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: ParticipationFunction

Official URL: http://terminology.hl7.org/ValueSet/v3-ParticipationFunction Version: 2.0.0
Active as of 2014-03-26 Computable Name: ParticipationFunction
Other Identifiers: : urn:oid:2.16.840.1.113883.1.11.10267

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).

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)

 

Expansion

This value set contains 41 concepts

Expansion based on ParticipationFunction v2.1.0 (CodeSystem)

LevelCodeSystemDisplayDefinition
1  _AuthorizedParticipationFunctionhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionAuthorizedParticipationFunction

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

2    _AuthorizedReceiverParticipationFunctionhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionAuthorizedReceiverParticipationFunction

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.

3      AUCGhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctioncaregiver information receiver

**Description:**Caregiver authorized to receive patient health information.

3      AULRhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionlegitimate relationship information receiver

**Description:**Provider with legitimate relationship authorized to receive patient health information.

3      AUTMhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctioncare team information receiver

**Description:**Member of care team authorized to receive patient health information.

3      AUWAhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionwork area information receiver

**Description:**Entities within specified work area authorized to receive patient health information.

2    _ConsenterParticipationFunctionhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionConsenterParticipationFunction

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

3      GRDCONhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionlegal guardian consent author

**Description:**Legal guardian of the subject of consent authorized to author a consent directive for the subject of consent.

3      POACONhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionhealthcare power of attorney consent author

**Description:**Person authorized with healthcare power of attorney to author a consent directive for the subject of consent.

3      PRCONhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionpersonal representative consent author

**Description:**Personal representative of the subject of consent authorized to author a consent directive for the subject of consent.

3      PROMSKhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionauthorized 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.

3      SUBCONhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionsubject of consent author

**Description:**Subject of consent authorized to author a consent directive.

2    _OverriderParticipationFunctionhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionOverriderParticipationFunction

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

3      AUCOVhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionconsent overrider

**Description:**Entity authorized to override a consent directive.

3      AUEMROVhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionemergency overrider

**Description:**Entity authorized to override a consent directive or privacy policy in an emergency.

1  _CoverageParticipationFunctionhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionCoverageParticipationFunction

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

2    _PayorParticipationFunctionhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionPayorParticipationFunction

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

3      CLMADJhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionclaims adjudication

Definition: Manages all operations required to adjudicate fee for service claims or managed care encounter reports.

3      ENROLLhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionenrollment broker

Definition: Managing the enrollment of covered parties.

3      FFSMGThttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionffs 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.

3      MCMGThttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionmanaged 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.

3      PROVMGThttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionprovider management

Definition: Managing provider contracting, provider services, credentialing, profiling, performance measures, and ensuring network adequacy.

3      UMGThttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionutilization 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.

2    _SponsorParticipationFunctionhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionSponsorParticipationFunction

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.

3      FULINRDhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionfully 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.

3      SELFINRDhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionself insured

Definition: Responsibility taken by a sponsor to organize the underwriting of risk and administration of a policy or program.

2    _UnderwriterParticipationFunctionhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionUnderwriterParticipationFunction

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

3      PAYORCNTRhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionpayor 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.

3      REINShttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionreinsures

Definition: Underwriting reinsurance for another underwriter for the policy or program.

3      RETROCEShttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionretrocessionaires

Definition: Underwriting reinsurance for another reinsurer.

3      SUBCTRThttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionsubcontracting 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 .

3      UNDERWRTNGhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionunderwriting

Definition: Provision of underwriting analysis for another underwriter without assumption of risk.

1  ADMPHYShttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionadmitting physician

A physician who admitted a patient to a hospital or other care unit that is the context of this service.

1  ANESThttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionanesthesist

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.

1  ANRShttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionanesthesia nurse

In a typical anesthesia setting the nurse principally assisting the anesthesiologist during the critical periods.

1  ASSEMBLERhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionassembly software

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.

1  ATTPHYShttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionattending physician

A physician who is primarily responsible for a patient during the hospitalization, which is the context of the service.

1  COMPOSERhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctioncomposer software

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.

1  DISPHYShttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctiondischarging physician

A physician who discharged a patient from a hospital or other care unit that is the context of this service.

1  FASSThttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionfirst assistant surgeon

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).

1  MDWFhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionmidwife

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.

1  NASSThttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionnurse assistant

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.).

1  PCPhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionprimary care physician

The healthcare provider that holds primary responsibility for the overall care of a patient.

1  PRISURGhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionprimary surgeon

In a typical surgery setting the primary performing surgeon.

1  REVIEWERhttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionreviewer

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)

1  RNDPHYShttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionrounding physician

A physician who made rounds on a patient in a hospital or other care center.

1  SASSThttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionsecond assistant surgeon

In a typical surgery setting the assistant who primarily holds the hooks.

1  SNRShttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionscrub nurse

In a typical surgery setting the nurse in charge of the instrumentation.

1  TASSThttp://terminology.hl7.org/CodeSystem/v3-ParticipationFunctionthird assistant

In 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
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

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