Kenya Patient Summary FHIR Implementation Guide, published by Digital Health Agency of Kenya. This guide is not an authorized publication; it is the continuous build for version 0.1.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/IntelliSOFT-Consulting/Kenya-Patient-Summary-FHIR-IG/ and changes regularly. See the Directory of published versions

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: KNHTS.CLMSTPS CodeSystem for claim Sub-types - XML Representation

Draft as of 2026-05-11

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<CodeSystem xmlns="http://hl7.org/fhir">
  <id value="knhts-clms-sb-typs-cs"/>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p class="res-header-id"><b>Generated Narrative: CodeSystem knhts-clms-sb-typs-cs</b></p><a name="knhts-clms-sb-typs-cs"> </a><a name="hcknhts-clms-sb-typs-cs"> </a><p>This case-insensitive code system <code>https://fhir.dha.go.ke/kps/CodeSystem/knhts-clms-sb-typs-cs</code> defines the following codes:</p><table class="codes"><tr><td style="white-space:nowrap"><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td style="white-space:nowrap">CLMSBTPS01<a name="knhts-clms-sb-typs-cs-CLMSBTPS01"> </a></td><td>PHC_OUTPATIENT</td><td>Outpatient Health Services (Primary Healthcare Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS02<a name="knhts-clms-sb-typs-cs-CLMSBTPS02"> </a></td><td>PHC_EAR</td><td>Ear Health Services (Primary Healthcare Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS03<a name="knhts-clms-sb-typs-cs-CLMSBTPS03"> </a></td><td>PHC_EYE</td><td>Eye Health Services (Primary Healthcare Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS04<a name="knhts-clms-sb-typs-cs-CLMSBTPS04"> </a></td><td>PHC_MENTAL</td><td>Mental and Behavioral Health Services (Primary Healthcare Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS05<a name="knhts-clms-sb-typs-cs-CLMSBTPS05"> </a></td><td>PHC_SCREENING</td><td>Screening Services (Primary Healthcare Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS06<a name="knhts-clms-sb-typs-cs-CLMSBTPS06"> </a></td><td>PHC_REHABILITATIVE</td><td>Rehabilitative Services (Primary Healthcare Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS07<a name="knhts-clms-sb-typs-cs-CLMSBTPS07"> </a></td><td>PHC_ASSISTIVE</td><td>Assistive Devices (Primary Healthcare Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS08<a name="knhts-clms-sb-typs-cs-CLMSBTPS08"> </a></td><td>PHC_MATERNITY</td><td>Maternity Healthcare Services (Primary Healthcare Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS09<a name="knhts-clms-sb-typs-cs-CLMSBTPS09"> </a></td><td>PHC_INPATIENT</td><td>Inpatient Services (Primary Healthcare Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS10<a name="knhts-clms-sb-typs-cs-CLMSBTPS10"> </a></td><td>PHC_LAST_EXPENSE</td><td>Last Expense (Primary Healthcare Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS11<a name="knhts-clms-sb-typs-cs-CLMSBTPS11"> </a></td><td>SHIF_OUTPATIENT</td><td>Outpatient (Social Health Insurance Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS12<a name="knhts-clms-sb-typs-cs-CLMSBTPS12"> </a></td><td>SHIF_INPATIENT</td><td>Inpatient (Social Health Insurance Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS13<a name="knhts-clms-sb-typs-cs-CLMSBTPS13"> </a></td><td>SHIF_MATERNITY</td><td>Maternity (Social Health Insurance Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS14<a name="knhts-clms-sb-typs-cs-CLMSBTPS14"> </a></td><td>SHIF_SURGICAL</td><td>Surgical (Social Health Insurance Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS15<a name="knhts-clms-sb-typs-cs-CLMSBTPS15"> </a></td><td>SHIF_NCD</td><td>NCD Screening (Social Health Insurance Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS16<a name="knhts-clms-sb-typs-cs-CLMSBTPS16"> </a></td><td>SHIF_CONGENITAL</td><td>Congenital Screening (Social Health Insurance Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS17<a name="knhts-clms-sb-typs-cs-CLMSBTPS17"> </a></td><td>SHIF_REHABILITATION</td><td>Rehabilitation Services (Social Health Insurance Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS18<a name="knhts-clms-sb-typs-cs-CLMSBTPS18"> </a></td><td>SHIF_CRITICAL_CARE</td><td>Critical Care Services (Social Health Insurance Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS19<a name="knhts-clms-sb-typs-cs-CLMSBTPS19"> </a></td><td>SHIF_PALLIATIVE_CARE</td><td>Palliative Care Services (Social Health Insurance Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS20<a name="knhts-clms-sb-typs-cs-CLMSBTPS20"> </a></td><td>SHIF_RADIOLOGY</td><td>Radiology Services (Social Health Insurance Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS21<a name="knhts-clms-sb-typs-cs-CLMSBTPS21"> </a></td><td>SHIF_CANCER_MANAGEMENT</td><td>Cancer Management (Social Health Insurance Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS22<a name="knhts-clms-sb-typs-cs-CLMSBTPS22"> </a></td><td>SHIF_ASSISTIVE_DEVICES</td><td>Assistive Devices (Social Health Insurance Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS23<a name="knhts-clms-sb-typs-cs-CLMSBTPS23"> </a></td><td>SHIF_OVERSEAS_TREATMENT</td><td>Overseas Treatment (Social Health Insurance Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS24<a name="knhts-clms-sb-typs-cs-CLMSBTPS24"> </a></td><td>SHIF_MORTUARY_FEE</td><td>Mortuary Fee (Social Health Insurance Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS25<a name="knhts-clms-sb-typs-cs-CLMSBTPS25"> </a></td><td>SHIF_DIALYSIS</td><td>Dialysis Services (Social Health Insurance Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS26<a name="knhts-clms-sb-typs-cs-CLMSBTPS26"> </a></td><td>SHIF_TRANSPLANT</td><td>Transplant Services (Social Health Insurance Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS29<a name="knhts-clms-sb-typs-cs-CLMSBTPS29"> </a></td><td>ECCIF_CHRONIC</td><td>Chronic Illness Fund (Chronic and Critical Illness Fund)</td></tr><tr><td style="white-space:nowrap">CLMSBTPS30<a name="knhts-clms-sb-typs-cs-CLMSBTPS30"> </a></td><td>ECCIF_AMBULANCE</td><td>Ambulance Services (Emergency Fund)</td></tr></table></div>
  </text>
  <url value="https://fhir.dha.go.ke/kps/CodeSystem/knhts-clms-sb-typs-cs"/>
  <version value="0.1.0"/>
  <name value="KNHTS_CLMS_SBTYPS"/>
  <title value="KNHTS.CLMSTPS CodeSystem for claim Sub-types"/>
  <status value="draft"/>
  <experimental value="false"/>
  <date value="2026-05-11T04:59:51+00:00"/>
  <publisher value="Digital Health Agency of Kenya"/>
  <contact>
    <name value="Digital Health Agency of Kenya"/>
    <telecom>
      <system value="url"/>
      <value value="https://www.dha.go.ke"/>
    </telecom>
    <telecom>
      <system value="email"/>
      <value value="interoperability@dha.go.ke"/>
    </telecom>
  </contact>
  <contact>
    <name value="Digital Health Agency of Kenya – Interoperability Team"/>
    <telecom>
      <system value="email"/>
      <value value="interoperability@dha.go.ke"/>
      <use value="work"/>
    </telecom>
    <telecom>
      <system value="url"/>
      <value value="https://www.dha.go.ke"/>
      <use value="work"/>
    </telecom>
  </contact>
  <description value="CodeSystem for KNHTS Claim Sub-types"/>
  <jurisdiction>
    <coding>
      <system value="urn:iso:std:iso:3166"/>
      <code value="KE"/>
      <display value="Kenya"/>
    </coding>
  </jurisdiction>
  <copyright
             value="Copyright © 2024+ Digital Health Agency of Kenya. This content is licensed under Creative Commons Zero v1.0 Universal (CC0 1.0). No rights reserved.
"/>
  <caseSensitive value="false"/>
  <content value="complete"/>
  <count value="28"/>
  <concept>
    <code value="CLMSBTPS01"/>
    <display value="PHC_OUTPATIENT"/>
    <definition value="Outpatient Health Services (Primary Healthcare Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS02"/>
    <display value="PHC_EAR"/>
    <definition value="Ear Health Services (Primary Healthcare Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS03"/>
    <display value="PHC_EYE"/>
    <definition value="Eye Health Services (Primary Healthcare Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS04"/>
    <display value="PHC_MENTAL"/>
    <definition
                value="Mental and Behavioral Health Services (Primary Healthcare Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS05"/>
    <display value="PHC_SCREENING"/>
    <definition value="Screening Services (Primary Healthcare Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS06"/>
    <display value="PHC_REHABILITATIVE"/>
    <definition value="Rehabilitative Services (Primary Healthcare Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS07"/>
    <display value="PHC_ASSISTIVE"/>
    <definition value="Assistive Devices (Primary Healthcare Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS08"/>
    <display value="PHC_MATERNITY"/>
    <definition
                value="Maternity Healthcare Services (Primary Healthcare Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS09"/>
    <display value="PHC_INPATIENT"/>
    <definition value="Inpatient Services (Primary Healthcare Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS10"/>
    <display value="PHC_LAST_EXPENSE"/>
    <definition value="Last Expense (Primary Healthcare Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS11"/>
    <display value="SHIF_OUTPATIENT"/>
    <definition value="Outpatient (Social Health Insurance Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS12"/>
    <display value="SHIF_INPATIENT"/>
    <definition value="Inpatient (Social Health Insurance Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS13"/>
    <display value="SHIF_MATERNITY"/>
    <definition value="Maternity (Social Health Insurance Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS14"/>
    <display value="SHIF_SURGICAL"/>
    <definition value="Surgical (Social Health Insurance Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS15"/>
    <display value="SHIF_NCD"/>
    <definition value="NCD Screening (Social Health Insurance Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS16"/>
    <display value="SHIF_CONGENITAL"/>
    <definition value="Congenital Screening (Social Health Insurance Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS17"/>
    <display value="SHIF_REHABILITATION"/>
    <definition
                value="Rehabilitation Services (Social Health Insurance Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS18"/>
    <display value="SHIF_CRITICAL_CARE"/>
    <definition
                value="Critical Care Services (Social Health Insurance Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS19"/>
    <display value="SHIF_PALLIATIVE_CARE"/>
    <definition
                value="Palliative Care Services (Social Health Insurance Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS20"/>
    <display value="SHIF_RADIOLOGY"/>
    <definition value="Radiology Services (Social Health Insurance Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS21"/>
    <display value="SHIF_CANCER_MANAGEMENT"/>
    <definition value="Cancer Management (Social Health Insurance Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS22"/>
    <display value="SHIF_ASSISTIVE_DEVICES"/>
    <definition value="Assistive Devices (Social Health Insurance Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS23"/>
    <display value="SHIF_OVERSEAS_TREATMENT"/>
    <definition value="Overseas Treatment (Social Health Insurance Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS24"/>
    <display value="SHIF_MORTUARY_FEE"/>
    <definition value="Mortuary Fee (Social Health Insurance Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS25"/>
    <display value="SHIF_DIALYSIS"/>
    <definition value="Dialysis Services (Social Health Insurance Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS26"/>
    <display value="SHIF_TRANSPLANT"/>
    <definition value="Transplant Services (Social Health Insurance Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS29"/>
    <display value="ECCIF_CHRONIC"/>
    <definition
                value="Chronic Illness Fund (Chronic and Critical Illness Fund)"/>
  </concept>
  <concept>
    <code value="CLMSBTPS30"/>
    <display value="ECCIF_AMBULANCE"/>
    <definition value="Ambulance Services (Emergency Fund)"/>
  </concept>
</CodeSystem>