HL7 Terminology (THO)
4.0.0 - Publication World

This page is part of the HL7 Terminology (v4.0.0: Release) based on FHIR R4. This is the current published version. For a full list of available versions, see the Directory of published versions

ValueSet: ActCoverageLimitCode

Official URL: http://terminology.hl7.org/ValueSet/v3-ActCoverageLimitCode Version: 2.0.0
Active as of 2014-03-26 Computable Name: ActCoverageLimitCode
Other Identifiers: : urn:oid:2.16.840.1.113883.1.11.17496

Criteria that are applicable to the authorized coverage.

References

This value set is not used here; it may be used elsewhere (e.g. specifications and/or implementations that use this content)

Logical Definition (CLD)

This value set includes codes based on the following rules:

This value set excludes codes based on the following rules:

 

Expansion

This value set contains 7 concepts

Expansion based on ActCode v6.1.0 (CodeSystem)

CodeSystemDisplayDefinition
  _ActCoverageQuantityLimitCodehttp://terminology.hl7.org/CodeSystem/v3-ActCodeActCoverageQuantityLimitCode

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.

  COVPRDhttp://terminology.hl7.org/CodeSystem/v3-ActCodecoverage period

Codes representing the time period during which coverage is available; or financial participation requirements are in effect.

  LFEMXhttp://terminology.hl7.org/CodeSystem/v3-ActCodelife time maximum

Definition: Maximum amount paid by payer or covered party; or maximum number of services or products covered under the policy or program during a covered party's lifetime.

  NETAMThttp://terminology.hl7.org/CodeSystem/v3-ActCodeNet Amount

Maximum net amount that will be covered for the product or service specified.

  PRDMXhttp://terminology.hl7.org/CodeSystem/v3-ActCodeperiod maximum

Definition: Maximum amount paid by payer or covered party; or maximum number of services/products covered under the policy or program by time period specified by the effective time on the act.

  UNITPRICEhttp://terminology.hl7.org/CodeSystem/v3-ActCodeUnit Price

Maximum unit price that will be covered for the authorized product or service.

  UNITQTYhttp://terminology.hl7.org/CodeSystem/v3-ActCodeUnit Quantity

Maximum number of items that will be covered of the product or service specified.

  COVMXhttp://terminology.hl7.org/CodeSystem/v3-ActCodecoverage maximum

Definition: Codes representing the maximum coverate or financial participation requirements.

  _ActCoveredPartyLimitCodehttp://terminology.hl7.org/CodeSystem/v3-ActCodeActCoveredPartyLimitCode

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

  _ActCoveragePartyLimitGroupCodehttp://terminology.hl7.org/CodeSystem/v3-ActCodeActCoveragePartyLimitGroupCode

Codes representing the level of coverage provided under the policy or program in terms of the types of entities that may play covered parties based on their personal relationships or employment status.


Explanation of the columns that may appear on this page:

Level A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
System The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code The code (used as the code in the resource instance)
Display The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition An explanation of the meaning of the concept
Comments Additional notes about how to use the code

History

DateActionCustodianAuthorComment
2020-05-06reviseVocabulary WGTed KleinMigrated to the UTG maintenance environment and publishing tooling.
2014-03-26revise2014T1_2014-03-26_001283 (RIM release ID)Vocabulary (Woody Beeler) (no record of original request)Lock all vaue sets untouched since 2014-03-26 to trackingId 2014T1_2014_03_26