Patient Cost Transparency Implementation Guide
1.0.0 - STU 1 United States of America flag

Patient Cost Transparency Implementation Guide, published by HL7 International - Financial Management Work Group. This is not an authorized publication; it is the continuous build for version 1.0.0). This version is based on the current content of and changes regularly. See the Directory of published versions

ValueSet: PCT Subject-To-Medical-Management Reason Value Set

Official URL: Version: 1.0.0
Active as of 2023-03-29 Computable Name: PCTSubjectToMedicalMgmtReasonVS

Copyright/Legal: This Valueset is not copyrighted.

Codes for the classification of subject-to-medical-management reasons


Logical Definition (CLD)



This value set contains 4 concepts

Expansion based on PCT Subject-To-Medical-Management Reason Code System v1.0.0 (CodeSystem)

  concurrent-review Review

Concurrent Review

  prior-auth Authorization

Prior Authorization

  step-therapy Therapy

Step Therapy



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