Order Catalog Implementation Guide
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Order Catalog Implementation Guide, published by HL7 International - Orders and Observations Work Group. This is not an authorized publication; it is the continuous build for version current). This version is based on the current content of https://github.com/HL7/fhir-order-catalog/ and changes regularly. See the Directory of published versions

ValueSet: Laboratory service reimbursability categories ValueSet

Official URL: http://hl7.org/fhir/uv/order-catalog/ValueSet/laboratory-service-reimbursability-vs Version: current
Active as of 2020-03-20 Computable Name: LaboratoryServiceReimbursabilityVS

This value set provides codes summarizing the reimbursement dispositions that can affect a laboratory service

References

Logical Definition (CLD)

  • Include these codes as defined in http://hl7.org/fhir/uv/order-catalog/CodeSystem/laboratory-service-reimbursability
    CodeDisplayDefinition
    noneno reimbursement provided for the service in generalThe service is usually not covered by insurance plans, and charged to the paying party
    normalnormal reimbursement dispositions applicable to the serviceThe service is usually reimbursed (partially or totally) under general dispositions defined in insurance plans, independently of the service
    conditionalreimbursement of service subject to conditionsThe service reimbursement is conditioned by the clinical context of the order
    partialnormal reimbursement limited to a part of the serviceThe service is composed of a part that is usually reimbursed under general dispositions defined in insurance plans, and of a part that is non-reimbursable
    conditional-partialreimbursement limited to a part of the service and subject to conditionsThe service is composed of a part that is reimbursable depending on the clinical context, and of a part that is non-reimbursable

 

Expansion

This value set contains 5 concepts

Expansion based on Kinds of reibursability coarse categories for a laboratory service vcurrent (CodeSystem)

CodeSystemDisplayDefinition
  nonehttp://hl7.org/fhir/uv/order-catalog/CodeSystem/laboratory-service-reimbursabilityno reimbursement provided for the service in general

The service is usually not covered by insurance plans, and charged to the paying party

  normalhttp://hl7.org/fhir/uv/order-catalog/CodeSystem/laboratory-service-reimbursabilitynormal reimbursement dispositions applicable to the service

The service is usually reimbursed (partially or totally) under general dispositions defined in insurance plans, independently of the service

  conditionalhttp://hl7.org/fhir/uv/order-catalog/CodeSystem/laboratory-service-reimbursabilityreimbursement of service subject to conditions

The service reimbursement is conditioned by the clinical context of the order

  partialhttp://hl7.org/fhir/uv/order-catalog/CodeSystem/laboratory-service-reimbursabilitynormal reimbursement limited to a part of the service

The service is composed of a part that is usually reimbursed under general dispositions defined in insurance plans, and of a part that is non-reimbursable

  conditional-partialhttp://hl7.org/fhir/uv/order-catalog/CodeSystem/laboratory-service-reimbursabilityreimbursement limited to a part of the service and subject to conditions

The service is composed of a part that is reimbursable depending on the clinical context, and of a part that is non-reimbursable

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