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/ValueSet/v3-ParticipationFunction
Version:2.0.0
Name:ParticipationFunction
Status:Active
Title:ParticipationFunction
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).

OID:2.16.840.1.113883.1.11.10267 (for OID based terminology systems)
Source Resource:XML / JSON / Turtle

References

This value set is not used

Content Logical Definition

Logical Definition (CLD)

 

Expansion

This value set contains 41 concepts

Expansion based on ParticipationFunction v2.0.0 (CodeSystem)

All codes from system http://terminology.hl7.org/CodeSystem/v3-ParticipationFunction

LvlCodeDisplayDefinition
0_AuthorizedParticipationFunctionAuthorizedParticipationFunctionThis code is used to specify the exact function an actor is authorized to have in a service in all necessary detail.
1  _AuthorizedReceiverParticipationFunctionAuthorizedReceiverParticipationFunctionThis 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    AUCGcaregiver information receiver**Description:**Caregiver authorized to receive patient health information.
2    AULRlegitimate relationship information receiver**Description:**Provider with legitimate relationship authorized to receive patient health information.
2    AUTMcare team information receiver**Description:**Member of care team authorized to receive patient health information.
2    AUWAwork area information receiver**Description:**Entities within specified work area authorized to receive patient health information.
1  _ConsenterParticipationFunctionConsenterParticipationFunctionThis code is used to specify the exact function an actor is authorized to have in authoring a consent directive.
2    GRDCONlegal guardian consent author**Description:**Legal guardian of the subject of consent authorized to author a consent directive for the subject of consent.
2    POACONhealthcare power of attorney consent author**Description:**Person authorized with healthcare power of attorney to author a consent directive for the subject of consent.
2    PRCONpersonal representative consent author**Description:**Personal representative of the subject of consent authorized to author a consent directive for the subject of consent.
2    PROMSKauthorized 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.
2    SUBCONsubject of consent author**Description:**Subject of consent authorized to author a consent directive.
1  _OverriderParticipationFunctionOverriderParticipationFunctionThis code is used to specify the exact function an actor is authorized to have in authoring a consent override.
2    AUCOVconsent overrider**Description:**Entity authorized to override a consent directive.
2    AUEMROVemergency overrider**Description:**Entity authorized to override a consent directive or privacy policy in an emergency.
0_CoverageParticipationFunctionCoverageParticipationFunction**Definition:** Set of codes indicating the manner in which sponsors, underwriters, and payers participate in a policy or program.
1  _PayorParticipationFunctionPayorParticipationFunction**Definition:** Set of codes indicating the manner in which payors participate in a policy or program.</
2    CLMADJclaims adjudication**Definition:** Manages all operations required to adjudicate fee for service claims or managed care encounter reports.
2    ENROLLenrollment broker**Definition:** Managing the enrollment of covered parties.
2    FFSMGTffs 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.
2    MCMGTmanaged 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.
2    PROVMGTprovider management**Definition:** Managing provider contracting, provider services, credentialing, profiling, performance measures, and ensuring network adequacy.
2    UMGTutilization 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.
1  _SponsorParticipationFunctionSponsorParticipationFunction**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    FULINRDfully 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.
2    SELFINRDself insured**Definition:** Responsibility taken by a sponsor to organize the underwriting of risk and administration of a policy or program.
1  _UnderwriterParticipationFunctionUnderwriterParticipationFunction**Definition:** Set of codes indicating the manner in which underwriters participate in a policy or program.
2    PAYORCNTRpayor 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.
2    REINSreinsures**Definition:** Underwriting reinsurance for another underwriter for the policy or program.
2    RETROCESretrocessionaires**Definition:** Underwriting reinsurance for another reinsurer.
2    SUBCTRTsubcontracting 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 .
2    UNDERWRTNGunderwriting**Definition:** Provision of underwriting analysis for another underwriter without assumption of risk.
0ADMPHYSadmitting physicianA physician who admitted a patient to a hospital or other care unit that is the context of this service.
0ANESTanesthesistIn 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.
0ANRSanesthesia nurseIn a typical anesthesia setting the nurse principally assisting the anesthesiologist during the critical periods.
0ASSEMBLERassembly 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.
0ATTPHYSattending physicianA physician who is primarily responsible for a patient during the hospitalization, which is the context of the service.
0COMPOSERcomposer 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.
0DISPHYSdischarging physicianA physician who discharged a patient from a hospital or other care unit that is the context of this service.
0FASSTfirst 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).
0MDWFmidwifeA 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.
0NASSTnurse 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.).
0PCPprimary care physicianThe healthcare provider that holds primary responsibility for the overall care of a patient.
0PRISURGprimary surgeonIn a typical surgery setting the primary performing surgeon.
0REVIEWERreviewerA 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)
0RNDPHYSrounding physicianA physician who made rounds on a patient in a hospital or other care center.
0SASSTsecond assistant surgeonIn a typical surgery setting the assistant who primarily holds the hooks.
0SNRSscrub nurseIn a typical surgery setting the nurse in charge of the instrumentation.
0TASSTthird assistantIn a typical surgery setting there is rarely a third assistant (e.g., in some Hip operations the third assistant postures the affected leg).

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
Source 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

DateActionAuthorCustodianComment
2020-05-06reviseTed KleinVocabulary WGMigrated to the UTG maintenance environment and publishing tooling.
2014-03-26reviseVocabulary (Woody Beeler) (no record of original request)2014T1_2014-03-26_001283 (RIM release ID)Lock all vaue sets untouched since 2014-03-26 to trackingId 2014T1_2014_03_26