadian realm "pre-coordinate" coverage roles with other roles that a covered party must play in order to be eligible for coverage, e.g., "handicapped dependent". Other codes in the Abstract Value Set CoveredPartyRoleType domain can be "post-coordinated" with the EligiblePartyRoleType codes to denote comparable concepts. Decoupling the concepts is intended to support a wider range of concepts and semantic comparability of coded concepts.
2.16.840.1.113883.5.111 en
UPDATE: Description:A relationship between a party that receives benefit coverage under the terms of an insurance policy or program and the underwriter of the policy or program. The role is played by the party that receives benefit coverage under the terms of a particular insurance policy or program. The organization playing the underwriter of that policy or program is the scoping entity.

A covered party receives coverage under a policy because of some contractual or other relationship with the policy holder. In most cases, the policy holder has discretion over which parties may be covered under a policy, unless the policy holder assigns or is required by a court to assign this right.

A covered party receives coverage under a program by being determined eligible based on program eligibility criteria specified by the program sponsor.

Discussion:This reason for coverage is specified by use of a role type code from either of the abstract value sets beneath the PolicyOrProgramCoverageRoleType abstract value set.

The CoverageRoleType abstract value set can only be used when the role class is the concept code "covered party" (COVPTY) because this value set contains precoordinated coded concepts relating to coverage criteria that was developed for the Canadian realm. This is to avoid overlapping concepts, e.g., the DEPEN role.class cannot be used with the FAMDEP Role.code

The CoveredPartyRoleType abstract value set may be used with any of the covered party role class codes to support post coordination of coverage criteria. Where coverage under a policy depends on the concurrence of a policy holder, a relationship link with type code of indirect authority should be included using the policy holder role as the source, and the covered party role as the target.

Note:A particular policy may cover several parties, one of whom may be, but need not be, the policy holder. Thus the notion of covered party is a role that is distinct from that of the policy holder.Note:The entity playing the role of covered party is an organization, a non-person living subject or a group of persons, the role class codes Subscriber and Dependent may not be used.
2.16.840.1.113883.5.110 en
UPDATE: Description:A role played by a party to an insurance policy to which the insurer agrees to indemnify for losses, provides benefits for, or renders services. A named insured may be either a person, non-person living subject, or an organization, or a group of persons, non-person living subjects, or organizations.Discussion:The coded concept NAMED should not be used where a more specific child concept in this Specializable value set applies. In some cases, the named insured may not be the policy holder, e.g., where a policy holder purchases life insurance policy in which another party is the named insured and the policy holder is the beneficiary of the policy.Note:The party playing the role of a named insured is not a claimant in the sense conveyed by the RoleClassCoveredParty CLAIM (claimant). However, a named insured may make a claim under a policy, e.g., e.g., a party that is the named insured and policy holder under a comprehensive automobile insurance policy may become the claimant for coverage under that policy e.g., if injured in an automobile accident and there is no liable third party. In the case of a named insured making a claim, a role type code INSCLM (insured claimant) subtypes the class to indicate that a named insured has filed a claim for a loss.Example:The named insured under a comprehensive automobile, disability, or property and casualty policy that is the named insured and may or may not be the policy holder. 2.16.840.1.113883.5.110 en UPDATE: Description:A role recognized through the eligibility of an identified party for benefits covered under an insurance policy or a program based on meeting eligibility criteria.

Eligibility as a covered party may be conditioned on the party meeting criteria to qualify for coverage under a policy or program, which may be mandated by law. These criteria may be:

  • The sole basis for coverage, e.g., being differently abled may qualify a person for disability coverage

  • May more fully qualify a covered party role e.g, being differently abled may qualify an adult child as a dependent

  • May impact the level of coverage for a covered party under a policy or program, e.g., being differently abled may qualify a program eligible for additional benefits.

Discussion:The Abstract Value Set "CoverageRoleType", which was developed for use in the Canadian realm "pre-coordinate" coverage roles with other roles that a covered party must play in order to be eligible for coverage, e.g., "handicapped dependent". These role.codes may only be used with COVPTY to avoid overlapping concepts that would result from using them to specify the specializations of COVPTY, e.g., the role.class DEPEN should not be used with the role.code family dependent because that relationship has overlapping concepts due to the role.code precoodination and is conveyed in FICO with the personal relationship role that has a PART role link to the covered party role. For the same reasons, the role.class DEPEN should not be used with the role.code HANDIC (handicapped dependent); the role.code DIFFABLE (differently abled) should be used instead.

In summary, the coded concepts in the Abstract Value Set "CoveredPartyRoleType" can be "post-coordinated" with the "RoleClassCoveredParty" Abstract Value Set. Decoupling these concepts is intended to support an expansive range of covered party concepts and their semantic comparability.

2.16.840.1.113883.5.111 en
UPDATE:

**Description**A role recognized through the eligibility of a party play a claimant for benefits covered or provided under an insurance policy.

2.16.840.1.113883.5.111 en
UPDATE:

**Description:**A role recognized through the eligibility of a party to play a program eligible for benefits covered or provided under a program.

2.16.840.1.113883.5.111 en
UPDATE: Definition:A person playing the role of program eligible under a program based on military status.Discussion:This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the person's status as a member of the military meets jurisdictional or program criteria 2.16.840.1.113883.5.111 en UPDATE:

**Description**A role recognized through the eligibility of a party to play an individual insured for benefits covered or provided under an insurance policy where the party is also the policy holder.

2.16.840.1.113883.5.111 en
UPDATE: Description:A role recognized through the eligibility of a party to play a subscriber for benefits covered or provided under a health insurance policy. 2.16.840.1.113883.5.111 en UPDATE: Description:A role recognized through the eligibility of a party to play a dependent for benefits covered or provided under a health insurance policy because of an association with the subscriber that is recognized by the policy underwriter. 2.16.840.1.113883.5.111 en UPDATE:

**Description:**Direct participation in an exposure act where it is unknown that the participant is the source or subject of the exposure. If the participant is known to be the contact of an exposure then the EXPTRGT participation type should be used. If the participant is known to be the source then the EXSRC participation type should be used.

2.16.840.1.113883.5.90 en
UPDATE:

**Description:**A mandate, regulation, obligation, requirement, rule, or expectation unilaterally imposed by one party on:

* The activity of another party * The behavior of another party * The manner in which an act is executed

2.16.840.1.113883.5.6 en
UPDATE:

**Description:**Indicates how result sets should be filtered based on whether they have associated issues.

2.16.840.1.113883.5.1096 en
UPDATE: No description 2.16.840.1.113883.5.4 2.16.840.1.113883.6.1 en UPDATE:

**Definition:**An identifying modifier code for healthcare interventions or procedures.

2.16.840.1.113883.5.4 en
UPDATE: No description 2.16.840.1.113883.5.6 en UPDATE:

**Description:**Identifies the order in which content should be processed.

2.16.840.1.113883.5.1110 en
UPDATE:

**Description:**An observation of genomic phenomena.

2.16.840.1.113883.5.6 en
UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE:

**Description:**Identifies reasons for nullifying (retracting) a particular control act.

**Examples:**"Entered in error", "altered decision", etc.

2.16.840.1.113883.5.8 en
UPDATE:

The role played by a party who has legal responsibility for another party.

2.16.840.1.113883.5.111 en
UPDATE:

A relationship between two people in which one person authorizes another to act for him in a manner which is a legally binding upon the person giving such authority as if he or she personally were to do the acts.

2.16.840.1.113883.5.111 en
UPDATE:

The action of coming into sufficient physical proximity to allow physical or chemical interaction. Examples include: exposure to radiation, inhalation of peanut aerosol or viral particles. This includes intended exposure (e.g. administering a drug product) as well as accidental or environmental exposure. Actual vs. potential exposure can be differentiated using Act.uncertaintyCode.

The agent to which the subject was exposed is conveyed as aDirectparticipation or specialization there-of.Constraints:The following Participations should be used with the following Roles and Entities to distinguish the specific entities:

* The ***exposed entity*** is the entity of interest that is the recipient of the exposure and potentially affected. This is conveyed through the subject (SBJ) Participation. * An entity that has carried the agent transmitted in the exposure is the "***exposure source***" (EXSRC). For example: * a person or animal who carried an infectious disease and interacts (EXSRC) with another person or animal (SBJ) transmitting the disease agent; or * a place or other environment (EXSRC) and a person or animal (SBJ) who is exposed in the presence of this environment. * When it is unknown whether a participating entity is the source of the agent (EXSRC) or the target of the transmission (SBJ), also known as "***exposure contact***", the "participant" (PART) is used. * The substance to which the subject is exposed that carries the exposure agent or the chemical substance of interest itself, participates as a "consumable" (CSM). There are at least two configurations: (a) the player of the Role that participates as CSM is the chemical or biological substance mixed or carried by the scoper-entity of the Role (e.g., ingredient role); or (b) the player of the Role that participates as CSM is a mixture known to contain the chemical, radiological or biological substance of interest. * The device specifically used to administer the substance is associated using the device (DEV) Participation. This may be a device intentionally used (such as applicator device) or it may be a thing that accidentally carried this substance; for instance, an infected needle or knife. The same entity may be related in the act as both EXSRC and DEV.

2.16.840.1.113883.5.6 en
UPDATE:

**Description:**A code specifying the meaning and purpose of every TransmissionRelationship instance. Each of its values implies specific constraints to what kinds of Transmission objects can be related and in which way.

2.16.840.1.113883.5.1111 en
UPDATE:

A criterion or condition over actual and potential services that must apply for an associated service to be considered. Matches records any ActMoodCompletionTrack moods.

2.16.840.1.113883.5.1001 en
UPDATE:

A person reviews a list of microbiology results of a given patient.

2.16.840.1.113883.5.4 en
UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE:

A person reviews a list of medication orders submitted to a given patient

2.16.840.1.113883.5.4 en
UPDATE:

A person reviews a Risk Assessment Instrument report of a given patient.

2.16.840.1.113883.5.4 en
UPDATE:

A person reviews a clinical note of a given patient.

2.16.840.1.113883.5.4 en
UPDATE:

A person (e.g., clinician, the patient herself) reviews patient information in the electronic medical record.

2.16.840.1.113883.5.4 en
UPDATE:

A clinician enters a clinical note about a given patient

2.16.840.1.113883.5.4 en
UPDATE:

A person enters documentation about a given patient.

2.16.840.1.113883.5.4 en
UPDATE: Description:A task or action that a user may perform in a clinical information system. 2.16.840.1.113883.5.4 en UPDATE:

**Description:**PayorRoleType for a particular type of policy or program benefit package or plan where more detail about the coverage administration role of the Payor is required. The functions performed by a Payor qualified by a PayorRoleType may be specified by the PayorParticpationFunction value set.

**Examples:**A Payor that is a TPA may administer a managed care plan without underwriting the risk.

2.16.840.1.113883.5.111 en
UPDATE: Definition:Set of codes indicating the type of insurance policy or program that pays for the cost of benefits provided to covered parties. 2.16.840.1.113883.5.4 en UPDATE: Definition:Set of codes indicating the type of insurance policy. Insurance, in law and economics, is a form of risk management primarily used to hedge against the risk of potential financial loss. Insurance is defined as the equitable transfer of the risk of a potential loss, from one entity to another, in exchange for a premium and duty of care. A policy holder is an individual or an organization enters into a contract with an underwriter which stipulates that, in exchange for payment of a sum of money (a premium), one or more covered parties (insureds) is guaranteed compensation for losses resulting from certain perils under specified conditions. The underwriter analyzes the risk of loss, makes a decision as to whether the risk is insurable, and prices the premium accordingly. A policy provides benefits that indemnify or cover the cost of a loss incurred by a covered party, and may include coverage for services required to remediate a loss. An insurance policy contains pertinent facts about the policy holder, the insurance coverage, the covered parties, and the insurer. A policy may include exemptions and provisions specifying the extent to which the indemnification clause cannot be enforced for intentional tortious conduct of a covered party, e.g., whether the covered parties are jointly or severably insured.Discussion:In contrast to programs, an insurance policy has one or more policy holders, who own the policy. The policy holder may be the covered party, a relative of the covered party, a partnership, or a corporation, e.g., an employer. A subscriber of a self-insured health insurance policy is a policy holder. A subscriber of an employer sponsored health insurance policy is holds a certificate of coverage, but is not a policy holder; the policy holder is the employer. See CoveredRoleType. 2.16.840.1.113883.5.4 en UPDATE: Definition:Set of codes indicating the type of health insurance policy that covers health services provided to covered parties. A health insurance policy is a written contract for insurance between the insurance company and the policyholder, and contains pertinent facts about the policy owner (the policy holder), the health insurance coverage, the insured subscribers and dependents, and the insurer. Health insurance is typically administered in accordance with a plan, which specifies (1) the type of health services and health conditions that will be covered under what circumstances (e.g., exclusion of a pre-existing condition, service must be deemed medically necessary; service must not be experimental; service must provided in accordance with a protocol; drug must be on a formulary; service must be prior authorized; or be a referral from a primary care provider); (2) the type and affiliation of providers (e.g., only allopathic physicians, only in network, only providers employed by an HMO); (3) financial participations required of covered parties (e.g., co-pays, coinsurance, deductibles, out-of-pocket); and (4) the manner in which services will be paid (e.g., under indemnity or fee-for-service health plans, the covered party typically pays out-of-pocket and then file a claim for reimbursement, while health plans that have contractual relationships with providers, i.e., network providers, typically do not allow the providers to bill the covered party for the cost of the service until after filing a claim with the payer and receiving reimbursement). 2.16.840.1.113883.5.4 en UPDATE: Definition:A set of codes used to indicate coverage under a program. A program is an organized structure for administering and funding coverage of a benefit package for covered parties meeting eligibility criteria, typically related to employment, health, financial, and demographic status. Programs are typically established or permitted by legislation with provisions for ongoing government oversight. Regulations may mandate the structure of the program, the manner in which it is funded and administered, covered benefits, provider types, eligibility criteria and financial participation. A government agency may be charged with implementing the program in accordance to the regulation. Risk of loss under a program in most cases would not meet what an underwriter would consider an insurable risk, i.e., the risk is not random in nature, not financially measurable, and likely requires subsidization with government funds.Discussion:Programs do not have policy holders or subscribers. Program eligibles are enrolled based on health status, statutory eligibility, financial status, or age. Program eligibles who are covered parties under the program may be referred to as members, beneficiaries, eligibles, or recipients. Programs risk are underwritten by not for profit organizations such as governmental entities, and the beneficiaries typically do not pay for any or some portion of the cost of coverage. See CoveredPartyRoleType. 2.16.840.1.113883.5.4 en UPDATE: Definition:An insurance policy for losses sustained in an automobile accident that typically covers losses incurred by the named insured and parties who may be claimants for losses, such as pedestrians and passengers. 2.16.840.1.113883.5.4 en UPDATE: Definition:Government mandated program providing coverage, disability income, and vocational rehabilitation for injuries sustained in the work place or in the course of employment. Employers may either self-fund the program, purchase commercial coverage, or pay a premium to a government entity that administers the program. Employees may be required to pay premiums toward the cost of coverage as well.

Managed care policies specifically exclude coverage for losses insured under a disability policy, workers' compensation program, liability insurance (including automobile insurance); or for medical expenses, coverage for on-site medical clinics or for limited dental or vision benefits when these are provided under a separate policy.

Discussion:Managed care policies are offered by managed care plans that contract with selected providers or health care organizations to provide comprehensive health care at a discount to covered parties and coordinate the financing and delivery of health care. Managed care uses medical protocols and procedures agreed on by the medical profession to be cost effective, also known as medical practice guidelines. Providers are typically reimbursed for covered services by a capitated amount on a per member per month basis that may reflect difference in the health status and level of services anticipated to be needed by the member.
2.16.840.1.113883.5.4 en
UPDATE: Definition:A policy under which the insurer agrees to pay a sum of money upon the occurrence of the covered partys death. In return, the policyholder agrees to pay a stipulated amount called a premium at regular intervals. Life insurance indemnifies the beneficiary for the loss of the insurable interest that a beneficiary has in the life of a covered party. For persons related by blood, a substantial interest established through love and affection, and for all other persons, a lawful and substantial economic interest in having the life of the insured continue. An insurable interest is required when purchasing life insurance on another person. Specific exclusions are often written into the contract to limit the liability of the insurer; for example claims resulting from suicide or relating to war, riot and civil commotion.

*Discussion:*A life insurance policy may be used by the covered party as a source of health care coverage in the case of a viatical settlement, which is the sale of a life insurance policy by the policy owner, before the policy matures. Such a sale, at a price discounted from the face amount of the policy but usually in excess of the premiums paid or current cash surrender value, provides the seller an immediate cash settlement. Generally, viatical settlements involve insured individuals with a life expectancy of less than two years. In countries without state-subsidized healthcare and high healthcare costs (e.g. United States), this is a practical way to pay extremely high health insurance premiums that severely ill people face. Some people are also familiar with life settlements, which are similar transactions but involve insureds with longer life expectancies (two to fifteen years).

2.16.840.1.113883.5.4 en
UPDATE: Definition:A a public or governmental health program with an organized structure for administering and funding coverage of a benefit package for covered parties meeting eligibility criteria, typically related to employment, health and financial status. These programs are established by legislation with provisions for ongoing government oversight. Regulations mandate the structure of the program, the manner in which it is funded and administered, covered benefits, provider types, eligibility criteria and financial participation. A government agency may be charged with implementing the program in accordance to the regulation.

For example, A Canadian provincial or national health plan such as the BC MSP (British Columbia Medical Services Plan) OHIP (Ontario Health Insurance Plan), NHS (National Health Service). Examples of U.S. government funded health programs include those for maternity case management, behavioral health, and HIV-AIDs, such as the Ryan White program.

2.16.840.1.113883.5.4 en
UPDATE: Definition:A public or government health program that administers and funds coverage for health and social services to assist program eligible who meet financial and health status criteria related to a particular disease.Example:Reproductive health, sexually transmitted disease, and end renal disease programs. 2.16.840.1.113883.5.4 en UPDATE: Definition:A government health program that provides coverage for health services to persons meeting eligibility criteria such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds. 2.16.840.1.113883.5.4 en UPDATE:

**Description:**Accommodation type. In Intent mood, represents the accommodation type requested. In Event mood, represents accommodation assigned/used. In Definition mood, represents the available accommodation type.

2.16.840.1.113883.5.4 en
UPDATE:

**Description:**The billable codes selected for Clinical Product Invoices. Steward is Financial Management.

2.16.840.1.113883.5.1060 en
UPDATE:

**Description:**Animals, including fish and insects, and microorganisms which may participate as assigned entities in biotherapies.

2.16.840.1.113883.5.111 en
UPDATE:

**Description:**A role type that is used to further qualify a non-person subject playing a role where the role class attribute is set to RoleClass AssignedEntity

2.16.840.1.113883.5.111 en
UPDATE:

**Description:**Codes used to specify reasons or criteria relating to coverage provided under a policy or program. May be used to convey reasons pertaining to coverage contractual provisions, including criteria for eligibility, coverage limitations, coverage maximums, or financial participation required of covered parties.

2.16.840.1.113883.5.8 en
UPDATE:

**Description:**Codes that indicate a specific type of sponsor. Used when the sponsor's role is only either as a fully insured sponsor or only as a self-insured sponsor. NOTE: Where a sponsor may be either, use the SponsorParticipationFunction.code (fully insured or self insured) to indicate the type of responsibility. (CO6-0057)

2.16.840.1.113883.5.111 en
UPDATE:

**Description:**United Nations Standard Products and Services Classification, managed by Uniform Code Council (UCC): www.unspsc.org

2.16.840.1.113883.5.4 en
UPDATE:

**Description:**Universal Product Code is one of a wide variety of bar code languages widely used in the United States and Canada for items in stores.

2.16.840.1.113883.5.4 en
UPDATE:

**Description:**Types of policies that further specify the ActClassPolicy value set.

2.16.840.1.113883.5.4 en
UPDATE: Definition:When identifying the "request" that resulted in an encounter, there is a need to distinguish whether the "request" was a general referral (CareProvisionRequest) or a more specific ordered or scheduled encounter (PatientEncounter). 2.16.840.1.113883.5.6 en UPDATE: No description 2.16.840.1.113883.5.6 en UPDATE: No description 2.16.840.1.113883.5.6 en UPDATE: No description 2.16.840.1.113883.5.14 en UPDATE: No description 2.16.840.1.113883.5.14 en UPDATE: Definition:A living arrangement within a private residence for single family. 2.16.840.1.113883.5.63 en UPDATE: Definition:Living arrangements lacking a permanent residence. 2.16.840.1.113883.5.63 en UPDATE: Definition:Use to convey the reason that a provider may or has accessed personal healthcare information. Typically, this involves overriding the subject's consent directives. 2.16.840.1.113883.5.8 en UPDATE: Definition:Consent to access healthcare information. 2.16.840.1.113883.5.4 en UPDATE: Definition:Consent to have healthcare information in an electronic health record accessed for research purposes. 2.16.840.1.113883.5.4 en UPDATE: Definition:The type of consent directive, e.g., to consent or dissent to collect, access, or use in specific ways within an EHRS or for health information exchange; or to disclose health information for purposes such as research. 2.16.840.1.113883.5.4 en UPDATE: Definition:Set of codes indicating the manner in which sponsors, underwriters, and payers participate in a policy or program. 2.16.840.1.113883.5.88 en UPDATE: Definition:Set of codes indicating the manner in which underwriters participate in a policy or program. 2.16.840.1.113883.5.88 en UPDATE: Definition:Set of codes indicating the manner in which sponsors participate in a policy or program. NOTE: use only when the Sponsor is not further specified with a SponsorRoleType as being either a fully insured sponsor or a self insured sponsor. 2.16.840.1.113883.5.88 en UPDATE: Definition:Set of codes indicating the manner in which payors participate in a policy or program.</ 2.16.840.1.113883.5.88 en UPDATE: Definition:Codes representing the maximum coverate or financial participation requirements. 2.16.840.1.113883.5.4 en UPDATE:

The type of personal health information to which the subject of the information, or the delegate of the subject, consents or dissents to authorize access.

2.16.840.1.113883.5.4 en
UPDATE: Definition:The number of matching instances (number of focal classes). The document header class is the focal class of a document, a record would therefore be equal to a document. 2.16.840.1.113883.5.1112 en UPDATE:

Codes specify the category of observation, evidence, or document used to assess for services, e.g., discharge planning, or to establish eligibility for coverage under a policy or program. The type of evidence is coded as observation values.

2.16.840.1.113883.5.1063 en
UPDATE:

Code specifying observations or indicators related to socio-economic status used to assess to assess for services, e.g., discharge planning, or to establish eligibility for coverage under a policy or program.

2.16.840.1.113883.5.1063 en
UPDATE:

Code specifying observations related to living situation for a person in a private residence.

2.16.840.1.113883.5.1063 en
UPDATE:

Continued living in private residence requires functional and health care assistance from spouse or life partner.

2.16.840.1.113883.5.1063 en
UPDATE:

Code specifying non-clinical indicators related to health status used to assess or establish eligibility for coverage under a policy or program, e.g., pregnancy, disability, drug use, mental health issues.

2.16.840.1.113883.5.1063 en
UPDATE:

Code specifying eligibility indicators used to assess or establish eligibility for coverage under a policy or program eligibility status, e.g., certificates of creditable coverage; student enrollment; adoption, marriage or birth certificate.

2.16.840.1.113883.5.1063 en
UPDATE:

Code specifying financial indicators used to assess or establish eligibility for coverage under a policy or program; e.g., pay stub; tax or income document; asset document; living expenses.

2.16.840.1.113883.5.1063 en
UPDATE:

Code specifying financial indicators used to assess or establish eligibility for coverage under a policy or program; e.g., pay stub; tax or income document; asset document; living expenses.

2.16.840.1.113883.5.1063 en
UPDATE:

Codes specifying asset indicators used to assess or establish eligibility for coverage under a policy or program.

2.16.840.1.113883.5.1063 en
UPDATE:

Codes specifying living expense indicators used to assess or establish eligibility for coverage under a policy or program.

2.16.840.1.113883.5.1063 en
UPDATE:

This code is used to specify the exact function an actor is authorized to have in a service in all necessary detail.

2.16.840.1.113883.5.88 en
UPDATE:

This code is used to specify the exact function an actor is authorized to have in authoring a consent directive.

2.16.840.1.113883.5.88 en
UPDATE:

This code is used to specify the exact function an actor is authorized to have in authoring a consent override.

2.16.840.1.113883.5.88 en
UPDATE:

This code is used to specify the exact function an actor is authorized to have as a receiver of information that is the subject of a consent directive or consent override.

2.16.840.1.113883.5.88 en
UPDATE:

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.

2.16.840.1.113883.5.4 en
UPDATE:

An exposure agent carrier is an entity that is capable of conveying an exposure agent from one entity to another. The scoper of the role must be the exposure agent (e.g., pathogen).

2.16.840.1.113883.5.110 en
UPDATE:

Concepts that identify the type or nature of exposure interaction. Examples include "household", "care giver", "intimate partner", "common space", "common substance", etc. to further describe the nature of interaction.

2.16.840.1.113883.5.4 en
UPDATE:

A qualitative measure of the degree of exposure to the causative agent. This includes concepts such as "low", "medium" and "high". This quantifies how the quantity that was available to be administered to the target differs from typical or background levels of the substance.

2.16.840.1.113883.5.1114 en
UPDATE:

Code for the mechanism by which the exposure agent was exchanged or potentially exchanged by the participants involved in the exposure.

2.16.840.1.113883.5.1113 en
UPDATE:

**Definition:**An observation that is considered to be desirable to occur in the future. The essential feature of a goal is that if it occurs it would be considered as a marker of a positive outcome or of progress towards a positive outcome.

**Examples:**Target weight below 80Kg, Stop smoking, Regain ability to walk, goal is to administer thrombolytics to candidate patients presenting with acute myocardial infarction.

Discussion:INT (intent) reflects a plan for the future, which is a declaration to do something. This contrasts with goal which doesn't represent an intention to act, merely a hope for an eventual result. A goal is distinct from the intended actions to reach that goal. "I will reduce the dose of drug x to 20mg" is an intent. "I hope to be able to get the patient to the point where I can reduce the dose of drug x to 20mg" is a goal. EXPEC (expectation) reflects a prediction rather than a hope. RSK (risk) reflects a potential negative event rather than a hope.
2.16.840.1.113883.5.1001 en
UPDATE:

An option is an alternative set of property-value bindings. Options specify alternative sets of values, typically used in definitions or orders to describe alternatives. An option can only be used as a group, that is, all assigned values must be used together.

Historical note: in HL7 v2.x option existed in the special case for alternative medication routes (RXR segment).

2.16.840.1.113883.5.1001 en
UPDATE:

A kind of service which is authorized to be performed.

2.16.840.1.113883.5.1001 en
UPDATE:

A request for authorization to perform a kind of service.

This is distinct from RQO which is a request for an actual act. PERMRQ is merely a request for permission to perform an act.*Discussion:*

2.16.840.1.113883.5.1001 en
UPDATE:

An intent to perform a service that has the strength of a commitment, i.e., other parties may rely on the originator of such promise that said originator will see to it that the promised act will be fulfilled. A promise can be either solicited or unsolicited.

2.16.840.1.113883.5.1001 en
UPDATE:

A non-mandated intent to perform an act where a level of professional responsibility is being accepted by making the proposal.

2.16.840.1.113883.5.1001 en
UPDATE:

A request or order for a service is an intent directed from a placer (request author) to a fulfiller (service performer).

Rationale:The concepts of a "request" and an "order" are viewed as different, because there is an implication of a mandate associated with order. In practice, however, this distinction has no general functional value in the inter-operation of health care computing. "Orders" are commonly refused for a variety of clinical and business reasons, and the notion of a "request" obligates the recipient (the fulfiller) to respond to the sender (the author). Indeed, in many regions, including Australia and Europe, the common term used is "request."

Thus, the concept embodies both notions, as there is no useful distinction to be made. If a mandate is to be associated with a request, this will be embodied in the "local" business rules applied to the transactions. Should HL7 desire to provide a distinction between these in the future, the individual concepts could be added as specializations of this concept.

The critical distinction here, is the difference between this concept and an "intent", of which it is a specialization. An intent involves decisions by a single party, the author. A request, however, involves decisions by two parties, the author and the fulfiller, with an obligation on the part of the fulfiller to respond to the request indicating that the fulfiller will indeed fulfill the request.

2.16.840.1.113883.5.1001 en
UPDATE:

**Definition:**An act that may occur in the future and which is regarded as undesirable. The essential feature of a risk is that if it occurs this would be regarded as a marker of a negative outcome or of deterioration towards a negative outcome. Recording a risk indicates that it is seen as more likely to occur in the subject than in a general member of the population but does not mean it is expected to occur.

**Examples:**Increased risk of DVT, at risk for sub-acute bacterial endocarditis.

**Discussion:**Note: An observation in RSK mood expresses the undesirable act, and not the underlying risk factor. A risk factor that is present (e.g. obesity, smoking, etc) should be expressed in event mood. INT (intent) reflects a plan for the future, which is a declaration to do something. This contrasts with RSK (risk), which is the potential that something negative will occur that may or may not ever happen. GOL (goal) reflects a hope to achieve something. EXPEC (expectation) is the prediction of a positive or negative event. This contrasts with RSK (risk), which is the potential that something negative will occur that may or may not ever happen, and may not be expected to happen.

2.16.840.1.113883.5.1001 en
UPDATE:

Periods of time on a schedule for a resource. Appointments occupy sets of one or more booked slots. A slot that is open for appointments is considered available and a slot that is held back for administrative purposes is considered blocked. A Resource slot that is "tentatively" booked is referred to as reserved.

2.16.840.1.113883.5.1001 en
UPDATE:

Condition is tested every time before execution of the service (WHILE condition DO service).

2.16.840.1.113883.5.10 en
UPDATE:

Condition is tested at the end of a repeated service execution. The service is repeated only if the condition is true (DO service WHILE condition).

2.16.840.1.113883.5.10 en
UPDATE:

Condition is tested once before the service is executed (IF condition THEN service).

2.16.840.1.113883.5.10 en
UPDATE:

Condition must be true throughout the execution and the service is interrupted (asynchronously) as soon as the condition turns false (asynchronous WHILE loop). The service must be interruptible.

2.16.840.1.113883.5.10 en
UPDATE:

Condition is a loop checkpoint, i.e. it is a step of an activity plan and, if negative causes the containing loop to exit.

2.16.840.1.113883.5.10 en
UPDATE:

Detach this branch from the other branches so it will not be resynchronized with the other branches.

2.16.840.1.113883.5.12 en
UPDATE:

When all other concurrent branches are terminated, interrupt and discontinue this branch.

2.16.840.1.113883.5.12 en
UPDATE:

Wait for this branch to terminate.

2.16.840.1.113883.5.12 en
UPDATE:

Wait for any one of the branches in the set of exclusive wait branches to terminate, then discontinue all the other exclusive wait branches.

2.16.840.1.113883.5.12 en
UPDATE:

The pre-condition associated with the branch is evaluated once and if true the branch may be entered. All other exclusive branches compete with each other and only one will be selected. This implements a COND, IF and CASE conditionals, or "XOR-split." The order in which the branches are considered may be specified in the priorityNumber attribute.

2.16.840.1.113883.5.13 en
UPDATE:

A branch is selected as soon as the pre-condition associated with the branch evaluates to true. If the condition is false, the branch may be entered later, when the condition turns true. All other exclusive branches compete with each other and only one will be selected. Each waiting branch executes in parallel with the default join code wait (see below). The order in which the branches are considered may be specified in the Service\_relationship.priority\_nmb.

2.16.840.1.113883.5.13 en
UPDATE:

A branch is executed if its associated preconditions permit. If associated preconditions do not permit, the branch is dropped. Inclusive branches are not suppressed and do not suppress other branches.

2.16.840.1.113883.5.13 en
UPDATE:

A branch is executed as soon as its associated conditions permit. If the condition is false, the branch may be entered later, when the condition turns true. Inclusive branches are not suppressed and do not suppress other branches. Each waiting branch executes in parallel with the default join code wait (see below).

2.16.840.1.113883.5.13 en
UPDATE:

An addendum (source) to an existing service object (target), containing supplemental information. The addendum is itself an original service object linked to the supplemented service object. The supplemented service object remains in place and its content and status are unaltered.

2.16.840.1.113883.5.1002 en
UPDATE:

The relationship that links to a Transportation Act (target) from another Act (source) indicating that the subject of the source Act entered into the source Act by means of the target Transportation act.

2.16.840.1.113883.5.1002 en
UPDATE:

A relationship in which the target act authorizes or certifies the source act.

2.16.840.1.113883.5.1002 en
UPDATE: Definition:The source act is performed to block the effects of the target act. This act relationship should be used when describing near miss type incidents where potential harm could have occurred, but the action described in the source act blocked the potential harmful effects of the incident actually occurring. 2.16.840.1.113883.5.1002 en UPDATE:

An assertion that a new observation was assumed to be the cause for another existing observation. The assumption is attributed to the same actor who asserts the observation. This is stronger and more specific than the support link. For example, a growth of Staphylococcus aureus may be considered the cause of an abscess. The source (cause) is typically an observation, but may be any service, while the target must be an observation.

2.16.840.1.113883.5.1002 en
UPDATE:

A relationship that provides an ability to associate a financial transaction (target) as a charge to a clinical act (source). A clinical act may have a charge associated with the execution or delivery of the service.

The financial transaction will define the charge (bill) for delivery or performance of the service.

Charges and costs are distinct terms. A charge defines what is charged or billed to another organization or entity within an organization. The cost defines what it costs an organization to perform or deliver a service or product.

2.16.840.1.113883.5.1002 en
UPDATE:

A contraindication is just a negation of a reason, i.e. it gives a condition under which the action is not to be done. Both, source and target can be any kind of service; target service is in criterion mood. How the strength of a contraindication is expressed (e.g., relative, absolute) is left as an open issue. The priorityNumber attribute could be used.

2.16.840.1.113883.5.1002 en
UPDATE:

A relationship that provides an ability to associate a financial transaction (target) as a cost to a clinical act (source). A clinical act may have an inherit cost associated with the execution or delivery of the service.

The financial transaction will define the cost of delivery or performance of the service.

Charges and costs are distinct terms. A charge defines what is charged or billed to another organization or entity within an organization. The cost defines what it costs an organization to perform or deliver a service or product.

2.16.840.1.113883.5.1002 en
UPDATE:

A relationship in which the source act is covered by or is under the authority of a target act. A financial instrument such as an Invoice Element is covered by one or more specific instances of an Insurance Policy.

2.16.840.1.113883.5.1002 en
UPDATE:

A credit relationship ties a financial transaction (target) to an account (source). A credit, once applied (posted), may have either a positive or negative effect on the account balance, depending on the type of account. An asset account credit will decrease the account balance. A non-asset account credit will decrease the account balance.

2.16.840.1.113883.5.1002 en
UPDATE:

A relationship from an Act to a Control Variable. For example, if a Device makes an Observation, this relates the Observation to its Control Variables documenting the device's settings that influenced the observation.

2.16.840.1.113883.5.1002 en
UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE:

A debit relationship ties a financial transaction (target) to an account (source). A debit, once applied (posted), may have either a positive or negative effect on the account balance, depending on the type of account. An asset account debit will increase the account balance. A non-asset account debit will decrease the account balance.

2.16.840.1.113883.5.1002 en
UPDATE:

The relationship that links to a Transportation Act (target) from another Act (source) indicating that the subject of the source Act departed from the source Act by means of the target Transportation act.

2.16.840.1.113883.5.1002 en
UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE:

The source act documents the target act.

2.16.840.1.113883.5.1002 en
UPDATE:

Associates a derived Act with its input parameters. E.G., an anion-gap observation can be associated as being derived from given sodium-, (potassium-,), chloride-, and bicarbonate-observations. The narrative content (Act.text) of a source act is wholly machine-derived from the collection of target acts.

2.16.840.1.113883.5.1002 en
UPDATE:

Expresses an association that links two instances of the same act over time, indicating that the instance are part of the same episode, e.g. linking two condition nodes for episode of illness; linking two encounters for episode of encounter.

2.16.840.1.113883.5.1002 en
UPDATE:

Indicates that the target Act provides evidence in support of the action represented by the source Act. The target is not a 'reason' for the source act, but rather gives supporting information on why the source act is an appropriate course of action. Possible targets might be clinical trial results, journal articles, similar successful therapies, etc.

Rationale:Provides a mechanism for conveying clinical justification for non-approved or otherwise non-traditional therapies.
2.16.840.1.113883.5.1002 en
UPDATE:

This is the inversion of support. Used to indicate that a given observation is explained by another observation or condition.

2.16.840.1.113883.5.1002 en
UPDATE:

The generalization relationship can be used to express categorical knowledge about services (e.g., amilorid, triamterene, and spironolactone have the common generalization potassium sparing diuretic).

2.16.840.1.113883.5.1002 en
UPDATE:

A goal-evaluation links an observation (intent or actual) to a goal to indicate that the observation evaluates the goal. Given the goal and the observation, a "goal distance" (e.g., goal to observation) can be "calculated" and need not be sent explicitly.

2.16.840.1.113883.5.1002 en
UPDATE:

A goal that one defines given a patient's health condition. Subsequently planned actions aim to meet that goal. Source is an observation or condition node, target must be an observation in goal mood.

2.16.840.1.113883.5.1002 en
UPDATE:

Used to capture the link between a potential service ("master" or plan) and an actual service, where the actual service instantiates the potential service. The instantiation may override the master's defaults.

2.16.840.1.113883.5.1002 en
UPDATE:

Items located

2.16.840.1.113883.5.1002 en
UPDATE:

A relationship that limits or restricts the source act by the elements of the target act. For example, an authorization may be limited by a financial amount (up to $500). Target Act must be in EVN.CRIT mood.

2.16.840.1.113883.5.1002 en
UPDATE:

An assertion that a new observation may be the manifestation of another existing observation or action. This assumption is attributed to the same actor who asserts the manifestation. This is stronger and more specific than an inverted support link. For example, an agitated appearance can be asserted to be the manifestation (effect) of a known hyperthyroxia. This expresses that one might not have realized a symptom if it would not be a common manifestation of a known condition. The target (cause) may be any service, while the source (manifestation) must be an observation.

2.16.840.1.113883.5.1002 en
UPDATE:

The source act removes or lessens the occurrence or effect of the target act.

2.16.840.1.113883.5.1002 en
UPDATE:

Definition: Used to link a newer version or 'snapshot' of a business object (source) to an older version or 'snapshot' of the same business object (target).

*Usage:*The identifier of the Act should be the same for both source and target. If the identifiers are distinct, RPLC should be used instead.

Name from source to target = "modifiesPrior"

Name from target to source = "modifiesByNew"

2.16.840.1.113883.5.1002 en
UPDATE:

A trigger-match links an actual service (e.g., an observation or procedure that took place) with a service in criterion mood. For example if the trigger is "observation of pain" and pain is actually observed, and if that pain-observation caused the trigger to fire, that pain-observation can be linked with the trigger.

2.16.840.1.113883.5.1002 en
UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE:

Used to assign a "name" to a condition thread. Source is a condition node, target can be any service.

2.16.840.1.113883.5.1002 en
UPDATE:

A desired state that a service action aims to maintain. E.g., keep systolic blood pressure between 90 and 110 mm Hg. Source is an intervention service. Target must be an observation in criterion mood.

2.16.840.1.113883.5.1002 en
UPDATE:

A desired outcome that a service action aims to meet finally. Source is any service (typically an intervention). Target must be an observation in criterion mood.

2.16.840.1.113883.5.1002 en
UPDATE:

The source act is a single occurrence of a repeatable target act. The source and target act can be in any mood on the "completion track" but the source act must be as far as or further along the track than the target act (i.e., the occurrence of an intent can be an event but not vice versa).

2.16.840.1.113883.5.1002 en
UPDATE:

A relationship between a source Act that provides more detailed properties to the target Act.

The source act thus is a specialization of the target act, but instead of mentioning all the inherited properties it only mentions new property bindings or refinements.

The typical use case is to specify certain alternative variants of one kind of Act. The priorityNumber attribute is used to weigh refinements as preferred over other alternative refinements.

Example: several routing options for a drug are specified as one SubstanceAdministration for the general treatment with attached refinements for the various routing options.

2.16.840.1.113883.5.1002 en
UPDATE:

A code indicating the type of name (e.g. nickname, alias, maiden name, legal, adopted)

2.16.840.1.113883.5.45 en
UPDATE:

Relates either an appointment request or an appointment to the order for the service being scheduled.

2.16.840.1.113883.5.1002 en
UPDATE:

A requirement to be true before a service is performed. The target can be any service in criterion mood. For multiple pre-conditions a conjunction attribute (AND, OR, XOR) is applicable.

2.16.840.1.113883.5.1002 en
UPDATE:

A relationship in which the target act is a predecessor instance to the source act. Generally each of these instances is similar, but no identical. In healthcare coverage it is used to link a claim item to a previous claim item that might have claimed for the same set of services.

2.16.840.1.113883.5.1002 en
UPDATE:

**Description:**A relationship in which the target act is carried out to determine whether an effect attributed to the source act can be recreated.

2.16.840.1.113883.5.1002 en
UPDATE: Definition:The source act is performed to recover from the effects of the target act. 2.16.840.1.113883.5.1002 en UPDATE:

A relationship in which the target act is referred to by the source act. This permits a simple reference relationship that distinguishes between the referent and the referee.

2.16.840.1.113883.5.1002 en
UPDATE:

Reference ranges are essentially descriptors of a class of result values assumed to be "normal", "abnormal", or "critical." Those can vary by sex, age, or any other criterion. Source and target are observations, the target is in criterion mood. This link type can act as a trigger in case of alarms being triggered by critical results.

2.16.840.1.113883.5.1002 en
UPDATE:

A relationship between a source Act that seeks to reverse or undo the action of the prior target Act.

Example: A posted financial transaction (e.g., a debit transaction) was applied in error and must be reversed (e.g., by a credit transaction) the credit transaction is identified as an undo (or reversal) of the prior target transaction.

Constraints: the "completion track" mood of the target Act must be equally or more "actual" than the source act. I.e., when the target act is EVN the source act can be EVN, or any INT. If the target act is INT, the source act can be INT.

2.16.840.1.113883.5.1002 en
UPDATE:

A noteworthy undesired outcome of a patient's condition that is either likely enough to become an issue or is less likely but dangerous enough to be addressed.

2.16.840.1.113883.5.1002 en
UPDATE:

A replacement source act replaces an existing target act. The state of the target act being replaced becomes obselete, but the act is typically still retained in the system for historical reference. The source and target must be of the same type.

2.16.840.1.113883.5.1002 en
UPDATE:

**Description:**A relationship in which the target act takes place with a defined temporal relationship with respect to the time at which the source act terminates.

2.16.840.1.113883.5.1002 en
UPDATE:

The source Act starts after the start of the target Act (i.e. if we say "ActOne SAS ActTwo", it means that ActOne starts after the start of ActTwo, therefore ActOne is the source and ActTwo is the target).

2.16.840.1.113883.5.1002 en
UPDATE:

Associates a specific time (and associated resources) with a scheduling request or other intent.

2.16.840.1.113883.5.1002 en
UPDATE:

A specialization of "has support" (SPRT), used to relate a secondary observation to a Region of Interest on a multidimensional observation, if the ROI specifies the true boundaries of the secondary observation as opposed to only marking the approximate area. For example, if the start and end of an ST elevation episode is visible in an EKG, this relation would indicate the ROI bounds the "ST elevation" observation -- the ROI defines the true beginning and ending of the episode. Conversely, if a ROI simply contains ST elevation, but it does not define the bounds (start and end) of the episode, the more general "has support" relation is used. Likewise, if a ROI on an image defines the true bounds of a "1st degree burn", the relation "has bounded support" is used; but if the ROI only points to the approximate area of the burn, the general "has support" relation is used.

2.16.840.1.113883.5.1002 en
UPDATE:

Relates an Act to its subject Act that the first Act is primarily concerned with.

Examples

  • The first Act may be a ControlAct manipulating the subject Act

  • The first act is a region of interest (ROI) that defines a region within the subject Act.

  • The first act is a reporting or notification Act, that echos the subject Act for a specific new purpose.

Constraints

An Act may have multiple subject acts.

Rationale

The ActRelationshipType "has subject" is similar to the ParticipationType "subject", Acts that primarily operate on physical subjects use the Participation, those Acts that primarily operate on other Acts (other information) use the ActRelationship.

2.16.840.1.113883.5.1002 en
UPDATE:

An act that contains summary values for a list or set of subordinate acts. For example, a summary of transactions for a particular accounting period.

2.16.840.1.113883.5.1002 en
UPDATE:

Used in the diagnosis of the indicated disease.

2.16.840.1.113883.5.1002 en
UPDATE:

A pre-condition that if true should result in the source Act being executed. The target is in typically in criterion mood. When reported after the fact (i.e. the criterion has been met) it may be in Event mood. A delay between the trigger and the triggered action can be specified.

Discussion:This includes the concept of a required act for a service or financial instrument such as an insurance plan or policy. In such cases, the trigger is the occurrence of a specific condition such as coverage limits being exceeded.
2.16.840.1.113883.5.1002 en
UPDATE:

A condition thread relationship specifically links condition nodes together to form a condition thread. The source is the new condition node and the target links to the most recent node of the existing condition thread.

2.16.840.1.113883.5.1002 en
UPDATE:

The source is a direct quote from the target.

2.16.840.1.113883.5.1002 en
UPDATE:

Used when the target Act is a transformation of the source Act. (For instance, used to show that a CDA document is a transformation of a DICOM SR document.)

2.16.840.1.113883.5.1002 en
UPDATE:

The Act has been terminated prior to the originally intended completion.

2.16.840.1.113883.5.14 en
UPDATE:

The Act can be performed or is being performed

2.16.840.1.113883.5.14 en
UPDATE:

The Act has been abandoned before activation.

2.16.840.1.113883.5.14 en
UPDATE:

An Act that has terminated normally after all of its constituents have been performed.

2.16.840.1.113883.5.14 en
UPDATE:

An Act that is still in the preparatory stages has been put aside. No action can occur until the Act is released.

2.16.840.1.113883.5.14 en
UPDATE:

An Act that is in the preparatory stages and may not yet be acted upon

2.16.840.1.113883.5.14 en
UPDATE:

This Act instance was created in error and has been 'removed' and is treated as though it never existed. A record is retained for audit purposes only.

2.16.840.1.113883.5.14 en
UPDATE:

This Act instance has been replaced by a new instance.

2.16.840.1.113883.5.14 en
UPDATE:

An Act that has been activated (actions could or have been performed against it), but has been temporarily disabled. No further action should be taken against it until it is released

2.16.840.1.113883.5.14 en
UPDATE:

The association adds to the existing context associated with the Act, but will not propagate to any descendant Acts reached by conducting ActRelationships (see contextControlCode). Examples: If an 'Author' Participation were marked as "Additive, Non-Propagating" it means that the author will be added to the set of author participations that have propagated from ancestor Acts for the purpose of this Act. However only the previously propagated authors will propagate to any child Acts that allow context to be propagated.

2.16.840.1.113883.5.1057 en
UPDATE:

The association adds to the existing context associated with the Act, and will propagate to any descendant Acts reached by conducting ActRelationships (see contextControlCode). Examples: If an 'Author' Participation were marked as "Additive, Propagating" it means that the author will be added to the set of author participations that have propagated from ancestor Acts, and will itself propagate with the other authors to any child Acts that allow context to be propagated.

2.16.840.1.113883.5.1057 en
UPDATE:

The association is added to the existing context associated with the Act, but overrides an association with the same typeCode. However, this overriding association will not propagate to any descendant Acts reached by conducting ActRelationships (see contextControlCode). Examples: If an 'Author' Participation were marked as "Overriding, Non-Propagating" it means that the author will replace the set of author participations that have propagated from ancestor Acts. Furthermore, no author participations whatsoever will propagate to any child Acts that allow context to be propagated.

2.16.840.1.113883.5.1057 en
UPDATE:

The association is added to the existing context associated with the Act, but overrides an association with the same typeCode. This overriding association will propagate to any descendant Acts reached by conducting ActRelationships (see contextControlCode). Examples: If an 'Author' Participation were marked as "Overriding, Propagating" it means that the author will replace the set of author participations that have propagated from ancestor Acts, and will itself be the only author to propagate to any child Acts that allow context to be propagated.

2.16.840.1.113883.5.1057 en
UPDATE:

A living subject from the animal kingdom.

2.16.840.1.113883.5.41 en
UPDATE:

A physical artifact that stores information about the granting of authorization.

2.16.840.1.113883.5.41 en
UPDATE:

A substance that is fully defined by an organic or inorganic chemical formula, includes mixtures of other chemical substances. Refine using, e.g., IUPAC codes.

2.16.840.1.113883.5.41 en
UPDATE:

The territory of a city, town or other municipality.

2.16.840.1.113883.5.41 en
UPDATE:

The territory of a sovereign nation.

2.16.840.1.113883.5.41 en
UPDATE:

The territory of a county, parish or other division of a state or province.

2.16.840.1.113883.5.41 en
UPDATE:

Naturally occurring, processed or manufactured entities that are primarily used as food for humans and animals.

2.16.840.1.113883.5.41 en
UPDATE:

A health chart included to serve as a document receiving entity in the management of medical records.

2.16.840.1.113883.5.41 en
UPDATE:

A type of container that can hold other containers or other holders.

2.16.840.1.113883.5.41 en
UPDATE:

All single celled living organisms including protozoa, bacteria, yeast, viruses, etc.

2.16.840.1.113883.5.41 en
UPDATE:

Class to contain unique attributes of diagnostic imaging equipment.

2.16.840.1.113883.5.41 en
UPDATE:

A politically organized body of people bonded by territory and known as a nation.

2.16.840.1.113883.5.41 en
UPDATE:

A living subject from the order of plants.

2.16.840.1.113883.5.41 en
UPDATE:

The territory of a state, province, department or other division of a sovereign country.

2.16.840.1.113883.5.41 en
UPDATE:

A living subject of the species homo sapiens.

2.16.840.1.113883.5.41 en
UPDATE:

An agency of the people of a state often assuming some authority over a certain matter. Includes government, governmental agencies, associations.

2.16.840.1.113883.5.41 en
UPDATE:

A grouping of resources (personnel, material, or places) to be used for scheduling purposes. May be a pool of like-type resources, a team, or combination of personnel, material and places.

2.16.840.1.113883.5.41 en
UPDATE:

The specific determiner indicates that the given Entity is taken as one specific thing instance. For example, a human INSTANCE (quantity = 1,) stands for exactly one human being.

2.16.840.1.113883.5.30 en
UPDATE:

The described quantified determiner indicates that the given Entity is taken as a general description of a specific amount of a thing. For example, QUANTIFIED\_KIND of syringe (quantity = 3,) stands for exactly three syringes.

2.16.840.1.113883.5.30 en
UPDATE:

The state representing the fact that the Entity record is currently active.

2.16.840.1.113883.5.1061 en
UPDATE: Definition:The state representing the fact that the entity is inactive. 2.16.840.1.113883.5.1061 en UPDATE:

The state representing the termination of an Entity record instance that was created in error.

2.16.840.1.113883.5.1061 en
UPDATE:

The state representing the fact that the Participation is in progress.

2.16.840.1.113883.5.1062 en
UPDATE:

The terminal state resulting from cancellation of the Participation prior to activation.

2.16.840.1.113883.5.1062 en
UPDATE:

The terminal state representing the successful completion of the Participation.

2.16.840.1.113883.5.1062 en
UPDATE:

The state representing the termination of a Participation instance that was created in error.

2.16.840.1.113883.5.1062 en
UPDATE:

The state representing that fact that the Participation has not yet become active.

2.16.840.1.113883.5.1062 en
UPDATE:

The practitioner who is responsible for admitting a patient to a patient encounter.

2.16.840.1.113883.5.90 en
UPDATE:

The practitioner that has responsibility for overseeing a patient's care during a patient encounter.

2.16.840.1.113883.5.90 en
UPDATE: Definition:A party that originates the Act and therefore has responsibility for the information given in the Act and ownership of this Act.Example:the report writer, the person writing the act definition, the guideline author, the placer of an order, the EKG cart (device) creating a report etc. Every Act should have an author. Authorship is regardless of mood always actual authorship.

Examples of such policies might include:

* The author and anyone they explicitly delegate may update the report; * All administrators within the same clinic may cancel and reschedule appointments created by other administrators within that clinic;

A party that is neither an author nor a party who is extended authorship maintenance rights by policy, may only amend, reverse, override, replace, or follow up in other ways on this Act, whereby the Act remains intact and is linked to another Act authored by that other party.

2.16.840.1.113883.5.90 en
UPDATE:

A verifier who attests to the accuracy of an act, but who does not have privileges to legally authenticate the act. An example would be a resident physician who sees a patient and dictates a note, then later signs it. Their signature constitutes an authentication.

2.16.840.1.113883.5.90 en
UPDATE:

In an obstetric service, the baby.

2.16.840.1.113883.5.90 en
UPDATE:

Target on behalf of whom the service happens, but that is not necessarily present in the service. Can occur together with direct target to indicate that a target is both, as in the case where the patient is the indirect beneficiary of a service rendered to a family member, e.g. counseling or given home care instructions. This concept includes a participant, such as a covered party, who derives benefits from a service act covered by a coverage act.

Note that the semantic role of the intended recipient who benefits from the happening denoted by the verb in the clause. Thus, a patient who has no coverage under a policy or program may be a beneficiary of a health service while not being the beneficiary of coverage for that service.

2.16.840.1.113883.5.90 en
UPDATE:

Definition: A factor, such as a microorganism, chemical substance, or form of radiation, whose presence, excessive presence, or (in deficiency diseases) relative absence is essential, in whole or in part, for the occurrence of a condition.

Constraint: The use of this participation is limited to observations.

2.16.840.1.113883.5.90 en
UPDATE:

A person or organization who should be contacted for follow-up questions about the act in place of the author.

2.16.840.1.113883.5.90 en
UPDATE:

An advisor participating in the service by performing evaluations and making recommendations.

2.16.840.1.113883.5.90 en
UPDATE:

The target participation for an individual in a health care coverage act in which the target role is either the policy holder of the coverage, or a covered party under the coverage.

2.16.840.1.113883.5.90 en
UPDATE:

Target that is taken up, is diminished, and disappears in the service.

2.16.840.1.113883.5.90 en
UPDATE:

An entity (person, organization or device) that is in charge of maintaining the information of this act (e.g., who maintains the report or the master service catalog item, etc.).

2.16.840.1.113883.5.90 en
UPDATE:

The practitioner who is responsible for the discharge of a patient from a patient encounter.

2.16.840.1.113883.5.90 en
UPDATE:

Distributes material used in or generated during the act.

2.16.840.1.113883.5.90 en
UPDATE:

In some organ transplantation services and rarely in transfusion services a donor will be a target participant in the service. However, in most cases transplantation is decomposed in three services: explantation, transport, and implantation. The identity of the donor (recipient) is often irrelevant for the explantation (implantation) service.

2.16.840.1.113883.5.90 en
UPDATE:

The destination for services. May be a static building (or room therein) or a movable facility (e.g., ship).

2.16.840.1.113883.5.90 en
UPDATE:

A location where data about an Act was entered.

2.16.840.1.113883.5.90 en
UPDATE:

A person entering the data into the originating system. The data entry person is collected optionally for internal quality control purposes. This includes the transcriptionist for dictated text.

2.16.840.1.113883.5.90 en
UPDATE:

Only with Transportation services. A person who escorts the patient.

2.16.840.1.113883.5.90 en
UPDATE: Description:The entity playing the associated role is the physical (including energy), chemical or biological substance that is participating in the exposure. For example in communicable diseases, the associated playing entity is the disease causing pathogen. 2.16.840.1.113883.5.90 en UPDATE: Description:The entity playing the associated role is the target (contact) of exposure. 2.16.840.1.113883.5.90 en UPDATE:

**Description:**The entity playing the associated role is the source of exposure.

2.16.840.1.113883.5.90 en
UPDATE:

The target person or organization contractually recognized by the issuer as a participant who has assumed fiscal responsibility for another personaTMs financial obligations by guaranteeing to pay for amounts owed to a particular account

*Example:*The subscriber of the patientaTMs health insurance policy signs a contract with the provider to be fiscally responsible for the patient billing account balance amount owed.

2.16.840.1.113883.5.90 en
UPDATE:

Participant who posses an instrument such as a financial contract (insurance policy) usually based on some agreement with the author.

2.16.840.1.113883.5.90 en
UPDATE:

A source of reported information (e.g., a next of kin who answers questions about the patient's history). For history questions, the patient is logically an informant, yet the informant of history questions is implicitly the subject.

2.16.840.1.113883.5.90 en
UPDATE:

A verifier who legally authenticates the accuracy of an act. An example would be a staff physician who sees a patient and dictates a note, then later signs it. Their signature constitutes a legal authentication.

2.16.840.1.113883.5.90 en
UPDATE:

An information recipient to notify for urgent matters about this Act. (e.g., in a laboratory order, critical results are being called by phone right away, this is the contact to call; or for an inpatient encounter, a next of kin to notify when the patient becomes critically ill).

2.16.840.1.113883.5.90 en
UPDATE:

A device that changes ownership due to the service, e.g., a pacemaker, a prosthesis, an insulin injection equipment (pen), etc. Such material may need to be restocked after he service.

2.16.840.1.113883.5.90 en
UPDATE:

The location of origin for services. May be a static building (or room therein) or a movable facility (e.g., ship).

2.16.840.1.113883.5.90 en
UPDATE:

The principal or primary performer of the act.

2.16.840.1.113883.5.90 en
UPDATE:

Information recipient to whom an act statement is primarily directed. E.g., a primary care provider receiving a discharge letter from a hospitalist, a health department receiving information on a suspected case of infectious disease. Multiple of these participations may exist on the same act without requiring that recipients be ranked as primary vs. secondary.

2.16.840.1.113883.5.90 en
UPDATE:

A material target that is brought forth (produced) in the service (e.g., specimen in a specimen collection, access or drainage in a placement service, medication package in a dispense service). It doesn't matter whether the material produced had existence prior to the service, or whether it is created in the service (e.g., in supply services the product is taken from a stock).

2.16.840.1.113883.5.90 en
UPDATE:

The record target indicates whose medical record holds the documentation of this act. This is especially important when the subject of a service is not the patient himself.

2.16.840.1.113883.5.90 en
UPDATE:

The person (or organization) who receives the product of an Act.

2.16.840.1.113883.5.90 en
UPDATE:

A device that does not change ownership due to the service, i.e., a surgical instrument or tool or an endoscope. The distinction between reuseable and non-reuseable must be made in order to know whether material must be re-stocked.

2.16.840.1.113883.5.90 en
UPDATE:

A person having referred the subject of the service to the performer (referring physician). Typically, a referring physician will receive a report.

2.16.840.1.113883.5.90 en
UPDATE:

A participant (e.g. provider) who has referred the subject of an act (e.g. patient).

Typically, a referred by participant will provide a report (e.g. referral).

2.16.840.1.113883.5.90 en
UPDATE:

The person who receives the patient

2.16.840.1.113883.5.90 en
UPDATE: No description 2.16.840.1.113883.5.1119 en UPDATE:

The person or organization that has primary responsibility for the act. The responsible party is not necessarily present in an action, but is accountable for the action through the power to delegate, and the duty to review actions with the performing actor after the fact. This responsibility may be ethical, legal, contractual, fiscal, or fiduciary in nature.

Example:A person who is the head of a biochemical laboratory; a sponsor for a policy or government program.
2.16.840.1.113883.5.90 en
UPDATE:

Some services take place at multiple concurrent locations (e.g., telemedicine, telephone consultation). The location where the principal performing actor is located is taken as the primary location (LOC) while the other location(s) are considered "remote."

2.16.840.1.113883.5.90 en
UPDATE:

The subject of non-clinical (e.g. laboratory) observation services is a specimen.

2.16.840.1.113883.5.90 en
UPDATE:

A person assisting in an act through his substantial presence and involvement This includes: assistants, technicians, associates, or whatever the job titles may be.

2.16.840.1.113883.5.90 en
UPDATE:

A secondary information recipient, who receives copies (e.g., a primary care provider receiving copies of results as ordered by specialist).

2.16.840.1.113883.5.90 en
UPDATE:

For services, an intermediate location that specifies a path between origin an destination.

2.16.840.1.113883.5.90 en
UPDATE:

Only with service events. A person witnessing the action happening without doing anything. A witness is not necessarily aware, much less approves of anything stated in the service event. Example for a witness is students watching an operation or an advanced directive witness.

2.16.840.1.113883.5.90 en
UPDATE:

A role in which the playing entity (material) provides access to another entity. The principal use case is intravenous (or other bodily) access lines that preexist and need to be referred to for medication routing instructions.

2.16.840.1.113883.5.110 en
UPDATE:

A therapeutically active ingredient (player) in a mixture (scoper), where the mixture is typically a manufactured pharmaceutical.

2.16.840.1.113883.5.110 en
UPDATE:

The molecule or ion that is responsible for the intended pharmacological action of the drug substance, excluding those appended or associated parts of the molecule that make the molecule an ester, salt (including a salt with hydrogen or coordination bonds), or other noncovalent derivative (such as a complex, chelate, or clathrate).

Examples: heparin-sodium and heparin-potassium have the same active moiety, heparin; the active moiety of morphine-hydrochloride is morphine.

2.16.840.1.113883.5.110 en
UPDATE:

A material (player) that can be administered to an Entity (scoper).

2.16.840.1.113883.5.110 en
UPDATE:

An ingredient (player) that is added to a base (scoper), that amounts to a minor part of the overall mixture.

2.16.840.1.113883.5.110 en
UPDATE:

Player of the Affiliate role has a business/professional relationship with scoper. Player and scoper may be persons or organization. The Affiliate relationship does not imply membership in a group, nor does it exist for resource scheduling purposes.

Example:A healthcare provider is affiliated with another provider as a business associate.
2.16.840.1.113883.5.110 en
UPDATE:

A portion (player) of an original or source specimen (scoper) used for testing or transportation.

2.16.840.1.113883.5.110 en
UPDATE:

A base ingredient (player) is what comprises the major part of a mixture (scoper). E.g., Water in most i.v. solutions, or Vaseline in salves. Among all ingredients of a material, there should be only one base. A base substance can, in turn, be a mixture.

2.16.840.1.113883.5.110 en
UPDATE:

Relates a place (playing Entity) as the location where a living subject (scoping Entity) was born.

2.16.840.1.113883.5.110 en
UPDATE:

A person responsible for the primary care of a patient at home.

2.16.840.1.113883.5.110 en
UPDATE:

A person, non-person living subject, or place that is the subject of an investigation related to a notifiable condition (health circumstance that is reportable within the applicable public health jurisdiction)

2.16.840.1.113883.5.110 en
UPDATE:

The player of the role is a child of the scoping entity, in a generic sense.

2.16.840.1.113883.5.110 en
UPDATE:

Citizen of apolitical entity

2.16.840.1.113883.5.110 en
UPDATE: Description:A role played by a party making a claim for coverage under a policy or program. A claimant must be either a person or organization, or a group of persons or organizations. A claimant is not a named insured or a program eligible.Discussion:With respect to liability insurance such as property and casualty insurance, a claimant must file a claim requesting indemnification for a loss that the claimant considers covered under the policy of a named insured. The claims adjuster for the policy underwriter will review the claim to determine whether the loss meets the benefit coverage criteria under a policy, and base any indemnification or coverage payment on that review. If a third party is liable in whole or part for the loss, the underwriter may pursue third party liability recovery. A claimant may be involved in civil or criminal legal proceedings involving claims against a defendant party that is indemnified by an insurance policy or to protest the finding of a claims adjustor. With respect to life insurance, a beneficiary designated by a named insured becomes a claimant of the proceeds of coverage, as in the case of a life insurance policy. However, a claimant for coverage under life insurance is not necessarily a designated beneficiary.Note:A claimant is not a named insured. However, a named insured may make a claim under a policy, e.g., an insured driver may make a claim for an injury under his or her comprehensive automobile insurance policy. Similarly, a program eligible may make a claim under program, e.g., an unemployed worker may claim benefits under an unemployment insurance program, but parties playing these covered party role classes are not, for purposes of this vocabulary and in an effort to clearly distinguish role classes, considered claimants.

In the case of a named insured making a claim, a role type code INSCLM (insured claimant) subtypes the class to indicate that either a named insured or an individual insured has filed a claim for a loss. In the case of a program eligible, a role type code INJWKR (injured worker) subtypes the class to indicate that the covered party in a workers compensation program is an injured worker, and as such, has filed a "claim" under the program for benefits. Likewise, a covered role type code UNEMP (unemployed worker) subtypes the program eligible class to indicate that the covered party in an unemployment insurance program has filed a claim for unemployment benefits.

Example:A claimant under automobile policy that is not the named insured.
2.16.840.1.113883.5.110 en
UPDATE:

A substance (player) influencing the optical aspect of material (scoper).

2.16.840.1.113883.5.110 en
UPDATE:

An Entity that is authorized to issue or instantiate permissions, privileges, credentials or other formal/legal authorizations.

2.16.840.1.113883.5.110 en
UPDATE:

Relates a material as the content (player) to a container (scoper). Unlike ingredients, the content and a container remain separate (not mixed) and the content can be removed from the container. A content is not part of an empty container.

2.16.840.1.113883.5.110 en
UPDATE:

A role played by an entity that receives credentials from the scoping entity.

2.16.840.1.113883.5.110 en
UPDATE:

A role played by a provider, always a person, who has agency authority from a Clinical Research Sponsor to direct the conduct of a clinical research trial or study on behalf of the sponsor.

2.16.840.1.113883.5.110 en
UPDATE:

A role played by an entity, usually an organization, that is the sponsor of a clinical research trial or study. The sponsor commissions the study, bears the expenses, is responsible for satisfying all legal requirements concerning subject safety and privacy, and is generally responsible for collection, storage and analysis of the data generated during the trial. No scoper is necessary, as a clinical research sponsor undertakes the role on its own authority and declaration. Clinical research sponsors are usually educational or other research organizations, government agencies or biopharmaceutical companies.

2.16.840.1.113883.5.110 en
UPDATE:

Definition: Relates a place (playing Entity) as the location where a living subject (scoping Entity) died.

2.16.840.1.113883.5.110 en
UPDATE: Description:A role played by a person covered under a policy or program based on an association with a subscriber, which is recognized by the policy holder.Note:The party playing the role of a dependent is not a claimant in the sense conveyed by the RoleClassCoveredParty CLAIM (claimant). However, a dependent may make a claim under a policy, e.g., a dependent under a health insurance policy may become the claimant for coverage under that policy for wellness examines or if injured and there is no liable third party. In the case of a dependent making a claim, a role type code INSCLM (insured claimant) subtypes the class to indicate that the dependent has filed a claim for services covered under the health insurance policy.Example:The dependent has an association with the subscriber such as a financial dependency or personal relationship such as that of a spouse, or a natural or adopted child. The policy holder may be required by law to recognize certain associations or may have discretion about the associations. For example, a policy holder may dictate the criteria for the dependent status of adult children who are students, such as requiring full time enrollment, or may recognize domestic partners as dependents. Under certain circumstances, the dependent may be under the indirect authority of a responsible party acting as a surrogate for the subscriber, for example, if the subscriber is differently abled or deceased, a guardian ad Lidem or estate executor may be appointed to assume the subscriberaTMs legal standing in the relationship with the dependent. 2.16.840.1.113883.5.110 en UPDATE:

A role of a place (player) that is intended to house the provision of services. Scoper is the Entity (typically Organization) that provides these services. This is not synonymous with "ownership."

2.16.840.1.113883.5.110 en
UPDATE:

An entity to be contacted in the event of an emergency.

2.16.840.1.113883.5.110 en
UPDATE:

A role played by an entity that has been exposed to a person or animal suffering a contagious disease, or with a location from which a toxin has been distributed. The player of the role is normally a person or animal, but it is possible that other entity types could become exposed. The role is scoped by the source of the exposure, and it is quite possible for a person playing the role of exposed party to also become the scoper a role played by another person. That is to say, once a person has become infected, it is possible, perhaps likely, for that person to infect others.

Management of exposures and tracking exposed parties is a key function within public health, and within most public health contexts - exposed parties are known as "contacts."

2.16.840.1.113883.5.110 en
UPDATE: Description:A vector is a living subject that carries an exposure agent. The vector does not cause the disease itself, but exposes targets to the exposure agent. A mosquito carrying malaria is an example of a vector. The scoper of the role must be the exposure agent (e.g., pathogen). 2.16.840.1.113883.5.110 en UPDATE:

A substance (player) added to a mixture (scoper) to make it taste a certain way. In food the use is obvious, in pharmaceuticals flavors can hide disgusting taste of the active ingredient (important in pediatric treatments).

2.16.840.1.113883.5.110 en
UPDATE: Description:A fomite is a non-living entity that is capable of conveying exposure agent from one entity to another. A doorknob contaminated with a Norovirus is an example of a fomite. Anyone touching the doorknob would be exposed to the virus. The scoper of the role must be the exposure agent (e.g., pathogen). 2.16.840.1.113883.5.110 en UPDATE:

A special link between pharmaceuticals indicating that the target (scoper) is a generic for the source (player).

2.16.840.1.113883.5.110 en
UPDATE:

A person or organization (player) that serves as a financial guarantor for another person or organization (scoper).

2.16.840.1.113883.5.110 en
UPDATE:

Guardian of a ward

2.16.840.1.113883.5.110 en
UPDATE:

Entity that is currently in the possession of a holder (scoper), who holds, or uses it, usually based on some agreement with the owner.

2.16.840.1.113883.5.110 en
UPDATE:

The role of a material (player) that is the physical health chart belonging to an organization (scoper).

2.16.840.1.113883.5.110 en
UPDATE:

Roles played by entities and scoped by entities that identify them for various purposes.

2.16.840.1.113883.5.110 en
UPDATE: Description:A role played by a party covered under a policy as the policy holder. An individual may be either a person or an organization.Note:The party playing the role of an individual insured is not a claimant in the sense conveyed by the RoleClassCoveredParty CLAIM (claimant). However, a named insured may make a claim under a policy, e.g., a party that is the named insured and policy holder under a comprehensive automobile insurance policy may become the claimant for coverage under that policy if injured in an automobile accident and there is no liable third party. In the case of an individual insured making a claim, a role type code INSCLM (insured claimant) subtypes the class to indicate that an individual insured has filed a claim for a loss.Example:The individual insured under a comprehensive automobile, disability, or property and casualty policy that is the policy holder. 2.16.840.1.113883.5.110 en UPDATE:

An individual piece of material (player) instantiating a class of material (scoper).

2.16.840.1.113883.5.110 en
UPDATE:

A role played by a place at which health care services may be provided without prior designation or authorization.

2.16.840.1.113883.5.110 en
UPDATE:

A microorganism that has been isolated from other microorganisms or a source matrix.

2.16.840.1.113883.5.110 en
UPDATE:

A role played by an entity that is a member of a group. The group provides the scope for this role.

Among other uses, groups as used in insurance (groups of covered individuals) and in scheduling where resources may be grouped for scheduling and logistical purposes.

2.16.840.1.113883.5.110 en
UPDATE:

A role played by a member of a military service. Scoper is the military service (e.g. Army, Navy, Air Force, etc.) or, more specifically, the unit (e.g. Company C, 3rd Battalion, 4th Division, etc.)

2.16.840.1.113883.5.110 en
UPDATE:

An entity (player) that is maintained by another entity (scoper). This is typical role held by durable equipment. The scoper assumes responsibility for proper operation, quality, and safety.

2.16.840.1.113883.5.110 en
UPDATE:

An individual designated for notification as the next of kin for a given entity.

2.16.840.1.113883.5.110 en
UPDATE: No description 2.16.840.1.113883.5.110 en UPDATE: No description 2.16.840.1.113883.5.110 en UPDATE: No description 2.16.840.1.113883.5.110 en UPDATE:

An Entity (player) for which someone (scoper) is granted by law the right to call the material (player) his own. This entitles the scoper to make decisions about the disposition of that material.

2.16.840.1.113883.5.110 en
UPDATE: No description 2.16.840.1.113883.5.110 en UPDATE:

An association between two Entities where the playing Entity is considered in some way "part" of the scoping Entity, e.g., as a member, component, ingredient, or content. Being "part" in the broadest sense of the word can mean anything from being an integral structural component to a mere incidental temporary association of a playing Entity with a (generally larger) scoping Entity.

2.16.840.1.113883.5.110 en
UPDATE:

**Description:**A Role of a LivingSubject (player) as a recipient of health care services from a healthcare provider (scoper).

2.16.840.1.113883.5.110 en
UPDATE:

The role of an organization or individual designated to receive payment for a claim against a particular coverage. The scoping entity is the organization that is the submitter of the invoice in question.

2.16.840.1.113883.5.110 en
UPDATE:

The role of an organization that undertakes to accept claims invoices, assess the coverage or payments due for those invoices and pay to the designated payees for those invoices. This role may be either the underwriter or a third-party organization authorized by the underwriter. The scoping entity is the organization that underwrites the claimed coverage.

2.16.840.1.113883.5.110 en
UPDATE: No description 2.16.840.1.113883.5.110 en UPDATE:

A role played by a person or organization that holds an insurance policy. The underwriter of that policy is the scoping entity.

*Discussion:*The identifier of the policy is captured in 'Role.id' when the Role is a policy holder.

A particular policy may cover several individuals one of whom may be, but need not be, the policy holder. Thus the notion of covered party is a role that is distinct from that of the policy holder.

2.16.840.1.113883.5.110 en
UPDATE: Description:A role played by a party that meets the eligibility criteria for coverage under a program. A program eligible may be either a person, non-person living subject, or an organization, or a group of persons, non-person living subjects, or organizations.Discussion:A program as typically government administered coverage for parties determined eligible under the terms of the program.Note:The party playing a program eligible is not a claimant in the sense conveyed by the RoleClassCoveredParty CLAIM (claimant). However a program eligible may make a claim under program, e.g., an unemployed worker may claim benefits under an unemployment insurance program, but parties playing these covered party role classes are not, for purposes of this vocabulary and in an effort to clearly distinguish role classes, considered claimants.

In the case of a program eligible, a role type code INJWKR (injured worker) subtypes the class to indicate that the covered party in a workers compensation program is an injured worker, and as such, has filed a "claim" under the program for benefits. Likewise, a covered role type code UNEMP (unemployed worker) subtypes the program eligible class to indicate that the covered party in an unemployment insurance program has filed a claim for unemployment benefits.

Example:A party meeting eligibility criteria related to health or financial status, e.g., in the U.S., persons meeting health, demographic, or financial criteria established by state and federal law are eligible for Medicaid.
2.16.840.1.113883.5.110 en
UPDATE:

An Entity (player) that is authorized to provide health care services by some authorizing agency (scoper).

2.16.840.1.113883.5.110 en
UPDATE:

Links two people in a personal relationship. The character of the relationship must be defined by a PersonalRelationshipRoleType code. The player and scoper are determined by PersonalRelationshipRoleType code as well.

2.16.840.1.113883.5.110 en
UPDATE:

A substance (player) added to a mixture (scoper) to prevent microorganisms (fungi, bacteria) to spoil the mixture.

2.16.840.1.113883.5.110 en
UPDATE:

An entity (player) that has been recognized as having certain training/experience or other characteristics that would make said entity an appropriate performer for a certain activity. The scoper is an organization that educates or qualifies entities.

2.16.840.1.113883.5.110 en
UPDATE:

**Definition:**Specifies the administrative functionality within a formal experimental design for which the ResearchSubject role was established.

Examples:Screening - role is used for pre-enrollment evaluation portion of the design; enrolled - role is used for subjects admitted to the experimental portion of the design.
2.16.840.1.113883.5.110 en
UPDATE:

Material (player) sold by a retailer (scoper), who also give advice to prospective buyers.

2.16.840.1.113883.5.110 en
UPDATE:

A product regulated by some governmentatl orgnization. The role is played by Material and scoped by Organization.

Rationale: To support an entity clone used to identify the NDC number for a drug product.

2.16.840.1.113883.5.110 en
UPDATE:

The "same" roleclass asserts an identity between playing and scoping entities: that they are in fact instances of the same entity and, in the case of discrepancies (e.g different DOB, gender), that one or both are in error.

Usage:

playing and scoping entities must have same classcode, but need not have identical attributes or values.

Example:

a provider registry maintains sets of conflicting demographic data for what is reported to be the same individual.

2.16.840.1.113883.5.110 en
UPDATE:

The role of a person (player) who is the officer or signature authority for of a scoping entity, usually an organization (scoper).

2.16.840.1.113883.5.110 en
UPDATE:

A role played by an entity, usually an organization that is the sponsor of an insurance plan or a health program. A sponsor is the party that is ultimately accountable for the coverage by employment contract or by law. A sponsor can be an employer, union, government agency, or association. Fully insured sponsors establish the terms of the plan and contract with health insurance plans to assume the risk and to administer the plan. Self-insured sponsors delegate coverage administration, but not risk, to third-party administrators. Program sponsors designate services to be covered in accordance with statute. Program sponsors may administer the coverage themselves, delegate coverage administration, but not risk to third-party administrators, or contract with health insurance plans to assume the risk and administrator a program. Sponsors qualify individuals who may become

  • a policy holder of the plan;

  • where the sponsor is the policy holder, who may become a subscriber or a dependent to a policy under the plan; or

  • where the sponsor is a government agency, who may become program eligibles under a program.

The sponsor role may be further qualified by the SponsorRole.code. Entities playing the sponsor role may also play the role of a Coverage Administrator.

Example:An employer, union, government agency, or association.
2.16.840.1.113883.5.110 en
UPDATE:

A stabilizer (player) added to a mixture (scoper) in order to prevent the molecular disintegration of the main substance.

2.16.840.1.113883.5.110 en
UPDATE:

A role played by an individual who is a student of a school, which is the scoping entity.

2.16.840.1.113883.5.110 en
UPDATE:

Relates an entity (player) (e.g. a device) to a location (scoper) at which it is normally found or stored when not used.

2.16.840.1.113883.5.110 en
UPDATE:

An entity that subsumes the identity of another. Used in the context of merging documented entity instances. Both the player and scoper must have the same classCode.

The use of this code isdeprecatedin favor of the term SUBY which is its inverse and is more ontologically correct.
2.16.840.1.113883.5.110 en
UPDATE: Description:A role played by a person covered under a policy based on association with a sponsor who is the policy holder, and whose association may provide for the eligibility of dependents for coverage.Discussion:The policy holder holds the contract with the policy or program underwriter. The subscriber holds a certificate of coverage under the contract. In legal proceedings concerning the policy or program, the terms of the contract takes precedence over the terms of the certificate of coverage if there are any inconsistencies.Note:The party playing the role of a subscriber is not a claimant in the sense conveyed by the RoleClassCoveredParty CLAIM (claimant). However, a subscriber may make a claim under a policy, e.g., a subscriber under a health insurance policy may become the claimant for coverage under that policy for wellness examines or if injured and there is no liable third party. In the case of a subscriber making a claim, a role type code INSCLM (insured claimant) subtypes the class to indicate that the subscriber has filed a claim for services covered under the health insurance policy.Example:An employee or a member of an association. 2.16.840.1.113883.5.110 en UPDATE:

Relates a prevailing record of an Entity (scoper) with another record (player) that it subsumes.

Examples:Show a correct new Person object (scoper) that subsumes one or more duplicate Person objects that had accidentally been created for the same physical person.Constraints:Both the player and scoper must have the same classCode.
2.16.840.1.113883.5.110 en
UPDATE:

Relates a place entity (player) as the region over which the scoper (typically an Organization) has certain authority (jurisdiction). For example, the Calgary Regional Health Authority (scoper) has authority over the territory "Region 4 of Alberta" (player) in matters of health.

2.16.840.1.113883.5.110 en
UPDATE:

A manufactured material (player) that is used for its therapeutic properties. The manufacturer is the scoper.

2.16.840.1.113883.5.110 en
UPDATE:

A role played by a person or an organization. It is the party that

  • accepts fiscal responsibility for insurance plans and the policies created under those plans;

  • administers and accepts fiscal responsibility for a program that provides coverage for services to eligible individuals; and/or

  • has the responsibility to assess the merits of each risk and decide a suitable premium for accepting all or part of the risk. If played by an organization, this role may be further specified by an appropriate RoleCode.

Example:
  • A health insurer;

  • Medicaid Program;

  • Lloyd's of London

2.16.840.1.113883.5.110 en
UPDATE:

A role a product plays when a guarantee is given to the purchaser by the seller (scoping entity) stating that the product is reliable and free from known defects and that the seller will repair or replace defective parts within a given time limit and under certain conditions.

2.16.840.1.113883.5.110 en
UPDATE:

This relationship indicates the source Role is available to the target Role as a backup. An entity in a backup role will be available as a substitute or replacement in the event that the entity assigned the role is unavailable. In medical roles where it is critical that the function be performed and there is a possibility that the individual assigned may be ill or otherwise indisposed, another individual is assigned to cover for the individual originally assigned the role. A backup may be required to be identified, but unless the backup is actually used, he/she would not assume the assigned entity role.

2.16.840.1.113883.5.107 en
UPDATE:

The source Role has direct authority over the target role in a chain of authority.

2.16.840.1.113883.5.107 en
UPDATE: Definition:The source role provides identification for the target role. The source role must be IDENT. The player entity of the source role is constrained to be the same as the player of the target role if present. If the player is absent from the source role, then it is assumed to be the same as the player of the target role. 2.16.840.1.113883.5.107 en UPDATE:

The source Role has indirect authority over the target role in a chain of authority.

2.16.840.1.113883.5.107 en
UPDATE:

The target Role is part of the Source Role.

2.16.840.1.113883.5.107 en
UPDATE:

This relationship indicates that the source Role replaces (or subsumes) the target Role. Allows for new identifiers and/or new effective time for a registry entry or a certification, etc.

2.16.840.1.113883.5.107 en
UPDATE:

The state representing the fact that the Entity is currently active in the Role.

2.16.840.1.113883.5.1068 en
UPDATE:

The terminal state resulting from cancellation of the role prior to activation.

2.16.840.1.113883.5.1068 en
UPDATE:

The state representing the termination of a Role instance that was created in error.

2.16.840.1.113883.5.1068 en
UPDATE:

The state representing that fact that the role has not yet become active.

2.16.840.1.113883.5.1068 en
UPDATE:

The state that represents a suspension of the Entity playing the Role. This state is arrived at from the "active" state.

2.16.840.1.113883.5.1068 en
UPDATE:

The state representing the successful termination of the Role.

2.16.840.1.113883.5.1068 en
UPDATE:

An accommodation is a service provided for a Person or other LivingSubject in which a place is provided for the subject to reside for a period of time. Commonly used to track the provision of ward, private and semi-private accommodations for a patient.

2.16.840.1.113883.5.6 en
UPDATE:

A financial account established to track the net result of financial acts.

2.16.840.1.113883.5.6 en
UPDATE:

A unit of work, a grouper of work items as defined by the system performing that work. Typically some laboratory order fulfillers communicate references to accessions in their communications regarding laboratory orders. Often one or more specimens are related to an accession such that in some environments the accession number is taken as an identifier for a specimen (group).

2.16.840.1.113883.5.6 en
UPDATE:

Sender asks addressee to do something depending on the focal Act of the payload. An example is "fulfill this order". Addressee has responsibilities to either reject the message or to act on it in an appropriate way (specified by the specific receiver responsibilities for the interaction).

2.16.840.1.113883.5.6 en
UPDATE:

A transformation process where a requested invoice is transformed into an agreed invoice. Represents the adjudication processing of an invoice (claim). Adjudication results can be adjudicated as submitted, with adjustments or refused.

Adjudication results comprise 2 components: the adjudication processing results and a restated (or adjudicated) invoice or claim

2.16.840.1.113883.5.6 en
UPDATE: Description:

An acquisition exposure act describes the proximity (location and time) through which the participating entity was potentially exposed to a physical (including energy), chemical or biological agent from another entity. The acquisition exposure act is used in conjunction with transmission exposure acts as part of an analysis technique for contact tracing. Although an exposure can be decomposed into transmission and acquisition exposures, there is no requirement that all exposures be treated in this fashion.

Constraints:The Acquisition Exposure inherits the participation constraints that apply to Exposure with the following exception. The EXPSRC (exposure source) participation must never be associated with the Transmission Exposure either directly or via context conduction.
2.16.840.1.113883.5.6 en
UPDATE:

An observation identifying a potential adverse outcome as a result of an Act or combination of Acts.

Examples:Detection of a drug-drug interaction; Identification of a late-submission for an invoice; Requesting discharge for a patient who does not meet hospital-defined discharge criteria.Discussion:This class is commonly used for identifying 'business rule' or 'process' problems that may result in a refusal to carry out a particular request. In some circumstances it may be possible to 'bypass' a problem by modifying the request to acknowledge the issue and/or by providing some form of mitigation.Constraints:the Act or Acts that may cause the the adverse outcome are the target of a subject ActRelationship. The subbtypes of this concept indicate the type of problem being detected (e.g. drug-drug interaction) while the Observation.value is used to repesent a specific problem code (e.g. specific drug-drug interaction id).
2.16.840.1.113883.5.6 en
UPDATE:

**Description:**A battery specifies a set of observations. These observations typically have a logical or practical grouping for generally accepted clinical or functional purposes, such as observations that are run together because of automation. A battery can define required and optional components and, in some cases, will define complex rules that determine whether or not a particular observation is made.

Examples:"Blood pressure", "Full blood count", "Chemistry panel".
2.16.840.1.113883.5.6 en
UPDATE:

A group of entries within a composition or topic that have a common characteristic - for example, Examination, Diagnosis, Management OR Subjective, Objective, Analysis, Plan.

The distinction from Topic relates to value sets. For Category there is a bounded list of things like "Examination", "Diagnosis" or SOAP categories. For Topic the list is wide open to any clinical condition or reason for a part of an encounter.

A CATEGORY MAY CONTAIN ENTRIES.

2.16.840.1.113883.5.6 en
UPDATE:

A clinical document that conforms to Level One of the HL7 Clinical Document Architecture (CDA)

2.16.840.1.113883.5.6 en
UPDATE:

The set of actions that define an experiment to assess the effectiveness and/or safety of a biopharmaceutical product (food, drug, device, etc.). In definition mood, this set of actions is often embodied in a clinical trial protocol; in event mood, this designates the aggregate act of applying the actions to one or more subjects.

2.16.840.1.113883.5.6 en
UPDATE:

A group of entries within a composition, topic or category that have a logical association with one another.

The representation of a single observation or action might itself be multi-part. The data might need to be represented as a nested set of values, as a table, list, or as a time series. The Cluster class permits such aggregation within an entry for such compound data.

Examples include "Haematology investigations" which might include two or more distinct batteries.

A cluster may contain batteries and/or individual entries

2.16.840.1.113883.5.6 en
UPDATE: Deprecation Comment:This value set has been deprecated because its root code was deprecated in an earlier vocabulary release. 2.16.840.1.113883.5.6 en UPDATE:

The Consent class represents informed consents and all similar medico-legal transactions between the patient (or his legal guardian) and the provider. Examples are informed consent for surgical procedures, informed consent for clinical trials, advanced beneficiary notice, against medical advice decline from service, release of information agreement, etc.

The details of consents vary. Often an institution has a number of different consent forms for various purposes, including reminding the physician about the topics to mention. Such forms also include patient education material. In electronic medical record communication, consents thus are information-generating acts on their own and need to be managed similar to medical activities. Thus, Consent is modeled as a special class of Act.

The "signatures" to the consent document are represented electronically through Participation instances to the consent object. Typically an informed consent has Participation.typeCode of "performer", the healthcare provider informing the patient, and "consenter", the patient or legal guardian. Some consent may associate a witness or a notary public (e.g., living wills, advanced directives). In consents where a healthcare provider is not required (e.g. living will), the performer may be the patient himself or a notary public.

Some consent has a minimum required delay between the consent and the service, so as to allow the patient to rethink his decisions. This minimum delay can be expressed in the act definition by the ActRelationship.pauseQuantity attribute that delays the service until the pause time has elapsed after the consent has been completed.

2.16.840.1.113883.5.6 en
UPDATE:

An Act where a container is registered either via an automated sensor, such as a barcode reader, or by manual receipt

2.16.840.1.113883.5.6 en
UPDATE:

When used in the EVN mood, this concept means with respect to a covered party:

  • A health care insurance policy or plan that is contractually binding between two or more parties; or

  • A health care program, usually administered by government entities, that provides coverage to persons determined eligible under the terms of the program.

* When used in the definition (DEF) mood, COV means potential coverage for a patient who may or may not be a covered party. * The concept's meaning is fully specified by the choice of ActCoverageTypeCode (abstract) ActProgramCode or ActInsurancePolicyCode.

2.16.840.1.113883.5.6 en
UPDATE:

An identified point during a clinical trial at which one or more actions are scheduled to be performed (definition mood), or are actually performed (event mood). The actions may or may not involve an encounter between the subject and a healthcare professional.

2.16.840.1.113883.5.6 en
UPDATE:

**Description:**A determinant peptide in a polypeptide as described by polypeptide.

2.16.840.1.113883.5.6 en
UPDATE:

Class for holding attributes unique to diagnostic images.

2.16.840.1.113883.5.6 en
UPDATE:

An action taken with respect to a subject Entity by a regulatory or authoritative body with supervisory capacity over that entity. The action is taken in response to behavior by the subject Entity that body finds to be undesirable.

Suspension, license restrictions, monetary fine, letter of reprimand, mandated training, mandated supervision, etc.*Examples:*

2.16.840.1.113883.5.6 en
UPDATE:

A context that distinguishes the body of a document from the document header. This is seen, for instance, in HTML documents, which have discrete <head> and <body> elements.

2.16.840.1.113883.5.6 en
UPDATE:

A context that subdivides the body of a document. Document sections are typically used for human navigation, to give a reader a clue as to the expected content. Document sections are used to organize and provide consistency to the contents of a document body. Document sections can contain document sections and can contain entries.

2.16.840.1.113883.5.6 en
UPDATE:

A context that comprises all compositions. The EHR is an extract that includes the entire chart.

NOTE:In an exchange scenario, an EHR is a specialization of an extract.
2.16.840.1.113883.5.6 en
UPDATE:

An interaction between a patient and healthcare participant(s) for the purpose of providing patient service(s) or assessing the health status of a patient. For example, outpatient visit to multiple departments, home health support (including physical therapy), inpatient hospital stay, emergency room visit, field visit (e.g., traffic accident), office visit, occupational therapy, telephone call.

2.16.840.1.113883.5.6 en
UPDATE:

**Description:**An expression level of genes/proteins or other expressed genomic entities.

2.16.840.1.113883.5.6 en
UPDATE:

An event that occurred outside of the control of one or more of the parties involved. Includes the concept of an accident.

2.16.840.1.113883.5.6 en
UPDATE:

Sender sends payload to addressee as information. Addressee does not have responsibilities beyond serving addressee's own interest (i.e., read and memorize if you see fit). This is equivalent to an FYI on a memo.

2.16.840.1.113883.5.6 en
UPDATE:

The act of transmitting information and understanding about a topic to a subject where the participation association must be SBJ.

Discussion:This act may be used to request that a patient or provider be informed about an Act, or to indicate that a person was informed about a particular act.
2.16.840.1.113883.5.6 en
UPDATE:

Represents concepts related to invoice processing in health care

2.16.840.1.113883.5.6 en
UPDATE:

An formalized inquiry into the circumstances surrounding a particular unplanned event or potential event for the purposes of identifying possible causes and contributing factors for the event. This investigation could be conducted at a local institutional level or at the level of a local or national government.

2.16.840.1.113883.5.6 en
UPDATE:

**Description:**A mandate, regulation, obligation, requirement, rule, or expectation unilaterally imposed by a jurisdiction on:

* The activity of another party * The behavior of another party * The manner in which an act is executed

**Examples:**A jurisdictional mandate regarding the prescribing and dispensing of a particular medication. A jurisdictional privacy or security regulation dictating the manner in which personal health information is disclosed. A jurisdictional requirement that certain services or health conditions are reported to a monitoring program, e.g., immunizations, methadone treatment, or cancer registries.

2.16.840.1.113883.5.6 en
UPDATE:

Working list collects a dynamic list of individual instances of Act via ActRelationship which reflects the need of an individual worker, team of workers, or an organization to manage lists of acts for many different clinical and administrative reasons. Examples of working lists include problem lists, goal lists, allergy lists, and to-do lists.

2.16.840.1.113883.5.6 en
UPDATE: Deprecation Comment:This value set has been deprecated because its root code was deprecated in an earlier vocabulary release. 2.16.840.1.113883.5.6 en UPDATE:

**Description:**The position of a gene (or other significant sequence) on the genome.

2.16.840.1.113883.5.6 en
UPDATE:

An officially or unofficially instituted program to track acts of a particular type or categorization.

2.16.840.1.113883.5.6 en
UPDATE:

Container for Observation Sequences (Observations whose values are contained in LIST<>'s) having values correlated with each other. Each contained Observation Sequence LIST<> must be the same length. Values in the LIST<>'s are correlated based on index. E.g. the values in position 2 in all the LIST<>'s are correlated. This is analogous to a table where each column is an Observation Sequence with a LIST<> of values, and each row in the table is a correlation between the columns. For example, a 12-lead ECG would contain 13 sequences: one sequence for time, and a sequence for each of the 12 leads.

2.16.840.1.113883.5.6 en
UPDATE:

**Description:**A mandate, obligation, requirement, rule, or expectation unilaterally imposed by an organization on:

* The activity of another party * The behavior of another party * The manner in which an act is executed

**Examples:**A clinical or research protocols imposed by a payer, a malpractice insurer, or an institution to which a provider must adhere. A mandate imposed by a denominational institution for a provider to provide or withhold certain information from the patient about treatment options.

2.16.840.1.113883.5.6 en
UPDATE:

An outbreak represents a series of public health cases. The date on which an outbreak starts is the earliest date of onset among the cases assigned to the outbreak, and its ending date is the last date of onset among the cases assigned to the outbreak.

2.16.840.1.113883.5.6 en
UPDATE: AnActthat of taking on whole or partial responsibility for, or attention to, safety and well-being of a subject of care.Discussion:Acare provisionevent may exist without any other care actions taking place. For example, when a patient is assigned to the care of a particular health professional.Inrequest(RQO) moodcare provisioncommunicates a referral, which is a request:

* from one party (linked as a **participant** of type **author** (AUT)), * to another party (linked as a **participant** of type **performer** (PRF), * to take responsibility for a scope specified by the code attribute, * for an entity (linked as a **participant** of type **subject** (SBJ)).

The scope of the care for which responsibility is taken is identified bycodeattribute.Inevent(EVN) moodcare provisionindicates the effective time interval of a specified scope of responsibility by aperformer(PRF) or set ofperformers(PRF) for asubject(SBJ).Examples:
  • Referral from GP to a specialist.

  • Assignment of a patient or group of patients to the case list of a health professional.

  • Assignment of inpatients to the care of particular nurses for a working shift.

2.16.840.1.113883.5.6 en
UPDATE:

**Description:**A genomic phenomenon that is expressed externally in the organism.

2.16.840.1.113883.5.6 en
UPDATE:

**Description:**A polypeptide resulting from the translation of a gene.

2.16.840.1.113883.5.6 en
UPDATE:

**Description:**An observation representing the degree to which the assignment of the spatial coordinates, based on a matching algorithm by a geocoding engine against a reference spatial database, matches true or accepted values.

2.16.840.1.113883.5.6 en
UPDATE:

**Description:**An observation representing one of a set of numerical values used to determine the position of a place. The name of the coordinate value is determined by the reference coordinate system.

2.16.840.1.113883.5.6 en
UPDATE: Deprecation Comment:This value set has been deprecated because its root code was deprecated in an earlier vocabulary release. 2.16.840.1.113883.5.6 en UPDATE:

Represents the act of maintaining information about the registration of its associated registered subject. The subject can be either an Act or a Role, and includes subjects such as lab exam definitions, drug protocol definitions, prescriptions, persons, patients, practitioners, and equipment.

The registration may have a unique identifier - separate from the unique identification of the subject - as well as a core set of related participations and act relationships that characterize the registration event and aid in the disposition of the subject information by a receiving system.*Usage notes:*

2.16.840.1.113883.5.6 en
UPDATE:

The act of examining and evaluating the subject, usually another act. For example, "This prescription needs to be reviewed in 2 months."

2.16.840.1.113883.5.6 en
UPDATE: Deprecation Comment:This value set has been deprecated because its root code was deprecated in an earlier vocabulary release. 2.16.840.1.113883.5.6 en UPDATE:

A Region of Interest (ROI) specified for a multidimensional observation, such as an Observation Series (OBSSER). The ROI is specified using a set of observation criteria, each delineating the boundary of the region in one of the dimensions in the multidimensional observation. The relationship between a ROI and its referenced Act is specified through an ActRelationship of type subject (SUBJ), which must always be present. Each of the boundary criteria observations is connected with the ROI using ActRelationships of type "has component" (COMP). In each boundary criterion, the Act.code names the dimension and the Observation.value specifies the range of values inside the region. Typically the bounded dimension is continuous, and so the Observation.value will be an interval (IVL) data type. The Observation.value need not be specified if the respective dimension is only named but not constrained. For example, an ROI for the QT interval of a certain beat in ECG Lead II would contain 2 boundary criteria, one naming the interval in time (constrained), and the other naming the interval in ECG Lead II (only named, but not constrained).

2.16.840.1.113883.5.6 en
UPDATE:

A Region of Interest (ROI) specified for an image using an overlay shape. Typically used to make reference to specific regions in images, e.g., to specify the location of a radiologic finding in an image or to specify the site of a physical finding by "circling" a region in a schematic picture of a human body. The units of the coordinate values are in pixels. The origin is in the upper left hand corner, with positive X values going to the right and positive Y values going down. The relationship between a ROI and its referenced Act is specified through an ActRelationship of type "subject" (SUBJ), which must always be present.

2.16.840.1.113883.5.6 en
UPDATE: Deprecation Comment:This value set has been deprecated because its root code was deprecated in an earlier vocabulary release. 2.16.840.1.113883.5.6 en UPDATE:

The act of introducing or otherwise applying a substance to the subject.

Discussion:The effect of the substance is typically established on a biochemical basis, however, that is not a requirement. For example, radiotherapy can largely be described in the same way, especially if it is a systemic therapy such as radio-iodine. This class also includes the application of chemical treatments to an area.Examples:Chemotherapy protocol; Drug prescription; Vaccination record
2.16.840.1.113883.5.6 en
UPDATE:

**Description:**An ethical or clinical obligation, requirement, rule, or expectation imposed or strongly encouraged by organizations that oversee particular clinical domains or provider certification which define the boundaries within which a provider may practice and which may have legal basis or ramifications on:

* The activity of another party * The behavior of another party * The manner in which an act is executed

**Examples:**An ethical obligation for a provider to fully inform a patient about all treatment options. An ethical obligation for a provider not to disclose personal health information that meets certain criteria, e.g., where disclosure might result in harm to the patient or another person. The set of health care services which a provider is credentialed or privileged to provide.

2.16.840.1.113883.5.6 en
UPDATE:

**Description:**A sequence of biomolecule like the DNA, RNA, protein and the like.

2.16.840.1.113883.5.6 en
UPDATE:

**Description:**A variation in a sequence as described by BioSequence.

2.16.840.1.113883.5.6 en
UPDATE: Deprecation Comment:This value set has been deprecated because its root code was deprecated in an earlier vocabulary release. 2.16.840.1.113883.5.6 en UPDATE: Deprecation Comment:This value set has been deprecated because its root code was deprecated in an earlier vocabulary release. 2.16.840.1.113883.5.6 en UPDATE:

An observation on a specimen in a laboratory environment that may affect processing, analysis or result interpretation

2.16.840.1.113883.5.6 en
UPDATE:

A procedure or treatment performed on a specimen to prepare it for analysis

2.16.840.1.113883.5.6 en
UPDATE:

Sender transmits a status change pertaining to the focal act of the payload. This status of the focal act is the final state of the state transition. This can be either a request or a command, according to the mood of the control act.

2.16.840.1.113883.5.6 en
UPDATE:

**Description:**A requirement, rule, or expectation typically documented as guidelines, protocols, or formularies imposed or strongly encouraged by an organization that oversees or has authority over the practices within a domain, and which may have legal basis or ramifications on:

* The activity of another party * The behavior of another party * The manner in which an act is executed

**Examples:**A payer may require a prescribing provider to adhere to formulary guidelines. An institution may adopt clinical guidelines and protocols and implement these within its electronic health record and decision support systems.

2.16.840.1.113883.5.6 en
UPDATE: Deprecation Comment:This value set has been deprecated because its root code was deprecated in an earlier vocabulary release. 2.16.840.1.113883.5.6 en UPDATE:

Definition: Indicates that the subject Act has undergone or should undergo substitution of a type indicated by Act.code.

Rationale: Used to specify "allowed" substitution when creating orders, "actual" susbstitution when sending events, as well as the reason for the substitution and who was responsible for it.

2.16.840.1.113883.5.6 en
UPDATE: Description:

A transmission exposure act describes the proximity (time and location) over which the participating source entity was capable of transmitting a physical (including energy), chemical or biological substance agent to another entity. The transmission exposure act is used in conjunction with acquisition exposure acts as part of an analysis technique for contact tracing. Although an exposure can be decomposed into transmission and acquisition exposures, there is no requirement that all exposures be treated in this fashion.

Constraints:The Transmission Exposure inherits the participation constraints that apply to Exposure with the following exception. The EXPTRGT (exposure target) participation must never be associated with the Transmission Exposure either directly or via context conduction.
2.16.840.1.113883.5.6 en
UPDATE:

A group of entries within a composition that are related to a common clinical theme - such as a specific disorder or problem, prevention, screening and provision of contraceptive services.

A topic may contain categories and entries.

2.16.840.1.113883.5.6 en
UPDATE: Deprecation Comment:This value set has been deprecated because its root code was deprecated in an earlier vocabulary release. 2.16.840.1.113883.5.6 en UPDATE: Definition:The act of transferring information without the intent of imparting understanding about a topic to the subject that is the recipient or holder of the transferred information where the participation association must be RCV or HLD. 2.16.840.1.113883.5.6 en UPDATE:

Transportation is the moving of a payload (people or material) from a location of origin to a destination location. Thus, any transport service has the three target instances of type payload, origin, and destination, besides the targets that are generally used for any service (i.e., performer, device, etc.)

2.16.840.1.113883.5.6 en
UPDATE:

An act which describes the process whereby a 'verifying party' validates either the existence of the Role attested to by some Credential or the actual Vetting act and its details.

2.16.840.1.113883.5.6 en
UPDATE:

A sub-class of Act representing any transaction between two accounts whose value is measured in monetary terms.

In the "intent" mood, communicates a request for a transaction to be initiated, or communicates a transfer of value between two accounts.

In the "event" mood, communicates the posting of a transaction to an account.

2.16.840.1.113883.5.6 en
UPDATE:

A planned Act for a specific time and place.

2.16.840.1.113883.5.1001 en
UPDATE:

A request for the booking of an appointment.

2.16.840.1.113883.5.1001 en
UPDATE:

A definition of a service (master).

Historical note: in previous RIM versions, the definition mood was captured as a separate class hierarchy, called Master\_service.

2.16.840.1.113883.5.1001 en
UPDATE:

A service that actually happens, may be an ongoing service or a documentation of a past service.

Historical note: in previous RIM versions, the event mood was captured as a separate class hierarchy, called Patient\_service\_event, and later Service\_event.

2.16.840.1.113883.5.1001 en
UPDATE:

A criterion or condition over service events that must apply for an associated service to be considered.

2.16.840.1.113883.5.1001 en
UPDATE:

**Definition:**An act that is considered likely to occur in the future. The essential feature of an act expressed in expectation mood is that it is likely to occur. An expectation may be desirable, undesirable or neutral in effect.

**Examples:**Prognosis of a condition, Expected date of discharge from hospital, patient will likely need an emergency decompression of the intracranial pressure by morning.

**Discussion:**INT (intent) reflects a plan for the future, which is a declaration to do something. This contrasts with expectation, which is a prediction that something will happen in the future. GOL (goal) reflects a hope rather than a prediction. RSK (risk) reflects a potential negative event that may or may not be expected to happen.

2.16.840.1.113883.5.1001 en
UPDATE: No description 2.16.840.1.113883.5.110 en UPDATE: No description 2.16.840.1.113883.5.110 en UPDATE: No description 2.16.840.1.113883.5.110 en UPDATE: No description 2.16.840.1.113883.5.110 en UPDATE:

A comprehensive classification of locations and settings where healthcare services are provided. This value set is based on the CMS Place of Service code set NHSN location code system that has been developed over a number of years through CDCaTMs interaction with a variety of healthcare facilities and is intended to serve a variety of reporting needs where coding of healthcare service locations is required. Excluded codes are those that do not represent an actual location where health care services can be delivered, IE: Float, or a location aggregation.

2.16.840.1.113883.6.259 2.16.840.1.113883.15.5 en
UPDATE: Description:Codes to specify the scope in which the identifier applies to the object with which it is associated, and used in the datatype property II. 2.16.840.1.113883.5.1116 en UPDATE: Description:The identifier was issued by the system responsible for constructing the instance. 2.16.840.1.113883.5.1117 en UPDATE: Description:An address line is for either an additional locator, a delivery address or a street address. 2.16.840.1.113883.5.16 en UPDATE: No description 2.16.840.1.113883.5.110 en UPDATE:

**Description:**Coded observation values for coverage limitations, for e.g., types of claims or types of parties covered under a policy or program.

2.16.840.1.113883.5.1063 en
UPDATE:

**Description:**Coded observation values for types of covered parties under a policy or program based on their personal relationships or employment status.

2.16.840.1.113883.5.1063 en
UPDATE:

**Description:**Cancelled, nullified and obsolete .

2.16.840.1.113883.5.14 en
UPDATE:

**Description:**These are moods describing activities as they progress in the business cycle, from defined, through planned and ordered to completed, and any applicable criterion or condition over actual and potential services that must apply for an associated service to be considered.

2.16.840.1.113883.5.1001 en
UPDATE: Description:Conveyance of the type of information transfer protocol. 2.16.840.1.113883.5.4 en UPDATE:

A code that provides additional detail about the means or technique used to ascertain the genetic analysis. Example, PCR, Micro Array

2.16.840.1.113883.5.84 en
UPDATE:

Codes that specify interpretation of genetic analysis, such as "positive", "negative", "carrier", "responsive", etc.

2.16.840.1.113883.5.83 en
UPDATE: Description:The domain contains genetic analysis specific observation values, e.g. Homozygote, Heterozygote, etc. 2.16.840.1.113883.5.1063 en UPDATE: Description:Identifies the kinds of genetic observations that can be performed. 2.16.840.1.113883.5.4 en UPDATE: No description 2.16.840.1.113883.5.45 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1001 en UPDATE:

**Description:**A value set of product related role classCodes

2.16.840.1.113883.5.110 en
UPDATE:

**Description:**A value set of role classCodes related to entity management.

2.16.840.1.113883.5.110 en
UPDATE:

**Description:**Trigger Event ID as published in the standard.

2.16.840.1.113883.1.18 en
UPDATE:

Countries of the world. ISO 3166, part 1, alpha-2 set.

1.0.3166.1 en
UPDATE: No description 2.16.840.1.113883.5.6 en UPDATE: No description 2.16.840.1.113883.5.6 en UPDATE: No description 2.16.840.1.113883.5.6 en UPDATE: Description:The status of an assessment for indications of an abnormal condition. 2.16.840.1.113883.5.14 en UPDATE:

**Description:**Basic abbreviations defined for the General timing Specification data type.

2.16.840.1.113883.5.1022 en
UPDATE:

**Description:**Other, more specific, abbreviations defined for the General timing Specification data type, that are specializations of one of the Base concepts.

2.16.840.1.113883.5.1022 en
UPDATE: Description:Concepts that define the telecommunication capabilities of a particular device. Used to identify the expected capabilities to be found at a particular telecommunication address. 2.16.840.1.113883.5.1118 en UPDATE: No description 2.16.840.1.113883.5.1119 en UPDATE: No description 2.16.840.1.113883.5.1119 en UPDATE: No description 2.16.840.1.113883.5.1119 en UPDATE:

**Description:**An entity (player) that is used by another entity (scoper)

2.16.840.1.113883.5.110 en
UPDATE:

**Description:**A set of codes advising a system or user which name in a set of names to select for a given purpose.

2.16.840.1.113883.5.1120 en
UPDATE:

**Description:**Indicates whether the name part is a given name, family name, prefix, suffix, etc.

2.16.840.1.113883.5.1121 en
UPDATE:

**Description:**The qualifier is a set of codes each of which specifies a certain subcategory of the name part in addition to the main name part type. For example, a given name may be flagged as a nickname, a family name may be a pseudonym or a name of public records.

2.16.840.1.113883.5.1122 en
UPDATE: No description 2.16.840.1.113883.1.18 en UPDATE: No description 2.16.840.1.113883.6.278 en UPDATE: No description 2.16.840.1.113883.6.279 en UPDATE:

Interpretations of the presence or absence of a component / analyte or organism in a test or of a sign in a clinical observation. In keeping with laboratory data processing practice, these concepts provide a categorical interpretation of the "meaning" of the quantitative value for the same observation.

2.16.840.1.113883.5.83 en
UPDATE:

Provides a categorization for annotations recorded directly against the patient

2.16.840.1.113883.5.4 en
UPDATE: No description 2.16.840.1.113883.5.6 en UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE: ActCodeProcessStep\- Property applies to value sets that contain classCode values in structural vocabularies. It identifies by name the Concept Domain(s) that represent(s) the concepts that are sub-types of the concept collection established by the value sets of class codes. 2.16.840.1.113883.5.6 en UPDATE:

**Definition:**Identifies why the dispense event was not completed

2.16.840.1.113883.5.8 en
UPDATE:

**Definition:**Indicates why the requested authorization to prescribe or dispense a medication has been refused.

2.16.840.1.113883.5.8 en
UPDATE:

**Definition:**Indicates why the request to transfer a prescription from one dispensing facility to another has been refused.

2.16.840.1.113883.5.8 en
UPDATE: No description 2.16.840.1.113883.5.8 2.16.840.1.113883.5.4 en UPDATE: No description 2.16.840.1.113883.5.8 2.16.840.1.113883.5.4 en UPDATE: No description 2.16.840.1.113883.5.6 en UPDATE: No description 2.16.840.1.113883.5.6 en UPDATE: Description: Deprecation Comment:Was mis-named, and a proper representation has been provided. Replaced by value set ActRelationshipCompliesWith. 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: Description:Subset of null flavors, used for associations as needed for the ITS, and used in InfrastructureRoot. 2.16.840.1.113883.5.1008 en UPDATE: Description:The ways that product safety Investigations, about which information is captured in an Individual Case Safety Report, are related to each other. One investigation may be performed at a patient care institution, and the second by a manufacturer, a third by a regulatory agency. They may all investigate the same case and are thus related. Other kinds of relationships are replacement (if the mode of the Investigation is changed). 2.16.840.1.113883.5.1002 en UPDATE: Description:The class of the primary role by which the party is identified as the subject of an adverse event assessment. 2.16.840.1.113883.5.110 en UPDATE: Description:All coded binding realms for terminology constraint context binding. 2.16.840.1.113883.5.1124 en UPDATE:

**Definition:**A comprehensive term for health care provided in a healthcare facility (e.g. a practitioneraTMs office, clinic setting, or hospital) on a nonresident basis. The term ambulatory usually implies that the patient has come to the location and is not assigned to a bed. Sometimes referred to as an outpatient encounter.

2.16.840.1.113883.5.4 en
UPDATE:

**Definition:**A patient encounter that takes place at a dedicated healthcare service delivery location where the patient receives immediate evaluation and treatment, provided until the patient can be discharged or responsibility for the patient's care is transferred elsewhere (for example, the patient could be admitted as an inpatient or transferred to another facility.)

2.16.840.1.113883.5.4 en
UPDATE:

**Definition:**A patient encounter that takes place both outside a dedicated service delivery location and outside a patient's residence. Example locations might include an accident site and at a supermarket.

2.16.840.1.113883.5.4 en
UPDATE:

**Definition:**Healthcare encounter that takes place in the residence of the patient or a designee

2.16.840.1.113883.5.4 en
UPDATE:

**Definition:**An encounter where the patient is admitted to a health care facility for a predetermined length of time, usually less than 24 hours.

2.16.840.1.113883.5.4 en
UPDATE:

**Definition:**A patient encounter where the patient and the practitioner(s) are not in the same physical location. Examples include telephone conference, email exchange, robotic surgery, and televideo conference.

2.16.840.1.113883.5.4 en
UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE:

Indicates why the act revision (status update) is being refused.

2.16.840.1.113883.5.8 en
UPDATE:

Codes used to define various metadata aspects of a health quality measure.

2.16.840.1.113883.5.4 en
UPDATE: No description 2.16.840.1.113883.5.1063 en UPDATE:

Observation values used to indicate what kind of health quality measure is used.

2.16.840.1.113883.5.1063 en
UPDATE:

Observation values used to assert various populations that a subject falls into.

2.16.840.1.113883.5.1063 en
UPDATE: Description:A rule set by regulators of product that somehow constrain the use of products. Regulator may be any organization with a mandate to issue such rules, regardless of level, regional, country, state, and local (e.g., an institutional Pharmaceutical and Treatment Committee.)Examples:

* Prescription Only * Controlled Substance Schedule II * Standard of Practice

2.16.840.1.113883.5.4 en
UPDATE:

A role type used to qualify a person's legal status within a country or nation.

Examples:

* Full citizen * Asylum seeker * Permit card holder

2.16.840.1.113883.5.111 en
UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1129 en UPDATE: No description 2.16.840.1.113883.5.1001 en UPDATE: No description 2.16.840.1.113883.5.1001 en UPDATE: No description 2.16.840.1.113883.5.1001 en UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE: No description 2.16.840.1.113883.5.4 en UPDATE:

The presence of an bio-chemical entity (substance) at a location or environment, such as an ingredient in a mixture, molecular part of a complex, a located entity at a cellular structure, or content of a container, such as a vesicle.

2.16.840.1.113883.5.110 en
UPDATE: No description 2.16.840.1.113883.5.90 en UPDATE: No description 2.16.840.1.113883.5.110 en UPDATE: No description 2.16.840.1.113883.5.110 en UPDATE: No description 2.16.840.1.113883.5.107 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE:

All codes from code system ActCode.\_IndividualCaseSafetyReportType

2.16.840.1.113883.5.4 en
UPDATE: No description 2.16.840.1.113883.5.90 en UPDATE: No description 2.16.840.1.113883.5.90 en UPDATE: No description 2.16.840.1.113883.5.110 en UPDATE: No description 2.16.840.1.113883.5.110 en UPDATE: No description 2.16.840.1.113883.5.110 en UPDATE: No description 2.16.840.1.113883.5.110 en UPDATE: No description 2.16.840.1.113883.5.110 en UPDATE: No description 2.16.840.1.113883.5.110 en UPDATE: No description 2.16.840.1.113883.5.6 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: Description:Coded reasons why an antigen is considered invalid. 2.16.840.1.113883.5.8 en UPDATE: Description:Indicates the valid antigen count. 2.16.840.1.113883.5.4 en UPDATE: Description:Reporting codes that are related to an immunization event. 2.16.840.1.113883.5.4 en UPDATE: No description 2.16.840.1.113883.5.9 en UPDATE: No description 2.16.840.1.113883.5.1137 en UPDATE: No description 2.16.840.1.113883.5.1137 en UPDATE: No description 2.16.840.1.113883.5.1137 en UPDATE: No description 2.16.840.1.113883.5.1137 en UPDATE: No description 2.16.840.1.113883.5.1137 en UPDATE: No description 2.16.840.1.113883.5.1137 en UPDATE: No description 2.16.840.1.113883.5.1137 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.8 en UPDATE:

**Description:**Describes types of identifiers other than the primary location registry identifier for a service delivery location. Identifiers may be assigned by a local service delivery organization, a formal body capable of accrediting the location for the capability to provide specific services or the identifier may be assigned at a jurisdictional level.

2.16.840.1.113883.5.111 en
UPDATE:

**Description:**Test methods designed to determine a microorganism's susceptibility to an antibiotic.

2.16.840.1.113883.5.84 en
UPDATE:

ActPrivacyPolicyType codes support the designation of the 1..\* policies that are applicable to an Act such as a Consent Directive, a Role such as a VIP Patient, or an Entity such as a patient who is a minor. 1..\* ActPrivacyPolicyType values may be associated with an Act or Role to indicate the policies that govern the assignment of an Act or Role confidentialityCode. Use of multiple ActPrivacyPolicyType values enables fine grain specification of applicable policies, but must be carefully assigned to ensure cogency and avoid creation of conflicting policy mandates. Statutory title may be named in the ActClassPolicy Act Act.title to specify which privacy policy is being referenced.

2.16.840.1.113883.5.4 en
UPDATE:

ActConsentDirective codes are used to specify the type of Consent Directive to which a Consent Directive Act conforms.

2.16.840.1.113883.5.4 en
UPDATE:

ActPrivacyLaw codes may be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialtyCode complies. May be used to further specify rationale for assignment of other ActPrivacyPolicy codes in the US realm, e.g., ETH and 42CFRPart2 can be differentiated from ETH and Title38Part1.

2.16.840.1.113883.5.4 en
UPDATE: Deprecation Comment:Content moved to ActCode, and is now represented in value set ActPrivacyLaw. 2.16.840.1.113883.5.1138 en UPDATE:

Sensitivity codes are not useful for interoperability outside of a policy domain because sensitivity policies are typically localized and vary drastically across policy domains even for the same information category because of differing organizational business rules, security policies, and jurisdictional requirements. For example, an "employee" sensitivity code would make little sense for use outside of a policy domain. "Taboo" would rarely be useful outside of a policy domain unless there are jurisdictional requirements requiring that a provider disclose sensitive information to a patient directly.

Sensitivity codes may be more appropriate in a legacy system's Master Files in order to notify those who access a patient's orders and observations about the sensitivity policies that apply. Newer systems may have a security engine that uses a sensitivity policy's criteria directly. The specializable Sensitivity Act.code may be useful in some scenarious if used in combination with a sensitivity identifier and/or Act.title.

2.16.840.1.113883.5.4 en
UPDATE:

ActSensitivity codes are used to bind information to an Act.confidentialityCode according to local sensitivity policy so that those confidentiality codes can then govern its handling across enterprises. Internally to a policy domain, however, local policies guide the access control system on how end users in that policy domain are able to use information tagged with these sensitivity values.

2.16.840.1.113883.5.4 en
UPDATE:

RoleSensitivity codes are used to bind information to a Role.confidentialityCode per organizational policy. Role.confidentialityCode is defined in the RIM as "an indication of the appropriate disclosure of information about this Role with respect to the playing Entity."

2.16.840.1.113883.5.4 en
UPDATE:

EntitySensitivity codes are used to convey a policy that is applicable to sensitive information conveyed by an entity attribute. May be used to bind a Role.confidentialityCode associated with an Entity per organizational policy. Role.confidentialityCode is defined in the RIM as "an indication of the appropriate disclosure of information about this Role with respect to the playing Entity."

2.16.840.1.113883.5.4 en
UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.110 en UPDATE: No description 2.16.840.1.113883.5.110 en UPDATE:

Types of security policies that further specify the ActClassPolicy value set.

Examples:

* encrypt * prohibit redisclosure without consent directive

2.16.840.1.113883.5.4 en
UPDATE:

Conveys the mandated workflow action that an information custodian, receiver, or user must perform.

Examples:

* encrypt

Usage Note:Per OASIS XACML, an obligation is an operation specified in a policy or policy that is performed in conjunction with the enforcement of an access control decision.
2.16.840.1.113883.5.4 en
UPDATE:

Conveys prohibited actions which an information custodian, receiver, or user is not permitted to perform unless otherwise authorized or permitted under specified circumstances.

Examples:

* prohibit redisclosure without consent directive

2.16.840.1.113883.5.4 en
UPDATE:

The rationale or purpose for an act relating to health information management, such as archiving information for the purpose of complying with an organization policy or jurisdictional law relating to data retention.

2.16.840.1.113883.5.8 en
UPDATE:

Supports communication of purpose of use at a general level.

2.16.840.1.113883.5.8 en
UPDATE:

Supports communication of purpose of use at a general level.

2.16.840.1.113883.5.8 en
UPDATE:

A set of codes that defines how a set of values are summarized in an aggregated computation, for use with sets of values do describe which aggregated statistic functions are to be applied (e.g., average, mode, min, max, standard deviation, variance).

2.16.840.1.113883.5.84 en
UPDATE:

The source Act starts after the end of the target Act (i.e. if we say "ActOne SBE ActTwo", it means that ActOne starts before the end of ActTwo, therefore ActOne is the source and ActTwo is the target).

2.16.840.1.113883.5.1002 en
UPDATE:

The source Act ends after the end of the target Act (i.e. if we say "ActOne EBE ActTwo", it means that ActOne ends before the end of ActTwo, therefore ActOne is the source and ActTwo is the target).

2.16.840.1.113883.5.1002 en
UPDATE:

The source Act starts when the target act ends (i.e. if we say "ActOne SCWE ActTwo", it means that ActOne starts when ActTwo ends, therefore ActOne is the source and ActTwo is the target).

2.16.840.1.113883.5.1002 en
UPDATE:

The source Act ends when the target act starts (i.e. if we say "ActOne ECWS ActTwo", it means that ActOne ends when ActTwo starts, therefore ActOne is the source and ActTwo is the target).

2.16.840.1.113883.5.1002 en
UPDATE:

A public health case is a Concern about an observation or event that has a specific significance for public health. The creation of a PublicHealthCase initiates the tracking of the object of concern. The decision to track is related to but somewhat independent of the underlying event or observation.

2.16.840.1.113883.5.6 en
UPDATE:

An Outbreak is a concern resulting from a series of public health cases.

2.16.840.1.113883.5.6 en
UPDATE:

Type of security metadata observation made about an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security metadata are used in security labels. According to ISO/TS 22600-3:2009(E) A.9.1.7 SECURITY LABEL MATCHING, Security label matching compares the initiator's clearance to the target's security label. All of the following must be true for authorization to be granted:

* The security policy identifiers shall be identical, * The classification level of the initiator shall be greater than or equal to that of the target (that is, there shall be at least one value in the classification list of the clearance greater than or equal to the classification of the target), and * For each security category in the target label, there shall be a security category of the same type in the initiator'ijs clearance and the initiator's classification level shall dominate that of the target.

2.16.840.1.113883.5.4 en
UPDATE:

Type of security metadata observation made about the classification of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions.

Security classification is defined by ISO/IEC 2382-8:1998(E/F)/ T-REC-X.812-1995 as: "The determination of which specific degree of protection against access the data or information requires, together with a designation of that degree of protection." Security classification metadata is based on an analysis of applicable policies and the risk of financial, reputational, or other harm that could result from unauthorized disclosure.

2.16.840.1.113883.5.4 en
UPDATE:

Type of security metadata observation made about the category of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security category metadata is defined by ISO/IEC 2382-8:1998(E/F)/ T-REC-X.812-1995 as: "A nonhierarchical grouping of sensitive information used to control access to data more finely than with hierarchical security classification alone."

2.16.840.1.113883.5.4 en
UPDATE:

Type of security metadata observation made about the control of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security control metadata conveys instructions for secure distribution, transmission, storage or use.

2.16.840.1.113883.5.4 en
UPDATE:

Type of security metadata observation made about the integrity of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions.

2.16.840.1.113883.5.4 en
UPDATE:

Type of security metadata observation made about the integrity status of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Indicates the completeness or workflow status of an IT resource, which may impact users that are authorized to access and use the resource.

2.16.840.1.113883.5.4 en
UPDATE:

Type of security metadata observation made about the integrity confidence of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions.

2.16.840.1.113883.5.4 en
UPDATE:

Type of security metadata observation made about the data integrity of an IT resource (data, information object, service, or system capability), which indicates the security mechanism used to preserve resource accuracy and consistency. Data integrity is defined by ISO 22600-23.3.21 as: "The property that data has not been altered or destroyed in an unauthorized manner", and by ISO/IEC 2382-8: The property of data whose accuracy and consistency are preserved regardless of changes made."

2.16.840.1.113883.5.4 en
UPDATE:

<pType of security metadata observation made about the alteration integrity of an IT resource (data, information object, service, or system capability), which indicates the mechanism used for authorized transformations of the resource.</p>

2.16.840.1.113883.5.4 en
UPDATE:

Type of security metadata observation made about the provenance integrity of an IT resource (data, information object, service, or system capability), which indicates the lifecycle completeness or workflow status of an IT resource, such as its creation, modification, suspension, and deletion; locations in which the resource has been collected or archived, from which it may be retrieved, and the history of its distribution and disclosure. Integrity provenance metadata about an IT resource may be used to assess its veracity, reliability, and trustworthiness.

2.16.840.1.113883.5.4 en
UPDATE:

Type of security metadata observation made about the integrity provenance of an IT resource (data, information object, service, or system capability), which indicates the entity that reported the existence of the resource. The reporting entity may not be the original author of the resource.

2.16.840.1.113883.5.4 en
UPDATE:

Type of security metadata observation made about the integrity provenance of an IT resource (data, information object, service, or system capability), which indicates the entity that made assertions about the resource. The asserting entity may not be the original informant about the resource.

2.16.840.1.113883.5.4 en
UPDATE:

Observation values used to indicate security observation metadata.

2.16.840.1.113883.5.1063 2.16.840.1.113883.5.25 en
UPDATE:

Security observation values used to indicate security category metadata. V:SecurityCategoryObservationValue is the union of V:PrivacyPolicyType, V:ActPrivacyLaw, V:ActConsentDirective, V:InformationSensitivityPolicy, V:ActInformationSensitivityPolicy, V:RoleInformationSensitivityPolicy, V:EntityInformationSensitivityPolicy, and the V:ActConsentType value used to populate the SecurityCategoryObservationValue attribute in order to convey one or more nonhierarchical categories of sensitivity metadata, which are used to control access to data more finely than with hierarchical security classification alone. Could be bound R1 to a V:ActUSPrivacyPolicy in a future US Realm.

2.16.840.1.113883.5.1063 2.16.840.1.113883.5.4 en
UPDATE:

Security observation values used to indicate security control metadata. V:SecurityControl is the union of V:SecurityPolicy, V:ObligationPolicy, V:RefrainPolicy, V:PurposeOfUse, and V:GeneralPurpose of Use, V:PrivacyMark, V:SecurityLabelMark, and V:ControlledUnclassifiedInformation used to populate the SecurityControlObservationValue attribute in order to convey one or more nonhierarchical security control metadata dictating handling caveats including, purpose of use, obligation policy, refrain policy, dissemination controls and privacy marks to which a custodian or receiver is required to comply.

2.16.840.1.113883.5.1063 2.16.840.1.113883.5.4 2.16.840.1.113883.5.8 en
UPDATE:

Identifies the set of participation types context that can be blocked (overridden) at the CDA section or sub-section level of a document.

2.16.840.1.113883.5.90 en
UPDATE:

Observation types for specifying criteria used to assert that a subject is included in a particular population.

2.16.840.1.113883.5.4 en
UPDATE:

Interpretations of the presence and level of reactivity of the specified component / analyte with the reagent in the performed laboratory test.

2.16.840.1.113883.5.83 en
UPDATE:

A named tag set for metadata used to populate a security category label field that "segments" an IT resource per policy by indicating that access and use is restricted to members of a defined community or project. (HL7 Healthcare Privacy and Security Classification System)

Usage Note:This is the healthcare analog to the US Intelligence Community's concept of a Special Access Program. Compartment codes may be used in as a field value in an initiator's clearance to indicate permission to access and use an IT Resource with a security label having the same compartment value in security category label field.

Map: Aligns with ISO 2382-8 definition of Compartment - "A division of data into isolated blocks with separate security controls for the purpose of reducing risk."

2.16.840.1.113883.5.4 en
UPDATE:

Security observation values used to indicate security classification metadata.

2.16.840.1.113883.5.25 en
UPDATE:

Security observation values used to indicate security integrity status metadata.

2.16.840.1.113883.5.33 en
UPDATE:

Type of security metadata observation made about the integrity of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions.

2.16.840.1.113883.5.1063 en
UPDATE: No description 2.16.840.1.113883.5.1063 en UPDATE:

Type of security metadata observation made about the data integrity of an IT resource (data, information object, service, or system capability), which indicates the security mechanism used to preserve resource accuracy and consistency. Data integrity is defined by ISO 22600-23.3.21 as: "The property that data has not been altered or destroyed in an unauthorized manner", and by ISO/IEC 2382-8: The property of data whose accuracy and consistency are preserved regardless of changes made."

2.16.840.1.113883.5.1063 en
UPDATE: No description 2.16.840.1.113883.5.1063 en UPDATE:

Type of security metadata observation made about the provenance integrity of an IT resource (data, information object, service, or system capability), which indicates the lifecycle completeness or workflow status of an IT resource, such as its creation, modification, suspension, and deletion; locations in which the resource has been collected or archived, from which it may be retrieved, and the history of its distribution and disclosure. Integrity provenance metadata about an IT resource may be used to assess its veracity, reliability, and trustworthiness.

2.16.840.1.113883.5.1063 en
UPDATE: No description 2.16.840.1.113883.5.1063 en UPDATE: No description 2.16.840.1.113883.5.1063 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE: No description 2.16.840.1.113883.5.1002 en UPDATE:

A standard value set allowing reference to all EntityDeterminer codes that are equal to or specializations of GROUP. This is the value set used when a model indicates that the binding is to "<= GROUP".

2.16.840.1.113883.5.30 en
UPDATE:

A standard value set allowing reference to all EntityDeterminer codes that are equal to or specializations of GROUPKIND. This is the value set used when a model indicates that the binding is to "<= GROUPKIND".

2.16.840.1.113883.5.30 en
UPDATE:

Indicates why an existing prescription is changed.

2.16.840.1.113883.5.8 en
UPDATE:

Pro-forma value set for each head code in the ActRelationshipType code system; all codes present and future below the head code.

2.16.840.1.113883.5.1002 en
UPDATE:

Pro-forma value set for each head code in the ActRelationshipType code system; all codes present and future below the head code.

2.16.840.1.113883.5.1002 en
UPDATE:

Pro-forma value set for each head code in the ActRelationshipType code system; all codes present and future below the head code.

2.16.840.1.113883.5.1002 en
UPDATE:

Pro-forma value set for each head code in the ActRelationshipType code system; all codes present and future below the head code.

2.16.840.1.113883.5.1002 en
UPDATE:

Pro-forma value set for each head code in the ActRelationshipType code system; all codes present and future below the head code.

2.16.840.1.113883.5.1002 en
UPDATE:

Pro-forma value set for each head code in the ActRelationshipType code system; all codes present and future below the head code.

2.16.840.1.113883.5.1002 en
UPDATE:

Pro-forma value set for each head code in the ActRelationshipType code system; all codes present and future below the head code.

2.16.840.1.113883.5.1002 en
UPDATE:

Pro-forma value set for each head code in the ActRelationshipType code system; all codes present and future below the head code.

2.16.840.1.113883.5.1002 en
UPDATE:

Pro-forma value set for each head code in the ActRelationshipType code system; all codes present and future below the head code.

2.16.840.1.113883.5.1002 en
UPDATE:

Pro-forma value set for each head code in the ActRelationshipType code system; all codes present and future below the head code.

2.16.840.1.113883.5.1002 en
UPDATE:

Pro-forma value set for each head code in the ActRelationshipType code system; all codes present and future below the head code.

2.16.840.1.113883.5.1002 en
UPDATE:

Pro-forma value set for each head code in the ActRelationshipType code system; all codes present and future below the head code.

2.16.840.1.113883.5.1002 en
UPDATE:

Pro-forma value set for each head code in the ActRelationshipType code system; all codes present and future below the head code.

2.16.840.1.113883.5.1002 en
UPDATE:

The reasons that may be used when relating a Quality Measure Document to other document types.

2.16.840.1.113883.5.1002 en
UPDATE:

\*\* none supplied \*\*

2.16.840.1.113883.5.14 en
UPDATE:

\*\* none supplied \*\*

2.16.840.1.113883.5.14 en
UPDATE:

Used to convey the relationship between two or more Documents for purpose of tracking provenance relationships such as a predecessor Document and a successor Document.

For example, a predecessor Clinical Summary Document from which a successor Clinical Summary Document is derived.

2.16.840.1.113883.5.1002 en
UPDATE:

Used to convey the relationship between two or more Acts for purpose of tracking provenance relationships such as the following:

* A predecessor Act and a successor Act (e.g., a predecessor Lab Result from which a successor Lab Result in derived) * A ProvenanceEvent Act and a target Act for which it records the Provenance (e.g., a target Act is an update of a predecessor Act) * A predecessor ProvenanceEvent Act and a successor ProvenanceEvent Act

UsageConstraint:The v:ActRelationshipActProvenance is intended to limit the types of relationships that could be conveyed by the ActRelationshipType codes to a subset that pertains to these provenance relations.
2.16.840.1.113883.5.1002 en
UPDATE:

A mandate, obligation, requirement, rule, or expectation conveyed as security metadata between senders and receivers required to establish the reliability, authenticity, and trustworthiness of their transactions.

Trust security metadata are observation made about aspects of trust applicable to an IT resource (data, information object, service, or system capability).

Trust applicable to IT resources is established and maintained in and among security domains, and may be comprised of observations about the domain's trust authority, trust framework, trust policy, trust interaction rules, means for assessing and monitoring adherence to trust policies, mechanisms that enforce trust, and quality and reliability measures of assurance in those mechanisms. \[Based on ISO IEC 10181-1 and NIST SP 800-63-2\]

2.16.840.1.113883.5.4 en
UPDATE:

Type of security metadata observation made about aspects of trust applicable to an IT resource (data, information object, service, or system capability). Trust applicable to IT resources is established and maintained in and among security domains, and may be comprised of observations about the domain's trust authority, trust framework, trust policy, trust interaction rules, means for assessing and monitoring adherence to trust policies, mechanisms that enforce trust, and quality and reliability measures of assurance in those mechanisms. \[Based on ISO IEC 10181-1 and NIST SP 800-63-2\]

Usage Note:SecurityTrustObservationType may be used as a trust attribute in a computable trust policy, trust credential, trust assertion, or trust label field in a security label and populated with trust observation values. The valued trust attributes may be used for used for authentication, authorization, and access control decisions. These may also be used to negotiate trust relationships, adjudicate or bridge trust policies, and to specify requirements for participation in a Trust Domain or for asserting compliance with a Trust Framework.
2.16.840.1.113883.5.4 en
UPDATE:

Type of security metadata observation made about the formal declaration by an authority or neutral third party that validates the technical, security, trust, and business practice conformance of Trust Agents to facilitate security, interoperability, and trust among participants within a security domain or trust framework.

2.16.840.1.113883.5.4 en
UPDATE:

Values for security metadata observation made about the digital quality or reliability of a trust assertion, activity, capability, information exchange, mechanism, process, or protocol.

2.16.840.1.113883.5.4 en
UPDATE:

Type of security metadata observation made about a set of security-relevant data issued by a security authority or trusted third party, together with security information which is used to provide the integrity and data origin authentication services for an IT resource (data, information object, service, or system capability). \[Based on ISO IEC 10181-1\]

2.16.840.1.113883.5.4 en
UPDATE:

Type of security metadata observation made about a complete set of contracts, regulations, or commitments that enable participating actors to rely on certain assertions by other actors to fulfill their information security requirements. \[Kantara Initiative\]

2.16.840.1.113883.5.4 en
UPDATE:

Type of security metadata observation made about a complete set of contracts, regulations, or commitments that enable participating actors to rely on certain assertions by other actors to fulfill their information security requirements. \[Kantara Initiative\]

2.16.840.1.113883.5.4 en
UPDATE:

Type of security metadata observation made about security requirements for a security domain. \[ISO IEC 10181-1\]

2.16.840.1.113883.5.4 en
UPDATE:

Values for security metadata observation made about aspects of trust applicable to an IT resource (data, information object, service, or system capability). Trust applicable to IT resources is established and maintained in and among security domains, and may be comprised of observations about the domain's trust authority, trust framework, trust policy, trust interaction rules, means for assessing and monitoring adherence to trust policies, mechanisms that enforce trust, and quality and reliability measures of assurance in those mechanisms. \[Based on ISO IEC 10181-1 and NIST SP 800-63-2\]

2.16.840.1.113883.5.1063 en
UPDATE:

Values for security metadata observation made about the formal declaration by an authority or neutral third party that validates the technical, security, trust, and business practice conformance of Trust Agents to facilitate security, interoperability, and trust among participants within a security domain or trust framework.

2.16.840.1.113883.5.1063 en
UPDATE:

Values for security metadata observation made about the digital quality or reliability of a trust assertion, activity, capability, information exchange, mechanism, process, or protocol.

2.16.840.1.113883.5.1063 en
UPDATE:

Values for security metadata observation made about a set of security-relevant data issued by a security authority or trusted third party, together with security information which is used to provide the integrity and data origin authentication services for an IT resource (data, information object, service, or system capability). \[Based on ISO IEC 10181-1\]

2.16.840.1.113883.5.1063 en
UPDATE:

Values for security metadata observation made about a complete set of contracts, regulations, or commitments that enable participating actors to rely on certain assertions by other actors to fulfill their information security requirements. \[Kantara Initiative\]

2.16.840.1.113883.5.1063 en
UPDATE:

Values for security metadata observation made about a complete set of contracts, regulations, or commitments that enable participating actors to rely on certain assertions by other actors to fulfill their information security requirements. \[Kantara Initiative\]

2.16.840.1.113883.5.1063 en
UPDATE:

Type of security metadata observation made about security requirements for a security domain. \[ISO IEC 10181-1\] Definition Is Immutable: true

2.16.840.1.113883.5.1063 en
UPDATE:

Specifies the state change of a target Act, using ActStatus codes, from its previous state as a predecessor Act.

For example, if the target Act is the result of a predecessor Act being "obsoleted" and replaced with the target Act, the source ProvenanceEventCurrentState Act code would be "obsoleted".

2.16.840.1.113883.5.14 en
UPDATE:

Specifies the state change of a target Act using DocuymentCompletion codes, from its previous state as a predecessor Act.

For example, if the target Act is the result of a predecessor Act being "obsoleted" and replaced with the target Act, the source ProvenanceEventCurrentState Act code would be "obsoleted".

2.16.840.1.113883.5.33 en
UPDATE:

Specifies the state change of a target Act, such as a document or an entry, from its previous state as a predecessor Act.

For example, if the target Act is the result of a predecessor Act being "obsoleted" and replaced with the target Act, the source ProvenanceEventCurrentState Act code would be "obsoleted".

2.16.840.1.113883.5.4 2.16.840.1.113883.5.14 2.16.840.1.113883.5.33 en
UPDATE:

Observation interpretation codes for expected results based on additional information (contraindicators) about the patient's situation.

2.16.840.1.113883.5.83 en
UPDATE:

Recommended values for criticality observations

>

Steward:Security WG
2.16.840.1.113883.5.1063 en
UPDATE:

Conveyance of the type of context in which authorization given under jurisdictional law, by organizational policy, or by a patient consent directive permits the collection, access, use or disclosure of specified patient health information.

Steward:Security WG
2.16.840.1.113883.5.4 en
UPDATE:

ActConsentDirective and ActConsentType codes are used to specify the type of Consent Directive or Consent Type to which, for example, a Consent Act conforms, to which a Security Observation (Security Label) refers to, or to which a Privacy or Security Act refers.

>

Steward:Security WG
2.16.840.1.113883.5.4 en
UPDATE:

Observation values that communicate the method used in a quality measure to combine the component measure results that are included in a composite measure.

Steward:CQI WG
2.16.840.1.113883.5.1063 en
UPDATE:

The SNODENT identifiers for the recognized grades of tooth mobility according to the Miller Classification system.

This value set contains content from SNODENT® Copyright American Dental Association (ADA). All rights reserved. SNODENT is a registered trademark of the ADA.

http://www.ada.org/en/member-center/member-benefits/practice-resources/dental-informatics/snodent/licensing-snodent

Steward:Attachments WG
2.16.840.1.113883.3.3150 en
UPDATE:

The SNODENT identifiers for the relative positions around the tooth that are probed and measured in assessing a patient's periodontal health.

This value set contains content from SNODENT® Copyright American Dental Association (ADA). All rights reserved. SNODENT is a registered trademark of the ADA.

http://www.ada.org/en/member-center/member-benefits/practice-resources/dental-informatics/snodent/licensing-snodent

Steward:Attachments WG
2.16.840.1.113883.3.3150 en
UPDATE:

The SNODENT identifiers for all of the possible human teeth, both adult and adolescent.

This value set contains content from SNODENT® Copyright American Dental Association (ADA). All rights reserved. SNODENT is a registered trademark of the ADA.

http://www.ada.org/en/member-center/member-benefits/practice-resources/dental-informatics/snodent/licensing-snodent

Steward:Attachments WG
2.16.840.1.113883.3.3150 en
UPDATE:

The SNODENT identifiers for the relative location of a human tooth root that is being observed for furcation.

This value set contains content from SNODENT® Copyright American Dental Association (ADA). All rights reserved. SNODENT is a registered trademark of the ADA.

http://www.ada.org/en/member-center/member-benefits/practice-resources/dental-informatics/snodent/licensing-snodent

Steward:Attachments WG
2.16.840.1.113883.3.3150 en
UPDATE:

The SNODENT identifiers for the regions of the human frenum within the mouth.

This value set contains content from SNODENT® Copyright American Dental Association (ADA). All rights reserved. SNODENT is a registered trademark of the ADA.

http://www.ada.org/en/member-center/member-benefits/practice-resources/dental-informatics/snodent/licensing-snodent

Steward:Attachments WG
2.16.840.1.113883.3.3150 en
UPDATE:

The clinical status of an allergy disposition (Clinical Focus)

Used in Program: C-CDA, C-CDA R2.1 2017-06-09 using this value set

2.16.840.1.113883.6.96 en
UPDATE:

Provide the concepts for the value element of the C-CDA Work Classification Observation entry template.

2.16.840.1.113883.5.1139 en
UPDATE:

Describes an individual's typical arrangement of working hours for an occupation.

2.16.840.1.113883.5.1063 en
UPDATE:

Concepts representing whether a person does or does not currently have a job or is not currently in the labor pool seeking employment.

2.16.840.1.113883.5.1063 en
UPDATE:

The SNODENT identifiers for patient conditions that may preclude starting orthodontic treatment.

This value set contains content from SNODENT® Copyright American Dental Association (ADA). All rights reserved. SNODENT is a registered trademark of the ADA.

http://www.ada.org/en/member-center/member-benefits/practice-resources/dental-informatics/snodent/licensing-snodent

Steward:Attachments WG
2.16.840.1.113883.3.3150 en
UPDATE:

The SNODENT identifiers for gross patient findings that inform the course of orthodontic treatment to be performed.

This value set contains content from SNODENT® Copyright American Dental Association (ADA). All rights reserved. SNODENT is a registered trademark of the ADA.

http://www.ada.org/en/member-center/member-benefits/practice-resources/dental-informatics/snodent/licensing-snodent

Steward:Attachments WG
2.16.840.1.113883.3.3150 en
UPDATE:

The SNODENT identifiers for the most common craniofacial anomalies that may influence the course of orthodontic treatment to be performed.

This value set contains content from SNODENT® Copyright American Dental Association (ADA). All rights reserved. SNODENT is a registered trademark of the ADA.

http://www.ada.org/en/member-center/member-benefits/practice-resources/dental-informatics/snodent/licensing-snodent

Steward:Attachments WG
2.16.840.1.113883.3.3150 en
UPDATE:

The SNODENT identifiers for tooth-specific abnormalities that impact orthodontic treatment.

This value set contains content from SNODENT® Copyright American Dental Association (ADA). All rights reserved. SNODENT is a registered trademark of the ADA.

http://www.ada.org/en/member-center/member-benefits/practice-resources/dental-informatics/snodent/licensing-snodent

Steward:Attachments WG
2.16.840.1.113883.3.3150 en
UPDATE:

The SNODENT identifiers for the stages of dentition an individual progresses through during a lifetime.

This value set contains content from SNODENT® Copyright American Dental Association (ADA). All rights reserved. SNODENT is a registered trademark of the ADA.

http://www.ada.org/en/member-center/member-benefits/practice-resources/dental-informatics/snodent/licensing-snodent

Steward:Attachments WG
2.16.840.1.113883.3.3150 en
UPDATE:

The SNODENT identifiers for the two jaws (mandible and maxilla).

This value set contains content from SNODENT® Copyright American Dental Association (ADA). All rights reserved. SNODENT is a registered trademark of the ADA.

http://www.ada.org/en/member-center/member-benefits/practice-resources/dental-informatics/snodent/licensing-snodent

Steward:Attachments WG
2.16.840.1.113883.3.3150 en
UPDATE:

The SNODENT identifiers for regions in the mouth utilized to calculate the Salzmann Malocclusion Severity Index.

This value set contains content from SNODENT® Copyright American Dental Association (ADA). All rights reserved. SNODENT is a registered trademark of the ADA.

http://www.ada.org/en/member-center/member-benefits/practice-resources/dental-informatics/snodent/licensing-snodent

Steward:Attachments WG
2.16.840.1.113883.3.3150 en
UPDATE:

The SNODENT identifiers for dental anterior inter-arch deviations utilized to calculate the Salzmann Malocclusion Severity Index.

This value set contains content from SNODENT® Copyright American Dental Association (ADA). All rights reserved. SNODENT is a registered trademark of the ADA.

http://www.ada.org/en/member-center/member-benefits/practice-resources/dental-informatics/snodent/licensing-snodent

Steward:Attachments WG
2.16.840.1.113883.3.3150 en
UPDATE:

The SNODENT identifiers for dental posterior inter-arch deviations utilized to calculate the Salzmann Malocclusion Severity Index.

This value set contains content from SNODENT® Copyright American Dental Association (ADA). All rights reserved. SNODENT is a registered trademark of the ADA.

http://www.ada.org/en/member-center/member-benefits/practice-resources/dental-informatics/snodent/licensing-snodent

Steward:Attachments WG
2.16.840.1.113883.3.3150 en
UPDATE:

The SNODENT identifiers for the teeth in the maxilla assessed for tooth-specific inter-arch deviations as part of calculating the Salzmann Malocclusion Severity Index.

This value set contains content from SNODENT® Copyright American Dental Association (ADA). All rights reserved. SNODENT is a registered trademark of the ADA.

http://www.ada.org/en/member-center/member-benefits/practice-resources/dental-informatics/snodent/licensing-snodent

Steward:Attachments WG
2.16.840.1.113883.3.3150 en
UPDATE:

This attribute defines whether the message is being sent in current processing, archive mode, initial load mode, restore from archive mode, etc.

2.16.840.1.113883.5.101 en
UPDATE:

A code classifying the general nature of the response to a given query. Includes whether or not data was found, or whether an error occurred.

2.16.840.1.113883.5.1067 en
UPDATE:

Identifies common relational operators used in selection criteria.

2.16.840.1.113883.5.105 en
UPDATE:

A code depicting the living arrangements of a person

2.16.840.1.113883.5.63 en
UPDATE:

The manufacturer of a vaccine.

2.16.840.1.113883.5.144 en
UPDATE:

The kind of vaccine.

2.16.840.1.113883.5.145 en
UPDATE:

Identifies the current completion state of a clinical document.

2.16.840.1.113883.5.33 en
UPDATE:

Identifies the storage status of a document.

2.16.840.1.113883.5.34 en
UPDATE:

A code identifying a person's disability.

2.16.840.1.113883.5.93 en
UPDATE:

Specifies sequence of sort order.

2.16.840.1.113883.5.113 en
UPDATE:

Defines the timing and grouping of the response instances.

2.16.840.1.113883.5.109 en
UPDATE:

Indicates whether the subscription to a query is new or is being modified.

2.16.840.1.113883.5.81 en
UPDATE:

Code systems used in HL7 standards.

2.16.840.1.113883.5.22 en
UPDATE:

One or more codes providing a rough qualitative interpretation of the observation,such as "normal" / "abnormal", "low" / "high", "better" / "worse", "resistant" / "susceptible", "expected" / "not expected". The value set is intended to be for ANY use where coded representation of an interpretation is needed.

Usage Note:This is being communicated in v2.x in OBX-8, in v3 in ObservationInterpretation (CWE) in R1 (Representative Realm) and in FHIR Observation.interpretation. Historically these values come from the laboratory domain, and these codes are extensively used.
2.16.840.1.113883.5.83 en
UPDATE:

Acknowledgement code as described in HL7 message processing rules.

2.16.840.1.113883.5.18 en
UPDATE:

Identifies the time frame in which the response is expected.

2.16.840.1.113883.5.102 en
UPDATE:

A ‘personal and legal’ relationship records the role of a person in relation to another person, or a person to himself or herself. This value set is to be used when recording relationships based on personal or family ties or through legal assignment of responsibility.

2.16.840.1.113883.5.111 en
UPDATE:

High level observation categories for the general type of observation being made.

Steward:OO WG
2.16.840.1.113883.4.642.1.222 en
UPDATE:

Information the US Government creates or possesses, or that an entity creates or possesses for or on behalf of the Government, that a law, regulation, or Government-wide policy requires or permits an agency to handle using safeguarding or dissemination controls.

Purpose: Supports the selection of the entire ControlledUnclassifiedInformation value set for e.g., rules engine policy set purposes.

2.16.840.1.113883.5.4 en
UPDATE:

Information the US Government creates or possesses, or that an entity creates or possesses for or on behalf of the Government, that a law, regulation, or Government-wide policy requires or permits an agency to handle using safeguarding or dissemination controls

Purpose: Supports the selection of ControlledUnclassifiedInformation leaf concepts for use, e.g., in security labels.

2.16.840.1.113883.5.4 en
UPDATE:

Codes used for displayed Security Label tags. Supports selection of SecurityLabelMark value set with head code for e.g., rules engine policy set purposes.

2.16.840.1.113883.5.4 en
UPDATE:

Codes used for displayed Security Label tags. Supports the selection of SecurityLabelMark leaf concepts for use, e.g., in security labels.

2.16.840.1.113883.5.4 en
UPDATE:

Codes used for human readable marks indicating, e.g., the level of confidentiality protection, an authorized compartment, the integrity, or the handling instruction required by applicable policy. Such markings must be displayed as directed by applicable policy on electronically rendered information content and any electronic transmittal envelope or container; or on hardcopy information and any physical transmittal envelope or container.

Purpose: Supports the selection of the entire PrivacyMark value set with head code for e.g., rules engine policy set purposes.

2.16.840.1.113883.5.4 en
UPDATE:

Observation values used to indicate a knowledge subject of interest for which knowledge content is requested (e.g., a medication, a laboratory test, a medical condition).

2.16.840.1.113883.6.96 2.16.840.1.113883.6.177 2.16.840.1.113883.6.2 2.16.840.1.113883.6.3 2.16.840.1.113883.6.88 2.16.840.1.113883.6.69 2.16.840.1.113883.6.1
UPDATE:

Observation values used to indicate a knowledge subtopic of interest for which knowledge content is requested (e.g., treatment, etiology, prognosis).

2.16.840.1.113883.6.177 2.16.840.1.113883.6.96
UPDATE:

Observation values used to indicate the age group of a person in terms of age group concept codes.

2.16.840.1.113883.6.177
UPDATE:

Identifies a type of observation that captures the age of an entity involved in an act with no implied method of determination.

2.16.840.1.113883.6.1
UPDATE:

Identifies a type of observation that captures the age of a person in terms of age group concept codes.

2.16.840.1.113883.6.1
UPDATE:

Represents the patient's status with respect to their immunization guideline as of an evaluation date.

2.16.840.1.113883.6.96
UPDATE:

Set of LOINC codes that identify the type of date that is specified within an immunization forecast step.

2.16.840.1.113883.6.1
UPDATE:

A collection of items that can be counted by a quality measure (e.g., patients, encounters, procedures, etc.) for Observation.value used in the HQMF R2 MeasureAttribute class.

2.16.840.1.113883.6.96
UPDATE:

The LOINC Document Ontology constrained for usage in the Universal Realm by removal of "regional" Document Types such as the "VA Compensation and Pension" codes.

2.16.840.1.113883.6.1
UPDATE: No description 2.16.840.1.113883.6.1 UPDATE:

A type of document section within a health quality measure (aka eMeasure), used to cluster the various parts of the eMeasure into a more human navigable format.

2.16.840.1.113883.6.1
**Description:** Realm code for use of United States of America **Description:** Realm code for use of Universal realm or context, used in every instance **Description:** Realm code for use of Unclassified Realm **Description:** Realm code for use of Representative Realm **Description:** Realm code for use of Example Realm