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Kodesystem ParticipationFunction

Beschreibung

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).

Aktuelle Version

Codesystem Name Codesystem Id Version / Eingangsdatum Status
ParticipationFunction 2.16.840.1.113883.5.88 2012-07-24 definitiv
Level/Typ Code Anzeigename Beschreibung
0-L PRISURG EN-US.png primary surgeon

In a typical surgery setting the primary performing surgeon.

0-L FASST EN-US.png first 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).

0-L SASST EN-US.png second assistant surgeon

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

0-L SNRS EN-US.png scrub nurse

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

0-L TASST EN-US.png third 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).

0-L NASST EN-US.png nurse 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.).

0-L ANEST EN-US.png anesthesist

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.

0-L ANRS EN-US.png anesthesia nurse

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

0-L MDWF EN-US.png midwife

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.

0-L ATTPHYS EN-US.png attending physician

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

0-L ADMPHYS EN-US.png admitting physician

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

0-L DISPHYS EN-US.png discharging physician

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

0-L RNDPHYS EN-US.png rounding physician

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

0-L PCP EN-US.png primary care physician

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

0-A _CoverageParticipationFunction EN-US.png CoverageParticipationFunction

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

1-A _PayorParticipationFunction EN-US.png PayorParticipationFunction

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

2-L CLMADJ EN-US.png claims adjudication

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

2-L ENROLL EN-US.png enrollment broker

Definition: Managing the enrollment of covered parties.

2-L FFSMGT EN-US.png 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.

2-L MCMGT EN-US.png 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.

2-L PROVMGT EN-US.png provider management

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

2-L UMGT EN-US.png 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.

1-A _SponsorParticipationFunction EN-US.png 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.

2-L FULINRD EN-US.png 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.

2-L SELFINRD EN-US.png self insured

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

1-A _UnderwriterParticipationFunction EN-US.png UnderwriterParticipationFunction

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

2-L PAYORCNTR EN-US.png 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.

2-L REINS EN-US.png reinsures

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

2-L RETROCES EN-US.png retrocessionaires

Definition: Underwriting reinsurance for another reinsurer.

2-L SUBCTRT EN-US.png 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 .

2-L UNDERWRTNG EN-US.png underwriting

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

0-A _AuthorizedParticipationFunction EN-US.png AuthorizedParticipationFunction

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

1-A _AuthorizedReceiverParticipationFunction EN-US.png AuthorizedReceiverParticipationFunction

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.

2-L AUCG EN-US.png caregiver information receiver

Description:Caregiver authorized to receive patient health information.

2-L AULR EN-US.png legitimate relationship information receiver

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

2-L AUTM EN-US.png care team information receiver

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

2-L AUWA EN-US.png work area information receiver

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

1-A _ConsenterParticipationFunction EN-US.png ConsenterParticipationFunction

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

2-L GRDCON EN-US.png legal guardian consent author

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

2-L POACON EN-US.png healthcare power of attorney consent author

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

2-L PRCON EN-US.png personal representative consent author

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

2-L PROMSK EN-US.png 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.

2-L SUBCON EN-US.png subject of consent author

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

1-A _OverriderParticipationFunction EN-US.png OverriderParticipationFunction

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

2-L AUCOV EN-US.png consent overrider

Description:Entity authorized to override a consent directive.

2-L AUEMROV EN-US.png emergency overrider

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

Verwendung in Value Sets

Zusammenstellung aller Versionen dieses Kodesystems

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