HL7 Terminology
1.0.0 - Publication

This page is part of the HL7 Terminology (v1.0.0: Release) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

ParticipationFunction

Summary

Defining URL:http://terminology.hl7.org/CodeSystem/v3-ParticipationFunction
Version:2.0.0
Name:ParticipationFunction
Title:ParticipationFunction
Status:Active
Content:All the concepts defined by the code system are included in the code system resource
Definition:

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).

Publisher:Health Level 7
OID:2.16.840.1.113883.5.88 (for OID based terminology systems)
Content Mode:Complete
Source Resource:XML / JSON / Turtle

This Code system is referenced in the content logical definition of the following value sets:

ParticipationFunction

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).

Properties

CodeURLDescriptionType
SpecializesThe 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.Coding
GeneralizesInverse of Specializes. Only included as a derived relationship.Coding
internalIdhttp://terminology.hl7.org/CodeSystem/utg-concept-properties#v3-internal-idThe internal identifier for the concept in the HL7 Access database repository.code
notSelectablehttp://hl7.org/fhir/concept-properties#notSelectableIndicates that the code is abstract - only intended to be used as a selector for other conceptsboolean
statushttp://hl7.org/fhir/concept-properties#statusDesignation of a concept's state. Normally is not populated unless the state is retired.code

This code system http://terminology.hl7.org/CodeSystem/v3-ParticipationFunction defines the following codes:

LvlCodeDisplayDefinitioninternalIdNot Selectablestatus
1_AuthorizedParticipationFunction AuthorizedParticipationFunctionThis code is used to specify the exact function an actor is authorized to have in a service in all necessary detail.22338trueactive
2  _AuthorizedReceiverParticipationFunction AuthorizedReceiverParticipationFunctionThis 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.22341trueactive
3    AUCG caregiver information receiver**Description:**Caregiver authorized to receive patient health information.22900active
3    AULR legitimate relationship information receiver**Description:**Provider with legitimate relationship authorized to receive patient health information.22901active
3    AUTM care team information receiver**Description:**Member of care team authorized to receive patient health information.22902active
3    AUWA work area information receiver**Description:**Entities within specified work area authorized to receive patient health information.22903active
2  _ConsenterParticipationFunction ConsenterParticipationFunctionThis code is used to specify the exact function an actor is authorized to have in authoring a consent directive.22339trueactive
3    GRDCON legal guardian consent author**Description:**Legal guardian of the subject of consent authorized to author a consent directive for the subject of consent.22894active
3    POACON healthcare power of attorney consent author**Description:**Person authorized with healthcare power of attorney to author a consent directive for the subject of consent.22896active
3    PRCON personal representative consent author**Description:**Personal representative of the subject of consent authorized to author a consent directive for the subject of consent.22895active
3    PROMSK authorized provider masking author**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.22897active
3    SUBCON subject of consent author**Description:**Subject of consent authorized to author a consent directive.22893active
2  _OverriderParticipationFunction OverriderParticipationFunctionThis code is used to specify the exact function an actor is authorized to have in authoring a consent override.22340trueactive
3    AUCOV consent overrider**Description:**Entity authorized to override a consent directive.22898active
3    AUEMROV emergency overrider**Description:**Entity authorized to override a consent directive or privacy policy in an emergency.22899active
1_CoverageParticipationFunction CoverageParticipationFunction**Definition:** Set of codes indicating the manner in which sponsors, underwriters, and payers participate in a policy or program.22222trueactive
2  _PayorParticipationFunction PayorParticipationFunction**Definition:** Set of codes indicating the manner in which payors participate in a policy or program.</22223trueactive
3    CLMADJ claims adjudication**Definition:** Manages all operations required to adjudicate fee for service claims or managed care encounter reports.22226active
3    ENROLL enrollment broker**Definition:** Managing the enrollment of covered parties.22229active
3    FFSMGT ffs management**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.22228active
3    MCMGT managed care management**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.22227active
3    PROVMGT provider management**Definition:** Managing provider contracting, provider services, credentialing, profiling, performance measures, and ensuring network adequacy.22230active
3    UMGT utilization management**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.22231active
2  _SponsorParticipationFunction SponsorParticipationFunction**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.22224trueactive
3    FULINRD fully insured**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.22232active
3    SELFINRD self insured**Definition:** Responsibility taken by a sponsor to organize the underwriting of risk and administration of a policy or program.22233active
2  _UnderwriterParticipationFunction UnderwriterParticipationFunction**Definition:** Set of codes indicating the manner in which underwriters participate in a policy or program.22225trueactive
3    PAYORCNTR payor contracting**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.22234active
3    REINS reinsures**Definition:** Underwriting reinsurance for another underwriter for the policy or program.22235active
3    RETROCES retrocessionaires**Definition:** Underwriting reinsurance for another reinsurer.22236active
3    SUBCTRT subcontracting risk**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 .22237active
3    UNDERWRTNG underwriting**Definition:** Provision of underwriting analysis for another underwriter without assumption of risk.22238active
1ADMPHYS admitting physicianA physician who admitted a patient to a hospital or other care unit that is the context of this service.10278active
1ANEST anesthesistIn 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.10274active
1ANRS anesthesia nurseIn a typical anesthesia setting the nurse principally assisting the anesthesiologist during the critical periods.10275active
1ASSEMBLER assembly softwareA 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.23655active
1ATTPHYS attending physicianA physician who is primarily responsible for a patient during the hospitalization, which is the context of the service.10277active
1COMPOSER composer softwareA 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.23722active
1DISPHYS discharging physicianA physician who discharged a patient from a hospital or other care unit that is the context of this service.10279active
1FASST first assistant surgeonIn 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).10269active
1MDWF midwifeA 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.10276active
1NASST nurse assistantIn 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.).10273active
1PCP primary care physicianThe healthcare provider that holds primary responsibility for the overall care of a patient.10281active
1PRISURG primary surgeonIn a typical surgery setting the primary performing surgeon.10268active
1REVIEWER reviewerA 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)23656active
1RNDPHYS rounding physicianA physician who made rounds on a patient in a hospital or other care center.10280active
1SASST second assistant surgeonIn a typical surgery setting the assistant who primarily holds the hooks.10270active
1SNRS scrub nurseIn a typical surgery setting the nurse in charge of the instrumentation.10271active
1TASST third assistantIn a typical surgery setting there is rarely a third assistant (e.g., in some Hip operations the third assistant postures the affected leg).10272active

History

DateActionAuthorCustodianComment
2020-05-06reviseTed KleinVocabulary WGMigrated to the UTG maintenance environment and publishing tooling.