The type of document section. Possible values: review of systems, medical history, family history, microscopic findings, etc.

The kind of document. Possible values: discharge summary, progress note, Oncology note, etc.

Domain provides the root for HL7-defined detailed or rich codes for the Act classes.

An account represents a grouping of financial transactions that are tracked and reported together with a single balance. Examples of account codes (types) are Patient billing accounts (collection of charges), Cost centers; Cash.

Includes coded responses that will occur as a result of the adjudication of an electronic invoice at a summary level and provides guidance on interpretation of the referenced adjudication results.

The invoice element has been accepted for payment but one or more adjustment(s) have been made to one or more invoice element line items (component charges).

Also includes the concept 'Adjudicate as zero' and items not covered under a particular Policy.

Invoice element can be reversed (cancelled).

Recommend that the invoice element is saved for DUR (Drug Utilization Reporting).

The invoice element has been accepted for payment but one or more adjustment(s) have been made to one or more invoice element line items (component charges) without changing the amount.

Invoice element can be reversed (cancelled).

Recommend that the invoice element is saved for DUR (Drug Utilization Reporting).

The invoice element has passed through the adjudication process but payment is refused due to one or more reasons.

Includes items such as patient not covered, or invoice element is not constructed according to payor rules (e.g. 'invoice submitted too late').

If one invoice element line item in the invoice element structure is rejected, the remaining line items may not be adjudicated and the complete group is treated as rejected.

A refused invoice element can be forwarded to the next payor (for Coordination of Benefits) or modified and resubmitted to refusing payor.

Invoice element cannot be reversed (cancelled) as there is nothing to reverse.

Recommend that the invoice element is not saved for DUR (Drug Utilization Reporting).

The invoice element was/will be paid exactly as submitted, without financial adjustment(s).

If the dollar amount stays the same, but the billing codes have been amended or financial adjustments have been applied through the adjudication process, the invoice element is treated as "Adjudicated with Adjustment."

If information items are included in the adjudication results that do not affect the monetary amounts paid, then this is still Adjudicated as Submitted (e.g. 'reached Plan Maximum on this Claim').

Invoice element can be reversed (cancelled).

Recommend that the invoice element is saved for DUR (Drug Utilization Reporting).

Catagorization of grouping criteria for the associated transactions and/or summary (totals, subtotals).

Transaction counts and value totals by Contract Identifier.

Transaction counts and value totals for each calendar day within the date range specified.

Transaction counts and value totals by service location (e.g clinic).

Transaction counts and value totals for each calendar month within the date range specified.

Transaction counts and value totals for the date range specified.

Transaction counts and value totals by Provider Identifier.

Transaction counts and value totals for each calendar week within the date range specified.

Transaction counts and value totals for each calendar year within the date range specified.

Actions to be carried out by the recipient of the Adjudication Result information.

The adjudication result associated is to be displayed to the receiver of the adjudication result.

The adjudication result associated is to be printed on the specified form, which is then provided to the covered party.

Identifies types of alerts for Act class "ALRT"

Identifies types of alerts regarding the administration or supply of an item to a patient.

Administration of the proposed therapy may be inappropriate or contraindicated as proposed

Proposed therapy may interact with an existing or recent therapeutic product

Proposed therapy may interact with an existing or recent drug therapy

Proposed therapy may interact with existing or recent natural health product therapy

Proposed therapy may interact with a non-prescription drug (e.g. alcohol, tobaco, Asprin)

Proposed therapy may interact with certain foods

Proposed therapy may be inappropriate or contraindicated due to conditions or characteristics of the patient

Proposed therapy may be inappropriate or contraindicated due to patient age

Proposed dosage exceeds standard practice for the patient's age

Proposed dosage is below suggested therapeutic levels for the patient's age

Proposed therapy may be inappropriate or contraindicated due to an existing/recent patient condition or diagnosis

Proposed therapy may be inappropriate or contraindicated when breast-feeding

Proposed therapy may be inappropriate or contraindicated during pregnancy

Proposed therapy may be inappropriate or contraindicated based on the potential for a patient reaction to the proposed product

Proposed therapy may be inappropriate or contraindicated because of a recorded patient allergy to the proposed product. (Allergies are immune based reactions.)

Proposed therapy may be inappropriate or contraindicated because of a recorded patient intolerance to the proposed product. (Intolerances are non-immune based sensitivities.)

Proposed therapy may be inappropriate or contraindicated because of a potential patient reaction to a cross-sensitivity related product.

Proposed therapy may be inappropriate or contraindicated because of a recorded patient allergy to a cross-sensitivity related product. (Allergies are immune based reactions.)

Proposed therapy may be inappropriate or contraindicated because of a recorded prior adverse reaction to a cross-sensitivity related product.

Proposed therapy may be inappropriate or contraindicated because of a recorded patient intolerance to a cross-sensitivity related product. (Intolerances are non-immune based sensitivities.)

Proposed therapy may be inappropriate or contraindicated due to patient genetic indicators.

Proposed therapy may be inappropriate or contraindicated due to patient gender.

Proposed therapy may be inappropriate or contraindicated due to recent lab test results

There may be an issue with the patient complying with the intentions of the proposed therapy

The proposed therapy appears to duplicate an existing therapy

A similar or identical therapy was recently ordered by a different practitioner.

This patient was recently supplied a similar or identical therapy from a different pharmacy or supplier.

Proposed dosage instructions for therapy differ from standard practice.

Proposed length of therpay differs from standard practice

Proposed length of therapy is longer than standard practice

Proposed length of therapy is longer than standard practice for the identified indication or diagnosis

Proposed length of therapy is shorter than that necessary for therapeutic effect

Proposed length of therapy is shorter than standard practice for the identified indication or diagnosis

Proposed dosage exceeds standard practice

Proposed dosage exceeds standard practice for the patient's age

Proposed dosage exceeds standard practice for the patient's height or body surface area

Proposed dosage exceeds standard practice for the patient's weight

Proposed dosage interval/timing differs from standard practice

Proposed dosage interval/timing differs from standard practice for the identified indication or diagnosis

Proposed dosage is below suggested therapeutic levels

Proposed dosage is below suggested therapeutic levels for the patient's age

Proposed dosage is below suggested therapeutic levels for the patient's height or body surface area

Proposed dosage is below suggested therapeutic levels for the patient's weight

Proposed therapy may be contraindicated or ineffective based on an existing or recent drug therapy

Proposed therapy may be inappropriate or ineffective based on the proposed start or end time.

Proposed therapy may be inappropriate or ineffective because the end of administration is too close to another planned therapy

Proposed therapy may be inappropriate or ineffective because the start of administration is too late after the onset of the condition

Supplying the product at this time may be inappropriate or indicate compliance issues with the associated therapy

The patient is receiving a subsequent fill significantly later than would be expected based on the amount previously supplied and the therapy dosage instructions

The patient is receiving a subsequent fill significantly earlier than would be expected based on the amount previously supplied and the therapy dosage instructions

Identifies types of alerts regarding to the performance of a clinical action on a patient.

Codes dealing with the management of Alert observations

Order is performed as issued, but other action taken to mitigate potential adverse effects

Provided education or training to the patient on appropriate therapy use

Instituted an additional therapy to mitigate potential negative effects

Suspended existing therapy that triggered interaction for the duration of this therapy

Aborted existing therapy that triggered interaction.

Arranged to monitor patient for adverse effects

Confirmed supply action appropriate

Patient's existing supply was lost/wasted

Supply date is due to patient vacation

Supply date is intended to carry patient over weekend

Supply is intended for use during a leave of absense from an institution

Confirmed drug therapy appropriate

Consulted prescriber, therapy confirmed

Consulted prescriber and recommended change, prescriber declined

Consulted other supplier/pharmacy, therapy confirmed

Assessed patient, therapy is appropriate

Patient gave adequate explanation

Consulted other supply source, therapy still appropriate

Concurrent therapy triggering alert is no longer on-going or planned

The type of provision(s) made for reimbursing for the deliver of healthcare services and/or goods provided by a Provider, over a specified period.

A billing arrangement where a Provider charges a lump sum to provide a group (volume) of services which occur over a period of time. Services included in the block may vary.

This billing arrangement is also known as Program of Care for some specific Payors and Program Fees for other Payors.

A billing arrangement where the payment made to a Provider is determined by analyzing one or more demographic attributes about the persons/patients who are enrolled with the Provider (in their practice).

A billing arrangement where a Provider charges a lump sum to provide a particular volume of one or more interventions/procedures or groups of interventions/procedures.

A billing arrangement where a Provider charges a separate fee for each intervention/procedure or product.

Fee for Service is used when an individual intervention/procedure is used for billing purposes. In other words, fees are associated with the intervention/procedure. For example, a specific CCI (Canadian Classification of Interventions) code has an associated fee and is used for billing purposes.

Concepts like office visit or session are NOT supported under this definition, as they are sessions (of one or more interventions/procedures).

A billing arrangement where a Provider charges for non-clinical items. This includes interest in arrears, mileage, etc. Clinical content is not included in Invoices submitted with this type of billing arrangement.

A billing arrangement where funding is based on a list of individuals registered as patients of the Provider.

A billing arrangement where a Provider charges a lump sum to provide a group (volume) of interventions/procedures which occur within one session, typically on the same date. Interventions/procedures included in the session may vary.

Sessional is used when one or more interventions/procedures are billed together. For example, an office visit or session at which multiple interventions/procedures were delivered).

Type of bounded ROI.

A fully specified bounded Region of Interest (ROI) delineates a ROI in which only those dimensions participate that are specified by boundary criteria, whereas all other dimensions are excluded. For example a ROI to mark an episode of "ST elevation" in a subset of the EKG leads V2, V3, and V4 would include 4 boundaries, one each for time, V2, V3, and V4.

A partially specified bounded Region of Interest (ROI) specifies a ROI in which at least all values in the dimensions specified by the boundary criteria participate. For example, if an episode of ventricular fibrillations (VFib) is observed, it usually doesn't make sense to exclude any EKG leads from the observation and the partially specified ROI would contain only one boundary for time indicating the time interval where VFib was observed.

Constrains the ActCode to the domain of Container Registration

used by one system to inform another that it has received a container

used by one system to inform another that the container is in position for specimen transfer (e.g., container removal from track, pipetting, etc.).

used by one system to inform another that the container has been released from that system.

used by one system to inform another that the container did not arrive at its next expected location.

used by one system to inform another that the specific container is being processed by the equipment. It is useful as a response to a query about Container Status, when the specific step of the process is not relevant.

status is used by one system to inform another that the processing has been completed, but the container has not been released from that system.

used by one system to inform another that the container is no longer available within the scope of the system (e.g., tube broken or discarded).

An observation form that determines parameters or attributes of an Act. Examples are the settings of a ventilator machine as parameters of a ventilator treatment act; the controls on dillution factors of a chemical analyzer as a parameter of a laboratory observation act; the settings of a physiologic measurement assembly (e.g., time skew) or the position of the body while measuring blood pressure.

Control variables are forms of observations because just as with clinical observations, the Observation.code determines the parameter and the Observation.value assigns the value. While control variables sometimes can be observed (by noting the control settings or an actually measured feedback loop) they are not primary observations, in the sense that a control variable without a primary act is of no use (e.g., it makes no sense to record a blood pressure position without recording a blood pressure, whereas it does make sense to record a systolic blood pressure without a diastolic blood pressure).

ISO 11073-10101 Health informatics - Point-of-care device codes, restricted to ECG Control Variables

Specifies whether or not automatic repeat testing is to be initiated on specimens.

A baseline value for the measured test that is inherently contained in the diluent. In the calculation of the actual result for the measured test, this baseline value is normally considered..

Specifies whether or not further testing may be automatically or manually initiated on specimens.

Response to an insurance coverage eligibility query or authorization request.

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

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.

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

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

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

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

Criteria that are applicable to the authorized coverage.

The initial amount the policy holder is required to pay for the authorized product or service specified.

The initial amount the payor is exempt from paying for the authorized product or service specified.

Maximum net amount that will be covered for the product or service specified.

Maximum unit price that will be covered for the authorized product or service.

Maximum number of items that will be covered of the product or service specified.

Code set to define specialized/allowed diets

A diet exclusively composed of oatmeal, semolina, or rice, to be extremely easy to eat and digest.

A diet that uses carbohydrates sparingly. Typically with a restriction in daily energy content (e.g. 1600o2000 kcal).

No enteral intake of foot or liquids whatsoever, no smoking. Typically 6 to 8 hours before anesthesia.

Gluten free diet for celiac disease.

A diet low in fat, particularly to patients with hepatic diseases.

A low protein diet for patients with renal failure.

A strictly liquid diet, that can be fully absorbed in the intestine, and therefore may not contain fiber. Used before enteral surgeries.

A diet low in sodium for patients with congestive heart failure and/or renal failure.

A normal diet, i.e. no special preparations or restrictions for medical reasons. This is notwithstanding any preferences the patient might have regarding special foods, such as vegetarian, kosher, etc.

A no fat diet for acute hepatic diseases.

Phenylketonuria diet.

Patient is supplied with parenteral nutrition, typically described in terms of i.v. medications.

A diet that seeks to reduce body fat, typically low energy content (800o1600 kcal).

A diet that avoids ingredients that might cause digestion problems, e.g., avoid excessive fat, avoid too much fiber (cabbage, peas, beans).

This is not really a diet, since it contains little nutritional value, but is essentially just water. Used before coloscopy examinations.

Diet with low content of the amino-acids valin, leucin, and isoleucin, for "maple syrup disease."

Accommodation type. In Intent mood, represents the accommodation type requested. In Event mood, represents accommodation assigned/used. In Definition mood, represents the available accommodation type.

Accommodations used in the care of diseases that are transmitted through casual contact or respiratory transmission.

Accommodations in which there is only 1 bed.

Uniquely designed and elegantly decorated accommodations with many amenities available for an additional charge.

Accommodations in which there are 2 beds.

Accommodations in which there are 3 or more beds.

Domain provides codes that qualify the ActEncounterClass (ENC)

An inpatient encounter is an encounter in which the patient is admitted to a hospital or equivalent facility.

An acute inpatient encounter.

Any category of inpatient encounter except 'acute'

General category of medical service provided to the patient during their encounter.

Provision of Alternate Level of Care to a patient in an acute bed. Patient is waiting for placement in a long-term care facility and is unable to return home.

Provision of recurring care for chronic illness.

Provision of treatment for oral health and/or dental surgery.

Provision of treatment for drug abuse.

General care performed by a general practitioner or family doctor as a responsible provider for a patient.

Provision of diagnostic and/or therapeutic treatment.

Provision of care of women during pregnancy, childbirth and immediate postpartum period. Also known as Maternity.

Provision of treatment and/or diagnosis related to tumors and/or cancer.

Provision of care for patients who are living or dying from an advanced illness.

Provision of diagnosis and treatment of diseases and disorders affecting children.

Pharmaceutical care performed by a pharmacist.

Provision of treatment for physical injury.

Provision of treatment of psychiatric disorder relating to mental illness.

Provision of surgical treatment.

An ambulatory encounter.

An emergency encounter.

Healthcare encounter that takes place outside a healthcare facility or home (e.g., helicopter, ambulance, accident site)

Healthcare encounter that takes place in the residence of the patient or a designee

An interaction between a practitioner and patient (or patient's agent) where the communication does not take place in person

A type of transaction that represents a charge for a service or product. Expressed in monetary terms.

A type of transaction that represents a reversal of a previous charge for a service or product. Expressed in monetary terms. It has the opposite effect of a standard charge.

Set of codes indicating the type of incident or accident.

Incident or accident is the result of a motor vehicle accident

Incident or accident is the result of a school place accident.

Incident or accident is the result of a sporting accident.

Incident or accident is the result of a work place accident

Set of codes indicating the type of insurance policy or other source of funds to cover healthcare costs.

Insurance policy for injuries sustained in an automobile accident. Will also typically covered non-named parties to the policy, such as pedestrians and passengers.

Private insurance policy that provides coverage in addition to other policies (e.g. in addition to a Public Healthcare insurance policy).

Insurance policy that provides for an allotment of funds replenished on a periodic (e.g. annual) basis. The use of the funds under this policy is at the discretion of the covered party.

Insurance policy funded by a public health system such as a provincial or national health plan. Examples include BC MSP (British Columbia Medical Services Plan) OHIP (Ontario Health Insurance Plan), NHS (National Health Service).

Insurance policy for injuries sustained in the work place or in the course of employment.

Type of invoice which will indicate to the payor te content rules to apply when processing and adjudicating the invoice.

Clinical product invoice where the Invoice Grouping contains one or more billable item and is supported by clinical product(s).

For example, a crutch or a wheelchair.

Clinical Services Invoice which can be used to describe a single service, multiple services or repeated services.

[1] Single Clinical services invoice where the Invoice Grouping contains one billable item and is supported by one clinical service.

For example, a single service for an office visit or simple clinical procedure (e.g. knee mobilization).

[2] Multiple Clinical services invoice where the Invoice Grouping contains more than one billable item, supported by one or more clinical services. The services can be distinct and over multiple dates, but for the same patient. This type of invoice includes a series of treatments which must be adjudicated together.

For example, an adjustment and ultrasound for a chiropractic session where fees are associated for each of the services and adjudicated (invoiced) together.

[3] Repeated Clinical services invoice where the Invoice Grouping contains one or more billable item, supported by the same clinical service repeated over a period of time.

For example, the same Chiropractic adjustment (service or treatment) delivered on 3 separate occasions over a period of time at the discretion of the provider (e.g. month).

Invoice Grouping without clinical justification. These will not require identification of participants and associations from a clinical context such as patient and provider.

Examples are interest charges and mileage.

HealthCare facility preferred accommodation invoice.

Pharmacy dispense invoice for a compound.

Pharmacy dispense invoice not involving a compound

Clinical services invoice where the Invoice Group contains one billable item for multiple clinical services in one or more sessions.

Identifies the different types of summary information that can be reported by queries dealing with Statement of Financial Activity (SOFA). The summary information is generally used to help resolve balance discrepancies between providers and payors.

Total counts and total net amounts adjudicated for all Invoice Groupings that were adjudicated within a time period based on the adjudication date of the Invoice Grouping.

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically.

Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.

Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically.

Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.

Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted manually.

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.

Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.

Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that do not match a specified payee (e.g. pay patient) and submitted manually.

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.

Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.

Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.

Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.

Identifies the total number of all Invoice Groupings that were adjudicated as payable during the specified time period (based on adjudication date) that match a specified payee (e.g. pay provider) and submitted manually.

Identifies the total net amount of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted electronically.

Identifies the total number of all Invoice Groupings that were adjudicated as payable prior to the specified time period (based on adjudication date), subsequently cancelled in the specified period and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted manually.

Identifies the total number of all Invoice Groupings that were adjudicated as refused prior to the specified time period (based on adjudication date) and submitted manually.

Identifies the total net amount of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted electronically.

Identifies the total number of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted manually.

Identifies the total number of all Invoice Groupings that were adjudicated as refused during the specified time period (based on adjudication date) and submitted manually.

Total counts and total net amounts paid for all Invoice Groupings that were paid within a time period based on the payment date.

Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently cancelled in the specified period and submitted electronically.

Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently cancelled in the specified period and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently cancelled in the specified period and submitted manually.

Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date), subsequently cancelled in the specified period and submitted manually.

Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently cancelled in the specified period and submitted electronically.

Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently cancelled in the specified period and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently cancelled in the specified period and submitted manually.

Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date), subsequently cancelled in the specified period and submitted manually.

Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually.

Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually.

Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually.

Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that do not match a specified payee (e.g. pay patient) and submitted manually.

Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically.

Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually.

Identifies the total number of all Invoice Groupings that were paid prior to the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually.

Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically.

Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted electronically.

Identifies the total net amount of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually.

Identifies the total number of all Invoice Groupings that were paid during the specified time period (based on payment date) that match a specified payee (e.g. pay provider) and submitted manually.

Total counts and total net amounts billed for all Invoice Groupings that were submitted within a time period. Adjudicated invoice elements are included.

Identifies the total net amount billed for all submitted Invoice Groupings within a time period and submitted electronically. Adjudicated invoice elements are included.

Identifies the total number of submitted Invoice Groupings within a time period and submitted electronically. Adjudicated invoice elements are included.

Identifies the total net amount billed for all submitted Invoice Groupings that were cancelled within a time period and submitted electronically. Adjudicated invoice elements are included.

Identifies the total number of submitted Invoice Groupings that were cancelled within a time period and submitted electronically. Adjudicated invoice elements are included.

Identifies the total net amount billed for all submitted Invoice Groupings that are pended or held by the payor, within a time period and submitted electronically. Adjudicated invoice elements are not included.

Identifies the total number of submitted Invoice Groupings that are pended or held by the payor, within a time period and submitted electronically. Adjudicated invoice elements are not included.

Includes coded responses that will occur as a result of the adjudication of an electronic invoice at a summary level and provides guidance on interpretation of the referenced adjudication results.

Insurance coverage problems have been encountered. Additional explanation information to be supplied.

The medical service was provided to a patient in good faith that they had medical coverage, although no evidence of coverage was available before service was rendered.

Knowingly over the payor's published time limit for this invoice possibly due to a previous payor's delays in processing. Additional reason information will be supplied.

Manual review of the invoice is requested. Additional information to be supplied.

The medical service and/or product was provided to a patient that has coverage in another jurisdiction.

Allows provider to explain lateness of invoice to a subsequent payor.

Rules of practice do not require a physician's referral for the provider to perform a billable service.

The same service was delivered within a time period that would usually indicate a duplicate billing. However, the repeated service is a medical necessity and therefore not a duplicate.

The provider has received a verbal permission from an authoritative source to perform the service or supply the item being invoiced.

Provides codes associated with ActClass value of LIST (working list)

List of medications.

List of current medications.

List of discharge medications.

Historical list of medications.

List of acts representing a care plan. The acts can be in a varierty of moods including event (EVN) to record acts that have been carried out as part of the care plan.

List of observations in goal mood.

List of intolerance observations.

List of problem observations.

List of risk factor observations.

Identifies types of monitoring programs

A monitoring program that focuses on narcotics and/or commonly abused substances that are subject to legal restriction.

DEA schedule for a drug.

Code identifying the method or the movement of payment instructions.

Codes are drawn from X12 data element 591 (PaymentMethodCode)

Automated Clearing House (ACH).

A written order to a bank to pay the amount specified from funds on deposit.

Electronic Funds Transfer (EFT) deposit into the payee's bank account

NonoPayment Data.

Identifies types of dispensing events

A supply action where there is no 'valid' order for the supplied medication. E.g. Emergency vacation supply, weekend supply (when prescriber is unavailable to provide a renewal prescription)

An emergency supply where the expectation is that a formal order authorizing the supply will be provided at a later date.

The initial fill against an order. (This includes initial fills against refill orders.)

A fill providing sufficient supply for one day

A first fill where the quantity supplied is equal to one full reptition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets).

A first fill where the quantity supplied is less than one full reptition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.)

A fill where a small portion is provided to allow for determination of the therapy effectiveness and patient tolerance.

A supply action that provides sufficient material for a single dose.

A fill against an order that has already been filled (or partially filled) at least once.

A fill providing sufficient supply for one day

A refill where the quantity supplied is equal to one full reptition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a complete fill would be for the full 90 tablets.)

The first fill against an order that has already been filled at least once at another facility.

A refill where the quantity supplied is less than one full reptition of the ordered amount. (e.g. If the order was 90 tablets, 3 refills, a partial fill might be for only 30 tablets.)

A fill where the remainder of a 'complete' fill is provided after a trial fill has been provided.

A supply action that provides sufficient material for a single dose.

A supply action to restock a smaller more local dispensary.

A supply of a manufacturer sample

The type of procedure Act

The method that a product is obtained for use by the subject of the supply act (e.g. patient). Product examples are consumable or durable goods.

Temporary supply of a product without transfer of ownership for the product.

Temporary supply of a product with financial compensation, without transfer of ownership for the product.

Transfer of ownership for a product.

Transfer of ownership for a product for financial compensation.

Identifies the type of observation that is made about a specimen that may affect its processing, analysis or further result interpretation

An observation that reports the dilution of a sample.

The dilution of a sample performed by automated equipment. The value is specified by the equipment

The dilution of a sample performed by automated equipment. The value is specified by the equipment

The dilution of the specimen made prior to being loaded onto analytical equipment

The value of the dilution of a sample after it had been analyzed at a prior dilution value

An observation that relates to factors that may potentially cause interference with the observation

The Fibrin Index of the specimen. In the case of only differentiating between Absent and Present, recommend using 0 and 1

An observation of the hemolysis index of the specimen in g/L

An observation that describes the icterus index of the specimen. It is recommended to use mMol/L of bilirubin

An observation used to describe the Lipemia Index of the specimen. It is recommended to use the optical turbidity at 600 nm (in absorbance units).

An observation that reports the volume of a sample.

The available quantity of specimen. This is the current quantity minus any planned consumption (e.g., tests that are planned)

The quantity of specimen that is used each time the equipment uses this substance

The current quantity of the specimen, i.e., initial quantity minus what has been actually used.

The initial quantity of the specimen in inventory

Describes the artificial blood identifier that is associated with the specimen.

Domain provides codes that qualify the ActLabObsEnvfctsCode domain. (Environmental Factors)

Set of codes related to specimen treatments

The lowering of specimen pH through the addition of an acid

The act rendering alkaline by impregnating with an alkali; a conferring of alkaline qualities.

The removal of fibrin from whole blood or plasma through physical or chemical means

The passage of a liquid through a filter, accomplished by gravity, pressure or vacuum (suction).

The act or process by which an acid and a base are combined in such proportions that the resulting compound is neutral.

The addition of calcium back to a specimen after it was removed by chelating agents

The filtration of a colloidal substance through a semipermeable medium that allows only the passage of small molecules.

Shape of the region on the object being referenced

A circle defined by two (column,row) pairs. The first point is the center of the circle and the second point is a point on the perimeter of the circle.

An ellipse defined by four (column,row) pairs, the first two points specifying the endpoints of the major axis and the second two points specifying the endpoints of the minor axis.

A single point denoted by a single (column,row) pair, or multiple points each denoted by a (column,row) pair.

A series of connected line segments with ordered vertices denoted by (column,row) pairs; if the first and last vertices are the same, it is a closed polygon.

The specific chemical or radiological substance administered or to be administered into the body for therapeutic effect.

Any substance or mixture of substances manufactured, sold or represented for use in: (a) the diagnosis, treatment, mitigation or prevention of a disease, disorder, abnormal physical state, or its symptoms, in human beings or animals; (b) restoring, correcting or modifying organic functions in human beings or animals.

Identifies a drug or the use of a drug as produced by a specific manufacturer

The method that a product is obtained for use by the subject of the supply act (e.g. patient), with financial compensation. Product examples are consumable or durable goods.

Temporary supply of a product with financial compensation, without transfer of ownership for the product.

Transfer of ownership for a product for financial compensation.

Identifies the kinds of observations that can be performed

ISO 11073-10101 Health informatics - Point-of-care device codes, restricted to ECG category names

FDA label data

FDA label coating

FDA label color

FDA label imprint code

FDA label logo

FDA label scoring

FDA label shape

FDA label size

The LOINC database provides a set of universal names and ID codes for identifying laboratory and clinical test results. The purpose is to facilitate the exchange and pooling of results, such as blood hemoglobin, serum potassium, or vital signs, for clinical care, outcomes management, and research. The LOINC codes are not intended to transmit all possible information about a test or observation. They are only intended to identify the test result or clinical observation. http://www.regenstrief.org/LOINC/LOINC.htm

An observation about the presence (or absense) of a particular disease state in a subject.

Admitting diagnosis are the diagnoses documented for administrative purposes as the basis for a hospital admission.

Discharge diagnosis are the diagnoses documented for administrative purposes as the time of hospital discharge.

Intermediate diagnoses are those diagnoses documented for administrative purposes during the course of a hospital stay.

ISO 11073-10101 Health informatics - Point-of-care device codes, restricted to ECG Lead Types

A sequence of values in the "absolute" time domain. This is the same time domain that all HL7 timestamps use. It is time as measured by the Gregorian calendar

A sequence of values in a "relative" time domain. The time is measured relative to the earliest effective time in the Observation Series containing this sequence.

This Observation Series type contains waveforms of a "representative beat" (a.k.a. "median beat" or "average beat"). The waveform samples are measured in relative time, relative to the beginning of the beat as defined by the Observation Series effective time. The waveforms are not directly acquired from the subject, but rather algorithmically derived from the "rhythm" waveforms.

This Observation type contains ECG "rhythm" waveforms. The waveform samples are measured in absolute time (a.k.a. "subject time" or "effective time"). These waveforms are usually "raw" with some minimal amount of noise reduction and baseline filtering applied.

Indicates a subjective evaluation of the criticality associated with another observation.