HL7 Terminology (THO)
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HL7 Terminology (THO), published by HL7 International - Vocabulary Work Group. This guide is not an authorized publication; it is the continuous build for version 6.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/HL7/UTG/ and changes regularly. See the Directory of published versions

ValueSet: ActCoverageConfirmationCode

Official URL: http://terminology.hl7.org/ValueSet/v3-ActCoverageConfirmationCode Version: 3.0.0
Active as of 2014-03-26 Responsible: Health Level Seven International Computable Name: ActCoverageConfirmationCode
Other Identifiers: OID:2.16.840.1.113883.1.11.17487

Copyright/Legal: This material derives from the HL7 Terminology THO. THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html

Response to an insurance coverage eligibility query or authorization request.

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)

Generated Narrative: ValueSet v3-ActCoverageConfirmationCode

Language: en

This value set includes codes based on the following rules:

This value set excludes codes based on the following rules:

 

Expansion

Generated Narrative: ValueSet

Language: en

Expansion based on codesystem ActCode v9.0.0 (CodeSystem)

This value set contains 6 concepts

CodeSystemDisplayInactiveDefinition
  _ActCoverageAuthorizationConfirmationCodehttp://terminology.hl7.org/CodeSystem/v3-ActCodeActCoverageAuthorizationConfirmationCode

Indication of authorization for healthcare service(s) and/or product(s). If authorization is approved, funds are set aside.

  AUTHhttp://terminology.hl7.org/CodeSystem/v3-ActCodeAuthorized

Authorization approved and funds have been set aside to pay for specified healthcare service(s) and/or product(s) within defined criteria for the authorization.

  NAUTHhttp://terminology.hl7.org/CodeSystem/v3-ActCodeNot Authorized

Authorization for specified healthcare service(s) and/or product(s) denied.

  _ActCoverageEligibilityConfirmationCodehttp://terminology.hl7.org/CodeSystem/v3-ActCodeActCoverageEligibilityConfirmationCodeinactive

Indication of eligibility coverage for healthcare service(s) and/or product(s).

  ELGhttp://terminology.hl7.org/CodeSystem/v3-ActCodeEligibleinactive

Insurance coverage is in effect for healthcare service(s) and/or product(s).

  NELGhttp://terminology.hl7.org/CodeSystem/v3-ActCodeNot Eligibleinactive

Insurance coverage is not in effect for healthcare service(s) and/or product(s). May optionally include reasons for the ineligibility.

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
2023-11-14reviseTSMGMarc DuteauAdd standard copyright and contact to internal content; up-476
2022-10-18reviseTSMGMarc DuteauFixing missing metadata; up-349
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