2.16.840.1.113883.5.8/static-2012-07-24

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Codesystem Name Codesystem Id Version / Eingangsdatum Status
ActReason 2.16.840.1.113883.5.8 2012-07-24 definitiv
Level/Typ Code Anzeigename Beschreibung
0-A _ActAccommodationReason (en-US) ActAccommodationReason

Identifies the reason the patient is assigned to this accommodation type

1-L ACCREQNA (en-US) Accommodation Requested Not Available

Accommodation requested is not available.

1-L FLRCNV (en-US) Floor Convenience

Accommodation is assigned for floor convenience.

1-L MEDNEC (en-US) Medical Necessity

Required for medical reasons(s).

1-L PAT (en-US) Patient request

The Patient requested the action

0-A _ActInvoiceCancelReason (en-US) ActInvoiceCancelReason

Domain specifies the codes used to describe reasons why a Provider is cancelling an Invoice or Invoice Grouping.

1-L INCCOVPTY (en-US) incorrect covered party as patient

The covered party (patient) specified with the Invoice is not correct.

1-L INCINVOICE (en-US) incorrect billing

The billing information, specified in the Invoice Elements, is not correct. This could include incorrect costing for items included in the Invoice.

1-L INCPOLICY (en-US) incorrect policy

The policy specified with the Invoice is not correct. For example, it may belong to another Adjudicator or Covered Party.

1-L INCPROV (en-US) incorrect provider

The provider specified with the Invoice is not correct.

0-A _SchedulingActReason (en-US) SchedulingActReason

Reasons for cancelling or rescheduling an Appointment

1-L BLK (en-US) Unexpected Block (of Schedule)

The time slots previously allocated are now blocked and no longer available for booking Appointments

1-L DEC (en-US) Patient Deceased

The Patient is deceased

1-L FIN (en-US) No Financial Backing

Patient unable to pay and not covered by insurance

1-L MED (en-US) Medical Status Altered

The medical condition of the Patient has changed

1-L MTG (en-US) In an outside meeting

The Physician is in a meeting. For example, he/she may request administrative time to talk to family after appointment

1-L PAT (en-US) Patient request

The Patient requested the action

1-L PHY (en-US) Physician request

The Physician requested the action

0-A _SubstanceAdminSubstitutionReason (en-US) SubstanceAdminSubstitutionReason

1-L CT (en-US) continuing therapy

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.

1-L FP (en-US) formulary policy

Indicates that the decision to substitute or to not substitute was driven by a policy expressed within the formulary.

1-L OS (en-US) out of stock

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.

1-L RR (en-US) regulatory requirement

Indicates that the decision to substitute or to not substitute was driven by a jurisdictional regulatory requirement mandating or prohibiting substitution.

0-A _TransferActReason (en-US) TransferActReason

The explanation for why a patient is moved from one location to another within the organization

1-L ER (en-US) Error

Moved to an error in placing the patient in the original location.

1-L RQ (en-US) Request

Moved at the request of the patient.

0-A _ControlActReason (en-US) ControlActReason

Identifies why a specific query, request, or other trigger event occurred.

1-A _MedicationOrderAbortReasonCode (en-US) medication order abort reason

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

2-L DISCONT (en-US) product discontinued

Description:The medication is no longer being manufactured or is otherwise no longer available.

2-L INEFFECT (en-US) ineffective

Description:The therapy has been found to not have the desired therapeutic benefit on the patient.

2-L MONIT (en-US) response to monitoring

Description:Monitoring the patient while taking the medication, the decision has been made that the therapy is no longer appropriate.

2-L NOREQ (en-US) no longer required for treatment

Description:The underlying condition has been resolved or has evolved such that a different treatment is no longer needed.

2-L NOTCOVER (en-US) not covered

Description:The product does not have (or no longer has) coverage under the patientaTMs insurance policy.

2-L PREFUS (en-US) patient refuse

Description:The patient refused to take the product.

2-L RECALL (en-US) product recalled

Description:The manufacturer or other agency has requested that stocks of a medication be removed from circulation.

2-S REPLACE (en-US) change in order

Description:Item in current order is no longer in use as requested and a new one has/will be created to replace it.

3-L DOSECHG (en-US) change in medication/dose

Description:The medication is being re-prescribed at a different dosage.

2-L REPLACEFIX (en-US) error in order

Description:Current order was issued with incorrect data and a new order has/will be created to replace it.

2-L UNABLE (en-US) unable to use

Description:<The patient is not (or is no longer) able to use the medication in a manner prescribed. Example:CanaTMt swallow.

1-A _MedicationOrderReleaseReasonCode (en-US) medication order release reason

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

2-L HOLDDONE (en-US) suspend reason no longer applies

Definition:The original reason for suspending the medication has ended.

2-L HOLDINAP (en-US) suspend reason inappropriate

Definition:

1-S _PharmacySupplyEventAbortReason (en-US) PharmacySupplyEventAbortReason

Definition:Identifies why the dispense event was not completed.

2-L CONTRA (en-US) contraindication

Definition:Contraindication identified

2-L FOABORT (en-US) order aborted

Definition:Order to be fulfilled was aborted

2-L FOSUSP (en-US) order suspended

Definition:Order to be fulfilled was suspended

2-L NOPICK (en-US) not picked up

Definition:Patient did not come to get medication

2-L PATDEC (en-US) patient changed mind

Definition:Patient changed their mind regarding obtaining medication

2-L QUANTCHG (en-US) change supply quantity

Definition:Patient requested a revised quantity of medication

1-A _PharmacySupplyEventStockReasonCode (en-US) pharmacy supply event stock reason

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

2-L FLRSTCK (en-US) floor stock

Definition:The bulk supply is issued to replenish a ward for local dispensing. (Includes both mobile and fixed-location ward stocks.)

2-L LTC (en-US) long term care use

Definition:The bulk supply will be administered within a long term care facility.

2-L OFFICE (en-US) office use

Definition:The bulk supply is intended for general clinician office use.

2-L PHARM (en-US) pharmacy transfer

Definition:The bulk supply is being transferred to another dispensing facility to. Example:Alleviate a temporary shortage.

2-L PROG (en-US) program use

Definition:The bulk supply is intended for dispensing according to a specific program. Example:Mass immunization.

1-A _PharmacySupplyRequestRenewalRefusalReasonCode (en-US) pharmacy supply request renewal refusal reason

Definition:A collection of concepts that identifies why a renewal prescription has been refused.

2-L ALREADYRX (en-US) new prescription exists

Definition:Patient has already been given a new (renewal) prescription.

2-L DISCONT (en-US) product discontinued

Description:The medication is no longer being manufactured or is otherwise no longer available.

2-L FAMPHYS (en-US) family physician must authorize further fills

Definition:Request for further authorization must be done through patient's family physician.

2-L MODIFY (en-US) modified prescription exists

Definition:Therapy has been changed and new prescription issued

2-L NEEDAPMT (en-US) patient must make appointment

Definition:Patient must see prescriber prior to further fills.

2-L NOTAVAIL (en-US) prescriber not available

Definition:Original prescriber is no longer available to prescribe and no other prescriber has taken responsibility for the patient.

2-L NOTPAT (en-US) patient no longer in this practice

Definition:Patient no longer or has never been under this prescribers care.

2-L ONHOLD (en-US) medication on hold

Definition:This medication is on hold.

2-L PRNA (en-US) product not available

Description:This product is not available or manufactured.

2-L TOOEARLY (en-US) too early

Definition:The patient should have medication remaining.

1-A _SupplyOrderAbortReasonCode (en-US) supply order abort reason

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-L IMPROV (en-US) condition improved

Definition:The patient's medical condition has nearly abated.

2-L INTOL (en-US) intolerance

Description:The patient has an intolerance to the medication.

2-L NEWSTR (en-US) new strength

Definition:The current medication will be replaced by a new strength of the same medication.

2-L NEWTHER (en-US) new therapy

Definition:A new therapy will be commenced when current supply exhausted.

0-A _ActNoImmunizationReason (en-US) ActNoImmunizationReason

A coded description of the reason for why a patient did not receive a scheduled immunization. (important for public health strategy

1-L IMMUNE (en-US) immunity

Definition:Testing has shown that the patient already has immunity to the agent targeted by the immunization.

1-L MEDPREC (en-US) medical precaution

Definition:The patient currently has a medical condition for which the vaccine is contraindicated or for which precaution is warranted.

1-L OSTOCK (en-US) product out of stock

Definition:There was no supply of the product on hand to perform the service.

1-L PATOBJ (en-US) patient objection

Definition:The patient or their guardian objects to receiving the vaccine.

1-L PHILISOP (en-US) philosophical objection

Definition:The patient or their guardian objects to receiving the vaccine because of philosophical beliefs.

1-L RELIG (en-US) religious objection

Definition:The patient or their guardian objects to receiving the vaccine on religious grounds.

1-L VACEFF (en-US) vaccine efficacy concerns

Definition:The intended vaccine has expired or is otherwise believed to no longer be effective. Example:Due to temperature exposure.

1-L VACSAF (en-US) vaccine safety concerns

Definition:The patient or their guardian objects to receiving the vaccine because of concerns over its safety.

0-A _ActSupplyFulfillmentRefusalReason (en-US) ActSupplyFulfillmentRefusalReason

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)

1-L FRR01 (en-US) order stopped

Definition:The order has been stopped by the prescriber but this fact has not necessarily captured electronically. Example:A verbal stop, a fax, etc.

1-L FRR02 (en-US) stale-dated order

Definition:Order has not been fulfilled within a reasonable amount of time, and may not be current.

1-L FRR03 (en-US) incomplete data

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.

1-L FRR04 (en-US) product unavailable

Definition:Product not available or manufactured. Cannot supply.

1-L FRR05 (en-US) ethical/religious

Definition:The dispenser has ethical, religious or moral objections to fulfilling the order/dispensing the product.

1-L FRR06 (en-US) unable to provide care

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.

0-A _SubstanceAdminSubstitutionNotAllowedReason (en-US) SubstanceAdminSubstitutionNotAllowedReason

Reasons why substitution of a substance administration request is not permitted.

1-L ALGINT (en-US) allergy intolerance

Definition: Patient has had a prior allergic intolerance response to alternate product or one of its components.

1-L COMPCON (en-US) compliance concern

Definition: Patient has compliance issues with medication such as differing appearance, flavor, size, shape or consistency.

1-L PAT (en-US) Patient request

The Patient requested the action

1-L THERCHAR (en-US) therapeutic characteristics

The prescribed product has specific clinical release or other therapeutic characteristics not shared by other substitutable medications.

1-L TRIAL (en-US) clinical trial drug

Definition: The specific manufactured drug is part of a clinical trial.

0-A _PatientProfileQueryReasonCode (en-US) patient profile query reason

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

1-L ADMREV (en-US) administrative review

Definition: To evaluate for service authorization, payment, reporting, or performance/outcome measures.

1-L LEGAL (en-US) subpoena

Definition:To provide information as a result of a subpoena.

1-L PATCAR (en-US) patient care

Definition:To obtain records as part of patient care.

1-L PATREQ (en-US) patient request query

Definition:Patient requests information from their profile.

1-L PRCREV (en-US) practice review

Definition:To evaluate the provider's current practice for professional-improvement reasons.

1-L REGUL (en-US) regulatory review

Description:Review for the purpose of regulatory compliance.

1-L RSRCH (en-US) research

Definition:To provide research data, as authorized by the patient.

1-L VALIDATION (en-US) validation review

Description:To validate the patient's record. Example:Merging or unmerging records.

0-A _ActCoverageReason (en-US) ActCoverageReason

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.

1-A _EligibilityActReasonCode (en-US) EligibilityActReasonCode

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.

2-A _ActIneligibilityReason (en-US) ActIneligibilityReason

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.

3-L COVSUS (en-US) coverage suspended

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).

3-L DECSD (en-US) deceased

Client deceased.

3-L REGERR (en-US) registered in error

Client was registered in error.

2-A _CoverageEligibilityReason (en-US) CoverageEligibilityReason

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.

3-L AGE (en-US) age eligibility

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.

3-L CRIME (en-US) crime victim

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.

3-L DIS (en-US) disability

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.

3-L EMPLOY (en-US) employment benefit

A person becomes eligible for insurance provided as an employment benefit based on employment status.

3-L FINAN (en-US) financial eligibility

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.

3-L HEALTH (en-US) health status

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

3-L MULTI (en-US) multiple criteria eligibility

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.

3-L PNC (en-US) property and casualty condition

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.

3-L STATUTORY (en-US) statutory eligibility

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.

3-L VEHIC (en-US) motor vehicle accident victim

A person becomes a claimant under a motor vehicle accident insurance because of a motor vehicle accident related health condition or injury.

3-L WORK (en-US) work related

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.

0-A _ClinicalResearchEventReason (en-US) ClinicalResearchEventReason

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

1-L RET (en-US) retest

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.

1-L SCH (en-US) scheduled

Definition:The event occurred due to it being scheduled in the research protocol.

1-L TRM (en-US) termination

Definition:The event occurred in order to terminate the subject's participation in the study.

1-L UNS (en-US) unscheduled

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.

0-A _ClinicalResearchObservationReason (en-US) ClinicalResearchObservationReason

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.

1-L NPT (en-US) non-protocol

Definition:The observation or test was neither defined or scheduled in the study protocol.

1-L PPT (en-US) per protocol

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.

1-L UPT (en-US) per definition

:The observation or test occurred as defined in the research protocol, but at a point in time not specified in the study protocol.

0-A _CombinedPharmacyOrderSuspendReasonCode (en-US) CombinedPharmacyOrderSuspendReasonCode

Description:Indicates why the prescription should be suspended.

1-L ALTCHOICE (en-US) try another treatment first

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.

1-L CLARIF (en-US) prescription requires clarification

Description:Clarification is required before the order can be acted upon.

1-L DRUGHIGH (en-US) drug level too high

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.

1-L HOSPADM (en-US) admission to hospital

Description:The patient has been admitted to a care facility and their community medications are suspended until hospital discharge.

1-L LABINT (en-US) lab interference issues

Description:The therapy would interfere with a planned lab test and the therapy is being withdrawn until the test is completed.

1-L NON-AVAIL (en-US) patient not-available

Description:Patient not available for a period of time due to a scheduled therapy, leave of absence or other reason.

1-L PREG (en-US) parent is pregnant/breast feeding

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.

1-L SALG (en-US) allergy

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.

1-L SDDI (en-US) drug interacts with another drug

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.

1-L SDUPTHER (en-US) duplicate therapy

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.

1-L SINTOL (en-US) suspected intolerance

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.

1-L SURG (en-US) patient scheduled for surgery

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.

1-L WASHOUT (en-US) waiting for old drug to wash out

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.

0-A _GenericUpdateReasonCode (en-US) GenericUpdateReasonCode

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

1-L CHGDATA (en-US) information change

Description:Information has changed since the record was created.

1-L FIXDATA (en-US) error correction

Description:Previously recorded information was erroneous and is being corrected.

1-L NEWDATA (en-US) new information

Description:New information has become available to supplement the record.

0-A _ActInformationManagementReason (en-US) ActInformationManagementReason

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.

1-A _ActHealthInformationManagementReason (en-US) ActHealthInformationManagementReason

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.

2-S PurposeOfUse (en-US) purpose of use

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.

3-L HMARKT (en-US) healthcare marketing

To perform one or more operations on information for marketing services and products related to health care.

3-S HOPERAT (en-US) healthcare operations

To perform one or more operations on information used for conducting administrative and contractual activities related to the provision of health care.

4-L DONAT (en-US) donation

To perform one or more operations on information used for cadaveric organ, eye or tissue donation.

4-L FRAUD (en-US) fraud

To perform one or more operations on information used for fraud detection and prevention processes.

4-L GOV (en-US) government

To perform one or more operations on information used within government processes.

4-L HACCRED (en-US) health accreditation

To perform one or more operations on information for conducting activities related to meeting accreditation criteria.

4-L HCOMPL (en-US) health compliance

To perform one or more operations on information used for conducting activities required to meet a mandate.

4-L HDECD (en-US) decedent

To perform one or more operations on information used for handling deceased patient matters.

4-L HDIRECT (en-US) directory

To perform one or more operation operations on information used to manage a patient directory. Examples: facility enterprise payer health information exchange patient directory

4-L HLEGAL (en-US) legal

To perform one or more operations on information for conducting activities required by legal proceeding.

4-L HOUTCOMS (en-US) health outcome measure

To perform one or more operations on information used for assessing results and comparative effectiveness achieved by health care practices and interventions.

4-L HPRGRP (en-US) health program reporting

To perform one or more operations on information used for conducting activities to meet program accounting requirements.

4-L HQUALIMP (en-US) health quality improvement

To perform one or more operations on information used for conducting administrative activities to improve health care quality.

4-L HSYSADMIN (en-US) health system administration

To perform one or more operations on information to administer the electronic systems used for the delivery of health care.

4-L MEMADMIN (en-US) member administration

To perform one or more operations on information to administer health care coverage to an enrollee under a policy or program.

4-L PATADMIN (en-US) patient administration

To perform one or more operations on information used for operational activities conducted to administer the delivery of health care to a patient.

4-L PATSFTY (en-US) patient safety

To perform one or more operations on information in processes related to ensuring the safety of health care.

4-L PERFMSR (en-US) performance measure

To perform one or more operations on information used for monitoring performance of recommended health care practices and interventions.

4-L RECORDMGT (en-US) records management

To perform one or more operations on information used within the health records management process.

4-L TRAIN (en-US) training

To perform one or more operations on information used in training and education.

3-S HPAYMT (en-US) healthcare payment

To perform one or more operations on information for conducting financial or contractual activities related to payment for provision of health care.

4-L CLMATTCH (en-US) claim attachment

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.

4-L COVAUTH (en-US) coverage authorization

To perform one or more operations on information for conducting prior authorization or predetermination of coverage for services.

4-S COVERAGE (en-US) coverage under policy or program

To perform one or more operations on information for conducting activities related to coverage under a program or policy.

5-L ELIGDTRM (en-US) eligibility determination

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.

5-L ELIGVER (en-US) eligibility verification

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.

5-L ENROLLM (en-US) enrollment

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.

4-L REMITADV (en-US) remittance advice

To perform one or more operations on information about the amount remitted for a health care claim.

3-S HRESCH (en-US) healthcare research

To perform one or more operations on information for conducting scientific investigations to obtain health care knowledge.

4-L CLINTRCH (en-US) clinical trial research

To perform one or more operations on information for conducting scientific investigations in accordance with clinical trial protocols to obtain health care knowledge.

3-S PATRQT (en-US) patient requested

To perform one or more operations on information in response to a patient's request.

4-L FAMRQT (en-US) family requested

To perform one or more operations on information in response to a request by a family member authorized by the patient.

4-L PWATRNY (en-US) power of attorney

To perform one or more operations on information in response to a request by a person appointed as the patient's legal representative.

4-L SUPNWK (en-US) support network

To perform one or more operations on information in response to a request by a person authorized by the patient.

3-S PUBHLTH (en-US) public health

To perform one or more operations on information for conducting public health activities, such as the reporting of notifiable conditions.

4-L DISASTER (en-US) 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.

4-L THREAT (en-US) 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.

3-S TREAT (en-US) treatment

To perform one or more operations on information for provision of health care.

4-L CAREMGT (en-US) Care Management

To perform one or more operations on information for provision of health care coordination.

4-L CLINTRL (en-US) clinical trial

To perform health care as part of the clinical trial protocol.

4-L ETREAT (en-US) Emergency Treatment

To perform one or more operations on information for provision of immediately needed health care for an emergent condition.

4-L POPHLTH (en-US) population health

To perform one or more operations on information for provision of health care to a population of living subjects, e.g., needle exchange program.

2-A _ActConsentInformationAccessOverrideReason (en-US) ActConsentInformationAccessOverrideReason

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.

3-L OVRER (en-US) emergency treatment override

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.

3-L OVRPJ (en-US) professional judgment override

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.

3-L OVRPS (en-US) public safety override

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.

3-L OVRTPS (en-US) third party safety override

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.

1-A _ActInformationPrivacyReason (en-US) ActInformationPrivacyReason

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.

2-L MARKT (en-US) marketing

Description:

2-S OPERAT (en-US) operations

Description:Administrative and contractual processes required to support an activity, product, or service

3-L ACCRED (en-US) accreditation

Description:Operational activities conducted for the purposes of meeting of criteria defined by an accrediting entity for an activity, product, or service

3-L COMPL (en-US) compliance

Description:Operational activities required to meet a mandate related to an activity, product, or service

3-L ENADMIN (en-US) entity administration

Description:Operational activities conducted to administer information relating to entities involves with an activity, product, or service

3-L LEGAL (en-US) subpoena

Definition:To provide information as a result of a subpoena.

3-L OUTCOMS (en-US) outcome measure

Description:Operational activities conducted for the purposes of assessing the results of an activity, product, or service

3-L PRGRPT (en-US) program reporting

Description:Operational activities conducted to meet program accounting requirements related to an activity, product, or service

3-L QUALIMP (en-US) quality improvement

Description:Operational activities conducted for the purposes of improving the quality of an activity, product, or service

3-L SYSADMN (en-US) system administration

Description:Operational activities conducted to administer the electronic systems used for an activity, product, or service

2-L PAYMT (en-US) payment

Description:Administrative, financial, and contractual processes related to payment for an activity, product, or service

2-L RESCH (en-US) research

Description:Investigative activities conducted for the purposes of obtaining knowledge

2-L SRVC (en-US) service

Description:Provision of a service, product, or capability to an individual or organization

0-S _ControlActNullificationReasonCode (en-US) ControlActNullificationReasonCode

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

1-L ALTD (en-US) altered decision

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.

1-L EIE (en-US) entered in error

Description:The information was recorded incorrectly or was recorded in the wrong record.

1-L NORECMTCH (en-US) no record match

Description: There is no match for the record in the database.

0-S _SubstanceAdministrationPermissionRefusalReasonCode (en-US) SubstanceAdministrationPermissionRefusalReasonCode

Definition:Indicates why the requested authorization to prescribe or dispense a medication has been refused.

1-L NOUSERPERM (en-US) no user permission

Definition:The user does not have permission

1-L PATINELIG (en-US) patient not eligible

Definition:Patient not eligible for drug

1-L PROTUNMET (en-US) protocol not met

Definition:Patient does not meet required protocol

1-L PROVUNAUTH (en-US) provider not authorized

Definition:Provider is not authorized to prescribe or dispense

0-S _PharmacySupplyRequestFulfillerRevisionRefusalReasonCode (en-US) PharmacySupplyRequestFulfillerRevisionRefusalReasonCode

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

1-L LOCKED (en-US) locked

Definition:The prescription may not be reassigned from the original pharmacy.

1-L NOUSERPERM (en-US) no user permission

Definition:The user does not have permission

1-L UNKWNTARGET (en-US) unknown target

Definition:The target facility does not recognize the dispensing facility.

0-A _RefusalReasonCode (en-US) RefusalReasonCode

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.

1-S NOMATCH (en-US) no match

Description: There is no match.

2-L NOPRODMTCH (en-US) no product match

Description: There is no match for the product in the master file repository.

2-L NORECMTCH (en-US) no record match

Description: There is no match for the record in the database.

2-L NOSERMTCH (en-US) no service match

Description: There is no match for the service in the master file repository.

2-L NOVERMTCH (en-US) no version match

Description: There is no match for the record and version.

1-S NOPERM (en-US) no permission

Description: There is no permission.

2-L NOAGNTPERM (en-US) no agent permission

Description: The agent does not have permission.

2-L NOUSERPERM (en-US) no user permission

Definition:The user does not have permission

0-S _StatusRevisionRefusalReasonCode (en-US) StatusRevisionRefusalReasonCode

Indicates why the act revision (status update) is being refused.

1-L FILLED (en-US) fully filled

Ordered quantity has already been completely fulfilled.

1-L INRQSTATE (en-US) in requested state

The record is already in the requested state.

1-L NORECMTCH (en-US) no record match

Description: There is no match for the record in the database.

1-L NOUSERPERM (en-US) no user permission

Definition:The user does not have permission

0-S _ActInvalidReason (en-US) ActInvalidReason

Description: Types of reasons why a substance is invalid for use.

1-S ADVSTORAGE (en-US) adverse storage condition

Description: Storage conditions caused the substance to be ineffective.

2-L COLDCHNBRK (en-US) cold chain break

Description: Cold chain was not maintained for the substance.

1-L EXPLOT (en-US) expired lot

Description: The lot from which the substance was drawn was expired.

1-L OUTSIDESCHED (en-US) administered outside recommended schedule

Description: The substance was administered outside of the recommended schedule.

1-L PRODRECALL (en-US) product recall

Description: The substance was recalled by the manufacturer.

0-A _ControlActNullificationRefusalReasonType (en-US) ControlActNullificationRefusalReasonType

Description: Reasons to refuse a transaction to be undone.

1-L INRQSTATE (en-US) in requested state

The record is already in the requested state.

1-S NOMATCH (en-US) no match

Description: There is no match.

2-L NOPRODMTCH (en-US) no product match

Description: There is no match for the product in the master file repository.

2-L NORECMTCH (en-US) no record match

Description: There is no match for the record in the database.

2-L NOSERMTCH (en-US) no service match

Description: There is no match for the service in the master file repository.

2-L NOVERMTCH (en-US) no version match

Description: There is no match for the record and version.

1-S NOPERM (en-US) no permission

Description: There is no permission.

2-L NOAGNTPERM (en-US) no agent permission

Description: The agent does not have permission.

2-L NOUSERPERM (en-US) no user permission

Definition:The user does not have permission

1-L WRNGVER (en-US) wrong version

Description: The record and version requested to update is not the current version.