HL7 v2.3.1 Vocabulary
0.2.0 - ci-build

HL7 v2.3.1 Vocabulary, published by HL7/FO. This guide is not an authorized publication; it is the continuous build for version 0.2.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/frankoemig/hl7.v2.terminology.v231/ and changes regularly. See the Directory of published versions

ValueSet: Condition Code (2.3.1 - 1.0.0) (Experimental)

Official URL: http://terminology.hl7.org/v2plusvocab/ValueSet/hl7VSconditionCode Version: 1.0.0
Active as of 2026-03-13 Computable Name: Hl7VSconditionCode
Other Identifiers: OID:2.16.840.1.113883.21.22, urn:ietf:rfc:3986#Uniform Resource Identifier (URI)#http://terminology.hl7.org/v2plusvocab/ValueSet/v2-0043

Copyright/Legal: HL7 Inc., 2026

Value Set of codes that specify the condition code.

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)

 

Expansion

Expansion performed internally based on codesystem Condition Code (2.3.1 - 1.0.0) v1.0.0 (CodeSystem)

This value set contains 56 concepts

SystemCodeDisplay (en)DefinitionJSONXML
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  01Military service relatedMilitary service related
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  02Condition is employment relatedCondition is employment related
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  03Patient covered by insurance not reflected herePatient covered by insurance not reflected here
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  04HMO enrolleeHMO enrollee
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  05Lien has been filedLien has been filed
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  06ESRD patient in first 18 months of entitlement covered by employer group health insuranceESRD patient in first 18 months of entitlement covered by employer group health insurance
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  07Treatment of non-terminal condition for hospice patientTreatment of non-terminal condition for hospice patient
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  08Beneficiary would not provide information concerning other insurance coverageBeneficiary would not provide information concerning other insurance coverage
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  09Neither patient nor spouse is employedNeither patient nor spouse is employed
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  10Patient and/or spouse is employed but no EGHP existsPatient and/or spouse is employed but no EGHP exists
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  11Disabled beneficiary but no LGHPDisabled beneficiary but no LGHP
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  12Payer codes.Payer codes.
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  13Payer codes.Payer codes.
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  14Payer codes.Payer codes.
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  15Payer codes.Payer codes.
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  16Payer codes.Payer codes.
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  18Maiden name retainedMaiden name retained
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  19Child retains mother's nameChild retains mother's name
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  20Beneficiary requested billingBeneficiary requested billing
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  21Billing for Denial NoticeBilling for Denial Notice
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  26VA eligible patient chooses to receive services in a Medicare certified facilityVA eligible patient chooses to receive services in a Medicare certified facility
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  27Patient referred to a sole community hospital for a diagnostic laboratory testPatient referred to a sole community hospital for a diagnostic laboratory test
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  28Patient and/or spouse’s EGHP is secondary to MedicarePatient and/or spouse’s EGHP is secondary to Medicare
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  29Disabled beneficiary and/or family member’s LGHP is secondary to MedicareDisabled beneficiary and/or family member’s LGHP is secondary to Medicare
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  31Patient is student (full time-day)Patient is student (full time-day)
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  32Patient is student (cooperative/work study program)Patient is student (cooperative/work study program)
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  33Patient is student (full time-night)Patient is student (full time-night)
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  34Patient is student (Part time)Patient is student (Part time)
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  36General care patient in a special unitGeneral care patient in a special unit
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  37Ward accommodation as patient requestWard accommodation as patient request
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  38Semi-private room not availableSemi-private room not available
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  39Private room medically necessaryPrivate room medically necessary
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  40Same day transferSame day transfer
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  41Partial hospitalizationPartial hospitalization
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  46Non-availability statement on fileNon-availability statement on file
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  48Psychiatric residential treatment centers for children and adolescentsPsychiatric residential treatment centers for children and adolescents
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  55SNF bed not availableSNF bed not available
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  56Medical appropriatenessMedical appropriateness
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  57SNF readmissionSNF readmission
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  60Day outlierDay outlier
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  61Cost outlierCost outlier
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  62Payer codePayer code
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  66Provider does not wish cost outlier paymentProvider does not wish cost outlier payment
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  67Beneficiary elects not to use life time reserve (LTR) daysBeneficiary elects not to use life time reserve (LTR) days
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  68Beneficiary elects to use life time reserve (LTR) daysBeneficiary elects to use life time reserve (LTR) days
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  70Self-administered EPOSelf-administered EPO
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  71Full care in unitFull care in unit
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  72Self-care in unitSelf-care in unit
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  73Self-care trainingSelf-care training
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  74HomeHome
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  75Home - 100% reimbursementHome - 100% reimbursement
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  76Back-up in facility dialysisBack-up in facility dialysis
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  77Provider accepts or is obligated/required due to a contractual arrangement or law to accept payment by a primary payer as payment in fullProvider accepts or is obligated/required due to a contractual arrangement or law to accept payment by a primary payer as payment in full
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  78New coverage not implemented by HMONew coverage not implemented by HMO
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  79Corf services provided off-siteCorf services provided off-site
http://terminology.hl7.org/v2plusvocab/CodeSystem/conditionCodes  80PregnantPregnant

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