code: RETRO

display: retro adjustment

definition: Bonus payments based on performance, volume, etc. as agreed to by the payor.


code: SUD

display: substance use disorder information sensitivity

definition:
Policy for handling information related to alcohol or drug use disorders and conditions caused by these disorders, which is afforded heightened confidentiality.

                           Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code.

resourceType: Concept


code: ASSERTION

display: Assertion

definition: Description:Refines classCode OBS to indicate an observation in which observation.value contains a finding or other nominalized statement, where the encoded information in Observation.value is not altered by Observation.code.  For instance, observation.code="ASSERTION" and observation.value="fracture of femur present" is an assertion of a clinical finding of femur fracture.


code: INVTYPE

display: invoice type

definition: Transaction counts and value totals by invoice type (e.g. RXDINV - Pharmacy Dispense)


code: TBOO

display: taboo

definition:
Policy for handling information not to be initially disclosed or discussed with patient except by a physician assigned to patient in this case. Information handling protocols based on organizational policies related to sensitive patient information that must be initially discussed with the patient by an attending physician before being disclosed to the patient.

                           Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.

                           Open Issue: This definition conflates a rule and a characteristic, and there may be a similar issue with ts sibling codes.


code: INFDNG

display: only if danger to others

definition: Authorization to collect, access, use, or disclose specified patient health information where deemed necessary to avert potential danger to other persons in accordance with jurisdictional law, organizational policy, or standards of practice.  For example, disclosure about a person threatening violence.


code: CHR

display: Chronic

definition: Provision of recurring care for chronic illness.


code: STRTLATE

display: Start Too Late Alert

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


code: MANDPOL

display: mandatory health program

definition: mandatory health program


display: non-matching identification

definition: Description: Metadata associated with the identification (e.g. name or gender) does not match the identification being verified.


code: PLYPHRM

display: Poly-supplier Alert

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


code: PRE

display: Pre-Dilution

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


code: SUBPOL

display: substance use policy

definition: Definition: A health insurance policy that covers benefits for substance use services.


code: LQ

display: liquid

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


code: UPGRDLABEL

display: upgrade security label

definition: Custodian security system must declassify information assigned security labels by instantiating a new version of the classified information so as to break the binding of the classifying security label when assigning a new security label that marks the information as classified at a more protected level  in accordance with applicable jurisdictional privacy policies associated with the target information. The system must retain an immutable record of the previous assignment and binding.


code: FD

display: food

definition: Description: The introduction of material into a subject with the intent of providing nutrition or other dietary supplements (e.g. minerals or vitamins).


code: NODUPS

display: duplicate values are not permitted

definition: Description:More than one element with the same value exists in the set.  Duplicates not permission in this set in a set.


code: ABUSE

display: commonly abused/misused alert

definition: Description:The proposed therapy is frequently misused or abused and therefore should be used with caution and/or monitoring.


code: SDV

display: sexual assault, abuse, or domestic violence information sensitivity

definition:
Policy for handling sexual assault, abuse, or domestic violence information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to sexual assault, abuse, or domestic violence information that is deemed sensitive.

                        SDV code covers violence perpetrated by related and non-related persons. This code should be specific to physical and mental trauma caused by a related person only.  The access control concerns are keeping the patient safe from the perpetrator who may have an abusive psychological control over the patient, may be stalking the patient, or may try to manipulate care givers into allowing the perpetrator to make contact with the patient.  The definition needs to be clarified.

                           Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.


code: PDNFPPELCT

display: paid nullified prior-period electronic count

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


display: ActConsentType

definition: Definition: The type of consent directive, e.g., to consent or dissent to collect, access, or use in specific ways within an EHRS or for health information exchange; or to disclose  health information  for purposes such as research.


code: MSRAGG

display: rate aggregation

definition:
Describes how to combine information calculated based on logic in each of several populations into one summarized result. It can also be used to describe how to risk adjust the data based on supplemental data elements described in the eMeasure. (e.g., pneumonia hospital measures antibiotic selection in the ICU versus non-ICU and then the roll-up of the two).

                           Open Issue: The description does NOT align well with the definition used in the HQMF specfication; correct the MSGAGG definition, and the possible distinction of MSRAGG as a child of AGGREGATE.


code: PRN

display: as needed

definition: Definition:A list of medications which the patient will consume intermittently based on the behavior of the condition for which the medication is indicated.


code: INFAUT

display: authorized information transfer

definition: Authorization to collect, access, use, or disclose specified patient health information in accordance with jurisdictional law, organizational policy, or a patient's consent directive, which may be implied, deemed, opt-in, opt-out, or explicit.


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

display: ActAdjudicationGroupCode


code: ADNPSPMNCT

display: adjud. non-payee payable same-period manual count

definition: 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.


code: MENCAT

display: mental health category

definition: Description: All information pertaining to a patient's mental health records.


code: IMPLIEDD

display: implied consent with opportunity to dissent

definition:
A grantor's presumed assent to the grantee's terms of agreement, which is based on the grantor's behavior, and includes a right to dissent to certain terms.

                           Comment: A grantor assenting to the grantee's terms of agreement may or may not exercise a right to dissent to grantor selected terms or to grantee's selected terms to which a grantor may dissent.

                           Usage Note: Implied or "implicit" consent with an "opportunity to dissent" occurs when the grantor's behavior is understood by a reasonable person to signal assent to the grantee's terms of agreement whether the grantor requests or the grantee approves further restrictions, is considered "granular consent".

                           Examples:

                           Healthcare Examples: A healthcare provider deems a patient's assent to disclosure of health information to family members and friends, but offers an opportunity or permits the patient to dissent to such disclosures.
                           A health information exchanges deems a patient to have assented to disclosure of health information for treatment purposes, but offers the patient an opportunity to dissents to disclosure to particular provider organizations.
                           Non-healthcare Examples: A bank deems a banking customer's assent to specified collection, access, use, or disclosure of financial information as a requirement of holding a bank account, but provides the user an opportunity to limit third-party collection, access, use or disclosure of that information for marketing purposes.


code: SECALTINTOBS

definition:
Type of security metadata observation made about the alteration integrity of an IT resource (data, information object, service, or system capability), which indicates the mechanism used for authorized transformations of the resource.

                           Examples: Types of security alteration integrity observation metadata, which may value the observation with a code used to indicate the mechanism used for authorized transformation of an IT resource, including:

                           translation
                           syntactic transformation
                           semantic mapping
                           redaction
                           masking
                           pseudonymization
                           anonymization

hierarchy: SECOBS SECINTOBS


code: DOSEH

display: High Dose Alert

definition: Proposed dosage exceeds standard practice


code: HEALTHREC

display: health record

definition: Description: Health Record Attachment


code: PDNPPPMNAT

display: paid non-payee payable prior-period manual amount

definition: 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.


code: CMIH

display: certified migraine headache care


code: TRNSFTRNS

display: transfusion transmission

definition: Communication of an agent from one living subject to another living subject through direct contact with blood or blood products where the contact with blood is part of  a therapeutic procedure.


display: ActBoundedROICode

definition: Type of bounded ROI.


code: DRUGPOL

display: drug policy

definition: Definition: A health insurance policy that covers benefits for prescription drugs, pharmaceuticals, and supplies.


code: CDEC

display: certified dermatology care

definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.


code: MEDOE

display: medication order entry task

definition: A clinician creates a request for the administration of one or more medications to a given patient.


code: ADPPSPMNAT

display: adjud. payee payable same-period manual amount

definition: 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.


code: HLTHCARE

display: Health Care Interaction - Not Patient Care

definition: Description: Exposure participants' interaction occurred during the course of health care delivery or in a health care delivery setting, but did not involve the direct provision of care (e.g. a janitor cleaning a patient's hospital room).


definition: Description:The type and scope of legal and/or professional responsibility taken-on by the performer of the Act for a specific subject of care as described by an agency for credentialing individuals.

display: act credentialed care provision peron


code: CFEL

display: certified frail elderly care

definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.


code: MCPOL

display: managed care policy

definition:
Definition: Government mandated program providing coverage, disability income, and vocational rehabilitation for injuries sustained in the work place or in the course of employment.  Employers may either self-fund the program, purchase commercial coverage, or pay a premium to a government entity that administers the program.  Employees may be required to pay premiums toward the cost of coverage as well.

                        Managed care policies specifically exclude coverage for losses insured under a disability policy, workers' compensation program, liability insurance (including automobile insurance); or for medical expenses, coverage for on-site medical clinics or for limited dental or vision benefits when these are provided under a separate policy.

                           Discussion: Managed care policies are offered by managed care plans that contract with selected providers or health care organizations to provide comprehensive health care at a discount to covered parties and coordinate the financing and delivery of health care. Managed care uses medical protocols and procedures agreed on by the medical profession to be cost effective, also known as medical practice guidelines. Providers are typically reimbursed for covered services by a capitated amount on a per member per month basis that may reflect difference in the health status and level of services anticipated to be needed by the member.


definition: AppropriatenessDetectedIssueCode

child: OBSA

display: AppropriatenessDetectedIssueCode


definition: Codes dealing with the management of Detected Issue observations for the administrative and patient administrative acts domains.


code: TRSTCERT

display: trust certificate

definition: Type of security metadata about a set of security-relevant data issued by a security authority or trusted third party, together with security information which is used to provide the integrity and data origin authentication services for an IT resource (data, information object, service, or system capability). [Based on ISO IEC 10181-1]


code: TRSTAGRE

display: trust agreement

definition: Type of security metadata about privacy and security requirements with which a security domain must comply. [ISO IEC 10181-1]


code: CURRENT

display: Current Volume

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


code: CIRCLE

display: circle

definition: 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.


code: CRPC

display: certified radiological physics care


code: FINBILL

display: financial

definition: 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.


code: RECA

display: Recalcification

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


display: code has been deprecated

definition: Description:The specified code has been deprecated and should no longer be used.  Select another code from the code system.


code: DSC

display: discount

definition: A reduction in the amount charged as a percentage of the amount. For example a 5% discount for volume purchase.


code: CRS

display: clinical recommendation statement

definition: Summary of relevant clinical guidelines or other clinical recommendations supporting this eMeasure.


code: CDSREV

display: clinical decision support intervention review

definition: A person reviews a recommendation/assessment provided automatically by a clinical decision support application for a given patient.


code: IMG

display: image attachment

definition: Description: Image Attachment


code: LABRREV

display: laboratory results review task

definition: A person reviews a list of laboratory results of a given patient.


display: authorization confirmed

definition: Description: Indicates that the permissions have been externally verified and the request should be processed.


code: ADNPPPELAT

display: adjud. non-payee payable prior-period electronic amount

definition: 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.


definition:
Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results.

                        Invoice elements of this type signify a grouping of one or more children (detail) invoice elements.  They do not have intrinsic costing associated with them, but merely reflect the sum of all costing for it's immediate children invoice elements.

display: ActInvoiceGroupCode


code: PROA

display: professional association deduction

definition: Professional association fee that is collected by the payor from the practitioner/provider on behalf of the association


code: CDIA

display: certified diabetes care

definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.


definition:
A policy deeming certain information to be private to an individual or organization.

                           Definition: A mandate, obligation, requirement, rule, or expectation relating to privacy.

                           Discussion: ActPrivacyPolicyType codes support the designation of the 1..* policies that are applicable to an Act such as a Consent Directive, a Role such as a VIP Patient, or an Entity such as a patient who is a minor.  1..* ActPrivacyPolicyType values may be associated with an Act or Role to indicate the policies that govern the assignment of an Act or Role confidentialityCode.  Use of multiple ActPrivacyPolicyType values enables fine grain specification of applicable policies, but must be carefully assigned to ensure cogency and avoid creation of conflicting policy mandates.

                           Usage Note: Statutory title may be named in the ActClassPolicy Act Act.title to specify which privacy policy is being referenced.

display: ActPrivacyPolicy


code: CTSC

display: certified thoracic surgery care

definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.


code: RXCAT

display: medication category

definition: Definition:All information pertaining to a patient's medication records (orders, dispenses and other active medications).


code: BDYFLDTRNS

display: body fluid contact transmission

definition: Communication of an agent from one living subject to another living subject through direct contact with any body fluid.


code: DRUGING

display: drug invoice group

definition: A grouping of invoice element details including the one specifying the drug being invoiced. It may also contain generic detail items such as markup.


code: ADPPPPMNCT

display: adjud. payee payable prior-period manual count

definition: 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.


code: DOSEDUR

display: Dose-Duration Alert

definition: Proposed length of therapy differs from standard practice.


code: CANPRG

display: women's cancer detection program

definition:
Definition: A program that provides low-income, uninsured, and underserved women access to timely, high-quality screening and diagnostic services, to detect breast and cervical cancer at the earliest stages.

                           Example: To improve women's access to screening for breast and cervical cancers, Congress passed the Breast and Cervical Cancer Mortality Prevention Act of 1990, which guided CDC in creating the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), which  provides access to critical breast and cervical cancer screening services for underserved women in the United States.  An estimated 7 to 10% of U.S. women of screening age are eligible to receive NBCCEDP services. Federal guidelines establish an eligibility baseline to direct services to uninsured and underinsured women at or below 250% of federal poverty level; ages 18 to 64 for cervical screening; ages 40 to 64 for breast screening.


code: CHRON

display: continuous/chronic

definition: Definition:A list of medications which are expected to be continued beyond the present order and which the patient should be assumed to be taking unless explicitly stopped.


code: HST

display: harmonized sales Tax

definition: Joint Federal/Provincial Sales Tax


code: DOSEDURLIND

display: Dose-Duration Low for Indication Alert

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


display: ActExposureCode

definition: Concepts that identify the type or nature of exposure interaction.  Examples include "household", "care giver", "intimate partner", "common space", "common substance", etc. to further describe the nature of interaction.


code: COND

display: Condition Alert

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


code: PPRD

display: prior period adjustment

definition: An amount that was owed to the payor as indicated, by a carry forward adjusment, in a previous payment advice


code: NUMEX

display: numerator exclusions

definition: Criteria for specifying instances that should not be included in the numerator data. (e.g., if the number of central line blood stream infections per 1000 catheter days were to exclude infections with a specific bacterium, that bacterium would be listed as a numerator exclusion).  Numerator Exclusions are used only in ratio eMeasures.


code: NAUTH

display: Not Authorized

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


code: DEMOCAT

display: demographics category

definition: Definition:All information pertaining to a patient's demographics (such as name, date of birth, gender, address, etc).


code: TEACHER

display: teacher

definition: Description: The patient's teacher when immunized.


code: CAP

display: capitation funding

definition: 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).


code: HIVAIDS

display: HIV-AIDS program

definition:
Definition: Government administered and funded HIV-AIDS program for beneficiaries meeting financial and health status criteria.  Administration, funding levels, eligibility criteria, covered benefits, provider types, and financial participation are typically set by a regulatory process.  Payer responsibilities for administering the program may be delegated to contractors.

                           Example: In the U.S., the Ryan White program, which is administered by the Health Resources and Services Administration.


code: DOCUMENT

display: document

definition: Description: Document Attachment


code: DRG

display: Drug Interaction Alert

definition: Proposed therapy may interact with an existing or recent drug therapy


code: INTERVAL

display: outside requested time

definition: Definition:The therapy action is being performed outside the bounds of the time period requested


code: AUDIT

display: audit

definition: Custodian system must monitor systems to ensure that all users are authorized to operate on information objects.


code: SECDATINTOBS

display: security data integrity observation

definition:
Type of security metadata observation made about the data integrity of an IT resource (data, information object, service, or system capability), which indicates the security mechanism used to preserve resource accuracy and consistency.  Data integrity is defined by ISO 22600-23.3.21 as: "The property that data has not been altered or destroyed in an unauthorized manner", and by ISO/IEC 2382-8:  The property of data whose accuracy and consistency are preserved regardless of changes made."

                           Examples: Types of security data integrity observation metadata, which may value the observation, include cryptographic hash function and digital signature.


code: SREC

display: specimen received

definition: Description:Specimen has been received by the participating organization/department.


code: MVA

display: Motor vehicle accident

definition: Incident or accident as the result of a motor vehicle accident


display: act observation verification

definition:
Identifies the type of verification investigation being undertaken with respect to the subject of the verification activity.

                           Examples:

                              Verification of eligibility for coverage under a policy or program - aka enrolled/covered by a policy or program

                              Verification of record - e.g., person has record in an immunization registry

                              Verification of enumeration - e.g. NPI

                              Verification of Board Certification - provider specific

                              Verification of Certification - e.g. JAHCO, NCQA, URAC

                              Verification of Conformance - e.g. entity use with HIPAA, conformant to the CCHIT EHR system criteria

                              Verification of Provider Credentials

                              Verification of no adverse findings - e.g. on National Provider Data Bank, Health Integrity Protection Data Base (HIPDB)


code: FORMULA

display: formula diet

definition: A diet consisting of a formula feeding, either for an infant or an adult, to provide nutrition either orally or through the gastrointestinal tract via tube, catheter or stoma.


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

child: FFS FFPS

code: FF

display: First Fill


code: DEDUCTIBLE

display: deductible

definition: That portion of the eligible charges which a covered party must pay in a particular period (e.g. annual) before the benefits are payable by the adjudicator. This amount represents the covered party's deductible that is applied to a particular adjudication result. It is expressed as a negative dollar amount in adjudication results.


code: RFFS

display: refill partial strength (first fill this facility)

definition: The first fill against an order that has already been filled at least once at another facility and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).

hierarchy: _ActPharmacySupplyType RF RFF


code: TRSTFWKOBS

display: trust framework observation

definition: Type of security metadata observation made about a complete set of contracts, regulations or commitments that enable participating actors to rely on certain assertions by other actors to fulfill their information security requirements. [Kantara Initiative]

hierarchy: SECOBS SECTRSTOBS


code: DEFB

display: Defibrination

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


code: PRDING

display: product invoice group

definition: A grouping of invoice element details including the one specifying the product (good or supply) being invoiced. It may also contain generic detail items such as tax or discount.


code: PATREPE

display: pathology report entry task

definition: A pathologist enters a report for a given patient.

hierarchy: _ActTaskCode PATDOC CLINNOTEE


code: VALIDAT

display: validation issue

definition: Description:The specified element did not pass business-rule validation.


definition: Domain provides codes that qualify the ActEncounterClass (ENC)

display: ActEncounterCode


code: PACOMPT

display: patient administration compartment

definition:
Patient administration members who have access to healthcare consumer information as part of a patient administration workflows.

                        Security Compartment Labels assigned to consumer information used in these workflows should be met or exceeded by the Security Compartment attribute claimed by a participant in a patient administration workflow who is requesting access to that information.


code: IMMUCAT

display: immunization category

definition: Definition:All information pertaining to a patient's vaccination records.


code: CCAR

display: certified cardiac care

definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.


code: ILLEGAL

display: illegal

definition: Description:The request is missing elements or contains elements which cause it to not meet the legal standards for actioning.


code: ADMDX

display: admitting diagnosis

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


code: FFS

display: fee for service

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

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


code: ARTBLD

display: ActSpecObsArtBldCode

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


code: MINEC

display: minimum necessary

definition:
Custodian must limit access and disclosure to the minimum information required to support an authorized user's purpose of use.

                           Usage Note: Limiting the information available for access and disclosure to that an authorized user or receiver "needs to know" in order to perform permitted workflow or purpose of use.


definition: The detail item codes to identify charges or changes to the total billing of a claim due to insurance rules and payments.

display: ActInvoiceDetailGenericCode


code: MSRSET

display: health quality measure care setting

definition:
Location(s) in which care being measured is rendered

                        Usage Note: MSRSET is used rather than RoleCode because the setting applies to what is being measured, as opposed to participating directly in the health quality measure documantion itself).


code: IND

display: indigenous peoples health program

definition:
Definition: Services provided directly and through contracted and operated indigenous peoples health programs.

                           Example: Indian Health Service in the U.S.


code: DALG

display: Drug Allergy

definition: An allergy to a pharmaceutical product.

hierarchy: _ObservationType OINT ALG


code: LS

display: low sodium

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


code: AUTO

display: auto-repeat permission

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


code: UNRELAT

display: unrelated service

definition: The service provided is not related to another billed service. For example, 2 unrelated services provided on the same day to the same patient which may normally result in a refused payment for one of the items.


display: additional quantity on separate dispense

definition: Description: Supply is different than expected as an additional quantity has been supplied in a separate dispense.


code: DF

display: Daily Fill

definition: A fill providing sufficient supply for one day


definition: An identifying data string for healthcare procedures.

display: ActInvoiceDetailClinicalServiceCode


code: DNTL

display: Dental

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


code: NEUT

display: Neutralization

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


code: ALRTSTRTLATE

display: start too late alert

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


code: ALGY

display: Allergy Alert

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


code: LACTTRNS

display: lactation transmission

definition: Communication of an agent from one living subject to another living subject through direct contact with mammalian milk or colostrum.


code: MSRTOPIC

display: health quality measure topic type

definition: health quality measure topic type


code: IMPLIED

display: implied consent

definition:
A grantor's presumed assent to the grantee's terms of agreement is based on the grantor's behavior, which may result from not expressly assenting to the consent directive offered, or from having no right to assent or dissent offered by the grantee.

                           Comment: Implied or "implicit" consent occurs when the behavior of the grantor is understood by a reasonable person to signal agreement to the grantee's terms.

                           Usage Note: Implied consent with no opportunity to assent or dissent to certain terms is considered "basic consent".

                           Examples:

                           Healthcare: A patient schedules an appointment with a provider, and either does not take the opportunity to expressly assent or dissent to the provider's consent directive, does not have an opportunity to do so, as in the case where emergency care is required, or simply behaves as though the patient [grantor] agrees to the rights granted to the provider [grantee] in an implicit consent directive.
                           An injured and unconscious patient is deemed to have assented to emergency treatment by those permitted to do so under jurisdictional laws, e.g., Good Samaritan laws.
                           Non-healthcare: Upon receiving a driver's license, the driver is deemed to have assented without explicitly consenting to undergoing field sobriety tests.
                           A corporation that does business in a foreign nation is deemed to have deemed to have assented without explicitly consenting to abide by that nation's laws.


code: SICKLE

display: sickle cell

definition:
Types of sensitivity policies that apply to Acts.  Act.confidentialityCode is defined in the RIM as "constraints around appropriate disclosure of information about this Act, regardless of mood."

                           Usage Note: ActSensitivity codes are used to bind information to an Act.confidentialityCode according to local sensitivity policy so that those confidentiality codes can then govern its handling across enterprises.  Internally to a policy domain, however, local policies guide the access control system on how end users in that policy domain are able to use information tagged with these sensitivity values.


code: LABRESULTS

display: lab results

definition: Description: Lab Results Attachment


code: ACSUBSTAB

display: substance abuse access

definition: Description:Provide consent to collect, use, disclose, or access substance abuse information for a patient.


code: INITIAL

display: Initial Volume

definition: The initial quantity of the specimen in inventory


code: EMRGONLY

display: emergency only

definition:
This general consent directive specifically limits disclosure of health information for purpose of emergency treatment. Additional parameters may further limit the disclosure to specific users, roles, duration, types of information, and impose uses obligations.

                           Definition: Opt-in to disclosure of health information for emergency only consent directive.


code: MSRSCORE

display: measure scoring

definition:
Indicates how the calculation is performed for the eMeasure
(e.g., proportion, continuous variable, ratio)


code: PATREPREV

display: pathology report review task

definition: A person reviews a pathology report of a given patient.


code: AUTHPOL

display: authorization policy

definition:
Authorisation policies are essentially security policies related to access-control and specify what activities a subject is permitted or forbidden to do, to a set of target objects. They are designed to protect target objects so are interpreted by access control agents or the run-time systems at the target system.

                        A positive authorisation policy defines the actions that a subject is permitted to perform on a target. A negative authorisation policy specifies the actions that a subject is forbidden to perform on a target. Positive authorisation policies may also include filters to transform the parameters associated with their actions.  (Based on PONDERS)


code: UNITPRICE

display: Unit Price

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


code: CHFC

display: certified heart failure care

definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.


display: ObservationQualityMeasureAttribute

definition: Codes used to define various metadata aspects of a health quality measure.


code: EAP

display: employee assistance program

definition: Definition: An employee assistance program is run by an employer or employee organization for the purpose of providing benefits and covering all or part of the cost for employees to receive counseling, referrals, and advice in dealing with stressful issues in their lives. These may include substance abuse, bereavement, marital problems, weight issues, or general wellness issues.  The services are usually provided by a third-party, rather than the company itself, and the company receives only summary statistical data from the service provider. Employee's names and services received are kept confidential.


code: ACUTE

display: inpatient acute

definition: An acute inpatient encounter.


code: PARTRNS

display: parenteral transmission

definition: Communication of an agent from a living subject or environmental source to a living subject where the acquisition of the agent is not via the alimentary canal.


code: M

display: Missing

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


code: ALK

display: Alkalization

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


code: CURMEDLIST

display: current medication list

definition: List of current medications.


code: CHRG

display: Standard Charge

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


code: SOCIAL

display: social service program

definition:
Definition: A social service program funded by a public or governmental entity.

                           Example: Programs providing habilitation, food, lodging, medicine, transportation, equipment, devices, products, education, training, counseling, alteration of living or work space, and other resources to persons meeting eligibility criteria.


code: DISC

display: disclaimer

definition: Disclaimer information for the eMeasure.


code: TRANF

display: transmission format

definition: Can be a URL or hyperlinks that link to the transmission formats that are specified for a particular reporting program.


code: PSEUD

display: pseudonymize

definition: Custodian system must strip information of data that would allow the identification of the source of the information or the information subject.  Custodian may retain a key to relink data necessary to reidentify the information subject.


code: FOMTRNS

display: fomite transmission

definition: Communication of an agent from an non-living material to a living subject through direct contact.


code: TRAN

display: transaction fee

definition: Fees deducted on behalf of a payee for charges based on a per-transaction or time-period (e.g. monthly) fee.


code: ADRFSPMNAT

display: adjud. refused same-period manual amount

definition: 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.


definition: Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure

child: DNAINT ENAINT FNAINT

code: NAINT

display: Non-Allergy Intolerance


code: LATE

display: late invoice

definition: 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.


code: AVAILABLE

display: Available Volume

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


code: REI

display: reinsurance policy

definition:
Definition: An agreement between two or more insurance companies by which the risk of loss is proportioned. Thus the risk of loss is spread and a disproportionately large loss under a single policy does not fall on one insurance company. Acceptance by an insurer, called a reinsurer, of all or part of the risk of loss of another insurance company.

                           Discussion: Reinsurance is a means by which an insurance company can protect itself against the risk of losses with other insurance companies. Individuals and corporations obtain insurance policies to provide protection for various risks (hurricanes, earthquakes, lawsuits, collisions, sickness and death, etc.). Reinsurers, in turn, provide insurance to insurance companies.

                        For example, an HMO may purchase a reinsurance policy to protect itself from losing too much money from one insured's particularly expensive health care costs. An insurance company issuing an automobile liability policy, with a limit of $100,000 per accident may reinsure its liability in excess of $10,000. A fire insurance company which issues a large policy generally reinsures a portion of the risk with one or several other companies. Also called risk control insurance or stop-loss insurance.


code: FININV

display: financial invoice

definition:
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.


display: ActInvoiceElementCode

definition: Type of invoice element that is used to assist in describing an Invoice that is either submitted for adjudication or for which is returned on adjudication results.


code: NOPERSISTP

display: no collection beyond purpose of use

definition: Prohibition on collection of the information beyond time necessary to accomplish authorized purpose of use is prohibited.


code: OBS

display: Obstetrics

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


code: RISKLIST

display: risk factors

definition: List of risk factor observations.


code: SUBPRG

display: substance use program

definition:
Definition: Government administered and funded substance use program for beneficiaries meeting financial, substance use behavior, and health status criteria.  Beneficiaries may be required to enroll as a result of legal proceedings.  Administration, funding levels, eligibility criteria, covered benefits, provider types, and financial participation are typically set by a regulatory process.  Payer responsibilities for administering the program may be delegated to contractors.

                           Example: In the U.S., states receive funding for substance use programs from the Substance Abuse Mental Health Administration (SAMHSA).


code: ACADR

display: adverse drug reaction access

definition: Description: Provide consent to collect, use, disclose, or access adverse drug reaction information for a patient.


display: Title 38 Section 7332

definition:
Title 38 Part 1-protected information may only be disclosed to a third party with the special written consent of the patient except where expressly authorized by 38 USC 7332. VA may disclose this information for specific purposes to: VA employees on a need to know basis - more restrictive than Privacy Act need to know; contractors who need the information in order to perform or fulfil the duties of the contract; and researchers who provide assurances that the information will not be identified in any report. This information may also be disclosed without consent where patient lacks decision-making capacity; in a medical emergency for the purpose of treating a condition which poses an immediate threat to the health of any individual and which requires immediate medical intervention; for eye, tissue, or organ donation purposes; and disclosure of HIV information for public health purposes.

                           Definition: Title 38 Part 1 - Section 1.462 Confidentiality restrictions.

                        (a) General. The patient records to which Sections 1.460 through 1.499 of this part apply may be disclosed or used only as permitted by these regulations and may not otherwise be disclosed or used in any civil, criminal, administrative, or legislative proceedings conducted by any Federal, State, or local authority. Any disclosure made under these regulations must be limited to that information which is necessary to carry out the purpose of the disclosure. SUBCHAPTER III--PROTECTION OF PATIENT RIGHTS Sec. 7332. Confidentiality of certain medical records (a)(1) Records of the identity, diagnosis, prognosis, or treatment of any patient or subject which are maintained in connection with the performance of any program or activity (including education, training, treatment, rehabilitation, or research) relating to drug abuse, alcoholism or alcohol abuse, infection with the human immunodeficiency virus, or sickle cell anemia which is carried out by or for the Department under this title shall, except as provided in subsections (e) and (f), be confidential, and (section 5701 of this title to the contrary notwithstanding) such records may be disclosed only for the purposes and under the circumstances expressly authorized under subsection (b).

                           Usage Note: May be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialityCode complies.


code: SESS

display: sessional funding

definition: A billing arrangement where a Provider charges a sum to provide a group (volume) of interventions/procedures to one or more patients within a defined period of time, typically on the same date.  Interventions/procedures included in the session may vary.


code: HMO

display: health maintenance organization policy

definition: Definition: A policy for a health plan that provides coverage for health care only through contracted or employed physicians and hospitals located in particular geographic or service areas.  HMOs emphasize prevention and early detection of illness. Eligibility to enroll in an HMO is determined by where a covered party lives or works.


code: INV

display: investigational

definition: Definition:A monitoring program that focuses on a drug which is under investigation and has not received regulatory approval for the condition being investigated


display: ECG representative beat waveforms

definition: 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.


code: CASESER

display: case seriousness criteria

definition: Definition:An observation that provides a characterization of the level of harm to an investigation subject as a result of a reaction or event.


code: VERBAUTH

display: verbal authorization

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


display: Consulted Supplier

definition: Consulted other supplier/pharmacy, therapy confirmed


code: EWB

display: employee welfare benefit plan policy

definition: Definition: An insurance policy under a benefit plan run by an employer or employee organization for the purpose of providing benefits other than pension-related to employees and their families. Typically provides health-related benefits, benefits for disability, disease or unemployment, or day care and scholarship benefits, among others.  An employer sponsored health policy includes coverage of health care expenses arising from sickness or accidental injury, coverage for on-site medical clinics or for dental or vision benefits, which are typically provided under a separate policy.  Coverage excludes health care expenses covered by accident or disability, workers' compensation, liability or automobile insurance.


code: HRCOMPT

display: human resource compartment

definition: A security category label field value, which indicates that access and use of an IT resource is restricted to members of human resources department or workflow.


code: ITMCNT

display: items counted

definition: Describes the items counted by the measure (e.g., patients, encounters, procedures, etc.)


code: TBS

display: trial balance partial strength

definition: A fill where the remainder of a 'complete' fill is provided after a trial fill has been provided and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).

hierarchy: _ActPharmacySupplyType RF TB


code: INFCON

display: after explicit consent

definition: Authorization to collect, access, use, or disclose specified patient health information as explicitly consented to by the subject of the information or the subject's representative.


code: ICTERUS

display: Icterus

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


code: FORM

display: Print on Form

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


code: PRS

display: patient requested information sensitivity

definition:
Policy for specially protecting information reported by or about a patient, which the patient deems sensitive, and the patient requests that collection, access, use, or disclosure of that information be restricted.  For example, a minor patient may request that information about reproductive health not be disclosed to the patient's family or to particular providers and payers.

                           Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.


code: GISTIER

display: GIS tier

definition: Description: Accuracy determined as per the GIS tier code system.


code: CONSUMPTION

display: Consumption Volume

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


code: RFS

display: refill partial strength

definition: A fill against an order that has already been filled (or partially filled) at least once and where the strength supplied is less than the ordered strength (e.g. 10mg for an order of 50mg where a subsequent fill will dispense 40mg tablets).


code: ADRFPPELAT

display: adjud. refused prior-period electronic amount

definition: 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.


code: CPLYOSP

display: comply with organizational security policy

definition: Custodian security system must retrieve, evaluate, and comply with the organizational security policies associated with the target information.


code: COPC

display: certified ophthalmology care

definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.


code: SECCONOBS

display: security control observation

definition:
Type of security metadata observation made about the control of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions.  Security control metadata convey instructions to users and receivers for secure distribution, transmission, and storage; dictate obligations or mandated actions; specify any action prohibited by refrain policy such as dissemination controls; and stipulate the permissible purpose of use of an IT resource.

                           Rationale: A security control observation supports requirement to specify applicable management, operational, and technical controls (i.e., safeguards or countermeasures) prescribed for an information system to protect the confidentiality, integrity, and availability of the system and its information. [FIPS 199]

                           Examples: Types of security control metadata include:

                           handling caveats
                           dissemination controls
                           obligations
                           refrain policies
                           purpose of use constraints


code: S

display: Suite

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


display: ObservationType

definition: Identifies the kinds of observations that can be performed


code: LABCAT

display: lab test category

definition: Description: All information pertaining to a patient's lab test records (orders & results)


display: Weekend Supply

definition: Supply date is intended to carry patient over weekend


code: LAWENF

display: law enforcement transport

definition: law enforcement transport


code: FNAINT

display: Food Non-Allergy Intolerance

definition: Hypersensitivity to an agent caused by a mechanism other than an immunologic response to an initial exposure

hierarchy: _ObservationType OINT FINT


code: ACDI

display: diagnostic imaging access

definition: Description: Provide consent to collect, use, disclose, or access diagnostic imaging information for a patient.


code: ULIFE

display: universal life insurance policy

definition: Definition: Life insurance under which the benefit is payable upon the insuredaTMs death or diagnosis of a terminal illness.  If an insured dies during that period, the beneficiary receives the death payments. If the insured survives, the policy ends and the beneficiary receives nothing


display: ActTransportationModeCode

definition:
Characterizes how a transportation act was or will be carried out.

                           Examples: Via private transport, via public transit, via courier.


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

display: InvoiceElementSubmitted


code: IRDSCL

display: information redisclosure

definition: Definition: Information re-disclosed without the patient's consent.


code: MST

display: military sexual trauma information sensitivity

definition:
Policy for handling information related to sexual assault or repeated, threatening sexual harassment that occurred while the patient was in the military, which is afforded heightened confidentiality.

                        Access control concerns for military sexual trauma is based on the patient being subject to control by a higher ranking military perpetrator and/or censure by others within the military unit.  Due to the relatively unfettered access to healthcare information by higher ranking military personnel and those who have command over the patient, there is a need to sequester this information outside of the typical controls on access to military health records.

                           Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law in addition to this more generic code.


code: PERSISTLABEL

display: persist security label

definition: Custodian security system must persist the binding of security labels to classify information received or imported by information systems under its control for collection, access, use and disclosure in accordance with applicable jurisdictional privacy policies associated with the target information.  The system must retain an immutable record of the assignment and binding.


code: NELG

display: Not Eligible

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


display: ActPharmacySupplyType

definition: Identifies types of dispensing events

child: UD


display: ActBillableModifierCode

definition: Definition:An identifying modifier code for healthcare interventions or procedures.


code: DOSELIND

display: Low Dose for Indication Alert

definition: Low Dose for Indication Alert


display: ActProcedureCode

definition: An identifying code for healthcare interventions/procedures.


code: CHK

display: Cheque

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


code: NUMER

display: numerator

definition: Criteria for specifying the processes or outcomes expected for each patient, procedure, or other unit of measurement defined in the denominator for proportion measures, or related to (but not directly derived from) the denominator for ratio measures (e.g., a numerator listing the number of central line blood stream infections and a denominator indicating the days per thousand of central line usage in a specific time period).


code: TRSTAGREOBS

display: trust agreement observation

definition: Type of security metadata observation made about privacy and security requirements with which a security domain must comply. [ISO IEC 10181-1]


code: FOOD

display: Food Interaction Alert

definition: Proposed therapy may interact with certain foods


display: 42 CFR Part2

definition:
42 CFR Part 2 stipulates the right of an individual who has applied for or been given diagnosis or treatment for alcohol or drug abuse at a federally assisted program.

                           Definition: Non-disclosure of health information relating to health care paid for by a federally assisted substance abuse program without patient consent.

                           Usage Note: May be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialityCode complies.


code: OPTOUTE

display: opt-out with exceptions

definition:
A grantor's dissent to the grantee's terms of agreement except for certain grantor or grantee selected terms.

                           Comment: A rejection of a grantee's terms of agreement while assenting to certain permissions sought by the grantee or requesting approval of additional grantor terms.

                           Usage Note: Opt-out with exceptions is considered a "granular consent" because the grantor has an opportunity to accept certain permissions sought by the grantee or request additional grantor terms, while rejecting other grantee terms.

                           Examples:

                           Healthcare: A patient [grantor] dissents to a health information exchange consent directive with the exception of disclosure based on a limited "time to live" shared secret [e.g., a token or password], which the patient can give to a provider when seeking care.
                           Non-healthcare: A social media user [grantor] dissents from public access to their account, but assents to access to a circle of friends.


code: IP

display: In Position

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


code: RXDINV

display: Rx dispense invoice

definition: Pharmacy dispense invoice not involving a compound


code: FFP

display: First Fill - Part Fill

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


code: ENDRENAL

display: end renal program

definition:
Definition: A public or government program that administers publicly funded coverage of kidney dialysis and kidney transplant services.

                        Example: In the U.S., the Medicare End-stage Renal Disease program (ESRD), the National Kidney Foundation (NKF) American Kidney Fund (AKF) The Organ Transplant Fund.


code: AUTH

display: Authorized

definition: 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.


definition:
A mandate, obligation, requirement, rule, or expectation characterizing the value or importance of a resource and may include its vulnerability. (Based on ISO7498-2:1989. Note: The vulnerability of personally identifiable sensitive information may be based on concerns that the unauthorized disclosure may result in social stigmatization or discrimination.) Description:  Types of Sensitivity policy that apply to Acts or Roles.  A sensitivity policy is adopted by an enterprise or group of enterprises (a 'policy domain') through a formal data use agreement that stipulates the value, importance, and vulnerability of information. A sensitivity code representing a sensitivity policy may be associated with criteria such as categories of information or sets of information identifiers (e.g., a value set of clinical codes or branch in a code system hierarchy).   These criteria may in turn be used for the Policy Decision Point in a Security Engine.  A sensitivity code may be used to set the confidentiality code used on information about Acts and Roles to trigger the security mechanisms required to control how security principals (i.e., a person, a machine, a software application) may act on the information (e.g., collection, access, use, or disclosure). Sensitivity codes are never assigned to the transport or business envelope containing patient specific information being exchanged outside of a policy domain as this would disclose the information intended to be protected by the policy.  When sensitive information is exchanged with others outside of a policy domain, the confidentiality code on the transport or business envelope conveys the receiver's responsibilities and indicates the how the information is to be safeguarded without unauthorized disclosure of the sensitive information.  This ensures that sensitive information is treated by receivers as the sender intends, accomplishing interoperability without point to point negotiations.

                           Usage Note: Sensitivity codes are not useful for interoperability outside of a policy domain because sensitivity policies are typically localized and vary drastically across policy domains even for the same information category because of differing organizational business rules, security policies, and jurisdictional requirements.  For example, an employee's sensitivity code would make little sense for use outside of a policy domain.   'Taboo' would rarely be useful outside of a policy domain unless there are jurisdictional requirements requiring that a provider disclose sensitive information to a patient directly.  Sensitivity codes may be more appropriate in a legacy system's Master Files in order to notify those who access a patient's orders and observations about the sensitivity policies that apply.  Newer systems may have a security engine that uses a sensitivity policy's criteria directly.  The specializable InformationSensitivityPolicy Act.code may be useful in some scenarios if used in combination with a sensitivity identifier and/or Act.title.

display: InformationSensitivityPolicy


code: ADNPSPELAT

display: adjud. non-payee payable same-period electronic amount

definition: 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.


code: ACCESSCONSCHEME

display: access control scheme

definition:
An access control policy specific to the type of access control scheme, which is used to enforce one or more authorization policies.

                           Usage Note: Access control schemes are the type of access control policy, which is comprised of access control policy rules concerning the provision of the access control service.

                        There are two categories of access control policies, rule-based and identity-based, which are identified in CCITT Rec. X.800 aka ISO 7498-2. Rule-based access control policies are intended to apply to all access requests by any initiator on any target in a security domain. Identity-based access control policies are based on rules specific to an individual initiator, a group of initiators, entities acting on behalf of initiators, or originators acting in a specific role. Context can modify rule-based or identity-based access control policies. Context rules may define the entire policy in effect. Real systems will usually employ a combination of these policy types; if a rule-based policy is used, then an identity-based policy is usually in effect also.

                        An access control scheme may be based on access control lists, capabilities, labels, and context or a combination of these.  An access control scheme is a component of an access control mechanism or "service") along with the supporting mechanisms required by that scheme to provide access control decision information (ADI) supplied by the scheme to the access decision facility (ADF also known as a PDP). (Based on ISO/IEC 10181-3:1996)

                           Examples:

                           Attribute Based Access Control (ABAC)
                           Discretionary Access Control (DAC)
                           History Based Access Control (HBAC)
                           Identity Based Access Control (IBAC)
                           Mandatory Access Control (MAC)
                           Organization Based Access Control (OrBAC)
                           Relationship Based Access Control (RelBac)
                           Responsibility Based Access Control (RespBAC)
                           Risk Adaptable Access Control (RAdAC)
                        >

hierarchy: _ActPolicyType SecurityPolicy AUTHPOL


code: BUS

display: business constraint violation

definition: Description:A local business rule relating multiple elements has been violated.


code: CSUC

display: certified surgery care

definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.


code: CDIO

display: case disease imported observation

definition:
An observation that states whether the disease was likely acquired outside the jurisdiction of observation, and if so, the nature of the inter-jurisdictional relationship.

                           OpenIssue: This code could be moved to LOINC if it can be done before there are significant implemenations using it.


code: COVPOL

display: benefit policy

definition:
Description:A mandate, obligation, requirement, rule, or expectation unilaterally imposed on benefit coverage under a policy or program by a sponsor, underwriter or payor on:

                              The activity of another party

                              The behavior of another party

                              The manner in which an act is executed

                           Examples:A clinical protocol imposed by a payer to which a provider must adhere in order to be paid for providing the service.  A formulary from which a provider must select prescribed drugs in order for the patient to incur a lower copay.


code: MINOCCURS

display: repetitions below minimum

definition: Description:The number of repeating elements is below the minimum number of repetitions allowed.


code: ACHC

display: accredited hospital care

definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the respective accreditation agency.


code: TOOSOON

display: Refill Too Soon Alert

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


code: DRUG

display: Drug therapy

definition: The introduction of a drug into a subject with the intention of altering its biologic state with the intent of improving its health status.


code: RALG

display: Related Allergy Alert

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


code: SBPDELAT

display: submitted pending electronic amount

definition: 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.


code: CVDC

display: certified vascular diseases care

definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.


code: TRANSFER

display: Transfer

definition: Transfer of ownership for a product.


code: ALLERLREV

display: allergy list review

definition: Description: A person reviews a list of known allergies of a given patient.


code: OBSOLETE

display: obsolete record returned

definition: Description: One or more records in the query response have a status of 'obsolete'.


code: ADRFSPELCT

display: adjud. refused same-period electronic count

definition: 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.


code: LF

display: low fat

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


code: DEMO

display: all demographic information sensitivity

definition:
Policy for handling all demographic information about an information subject, which will be afforded heightened confidentiality. Policies may govern sensitivity of information related to all demographic about an information subject, the disclosure of which could impact the privacy, well-being, or safety of that subject.

                           Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.


display: ActFinancialTransactionCode

definition: ActFinancialTransactionCode


code: SCA

display: sickle cell anemia information sensitivity

definition:
Policy for handling sickle cell disease information, which is afforded heightened confidentiality.  Information handling protocols are based on organizational policies related to sickle cell disease information, which is deemed sensitive.

                           Usage Note: If there is a jurisdictional mandate, then the Act valued with this ActCode should be associated with an Act valued with any applicable laws from the ActPrivacyLaw code system.


code: SUBSUPP

display: subsidized supplemental health program

definition:
Definition: A government health program that provides coverage for health services to persons meeting eligibility criteria for a supplemental health policy or program such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds.

                           Example:  Supplemental health coverage program may cover the cost of a health program or policy financial participations, such as the copays and the premiums, and may provide coverage for services in addition to those covered under the supplemented health program or policy.  In the U.S., Medicaid programs may pay the premium for a covered party who is also covered under the  Medicare program or a private health policy.

                           Discussion: The structure and business processes for underwriting and administering a subsidized supplemental retiree health program is further specified by the Underwriter and Payer Role.class and Role.code.


code: CPLYJPP

display: comply with jurisdictional privacy policy

definition: Custodian security system must retrieve, evaluate, and comply with applicable jurisdictional privacy policies associated with the target information.


code: ACU

display: short term/acute

definition: Definition:A list of medications which the patient is only expected to consume for the duration of the current order or limited set of orders and which is not expected to be renewed.


display: Replacement

definition: Patient's existing supply was lost/wasted


code: CPLYPOL

display: comply with policy

definition: Custodian security system must retrieve, evaluate, and comply with applicable policies associated with the target information.


code: CFPC

display: certified family practice care

definition: Description:Scope of responsibility taken on for specialty care as defined by the respective Specialty Board.


display: ActNonObservationIndicationCode

definition: Description:Concepts representing indications (reasons for clinical action) other than diagnosis and symptoms.


display: Interacting Therapy No Longer Active/Planned

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


definition: InteractionDetectedIssueCode

display: InteractionDetectedIssueCode


code: GDIS

display: genetic disease information sensitivity

definition:
Policy for handling genetic disease information, which will be afforded heightened confidentiality. Information handling protocols based on organizational policies related to genetic disease information that is deemed sensitive.

                           Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.


code: TOOLATE

display: Refill Too Late Alert

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


display: ActInformationAccessCode

definition: Description: The type of health information to which the subject of the information or the subject's delegate consents or dissents.


code: PAR

display: parenteral

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


code: CPRC

display: certified physical medicine and rehabilitation care


code: HIP

display: health insurance plan policy

definition:
Definition: A health insurance policy that covers healthcare benefits by protecting covered parties from medical expenses arising from health conditions, sickness, or accidental injury as well as preventive care. Health insurance policies explicitly exclude coverage for losses insured under a disability policy, workers' compensation program, liability insurance (including automobile insurance); or for medical expenses, coverage for on-site medical clinics or for limited dental or vision benefits when these are provided under a separate policy.

                           Discussion: Health insurance policies are offered by health insurance plans that typically reimburse providers for covered services on a fee-for-service basis, that is, a fee that is the allowable amount that a provider may charge.  This is in contrast to managed care plans, which typically prepay providers a per-member/per-month amount or capitation as reimbursement for all covered services rendered.  Health insurance plans include indemnity and healthcare services plans.


definition: Codes representing the types of covered parties that may receive covered benefits under a policy or program.

display: ActCoveredPartyLimitCode


code: SUBSIDFFS

display: subsidized fee for service program

definition:
Definition: A government health program that provides coverage on a fee for service basis for health services to persons meeting eligibility criteria such as income, location of residence, access to other coverages, health condition, and age, the cost of which is to some extent subsidized by public funds.

                           Discussion: The structure and business processes for underwriting and administering a subsidized fee for service program is further specified by the Underwriter and Payer Role.class and Role.code.


code: RFF

display: Refill (First fill this facility)

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


code: ORTHO

display: orthodontic service

definition: The service provided is required for orthodontic purposes. If the covered party has orthodontic coverage, then the service may be paid.


definition:
Specifies the type of agreement between one or more grantor and grantee in which rights and obligations related to one or more shared items of interest are allocated.

                           Usage Note: Such agreements may be considered "consent directives" or "contracts" depending on the context, and are considered closely related or synonymous from a legal perspective.

                           Examples:

                           Healthcare Privacy Consent Directive permitting or restricting in whole or part the collection, access, use, and disclosure of health information, and any associated handling caveats.
                           Healthcare Medical Consent Directive to receive medical procedures after being informed of risks and benefits, thereby reducing the grantee's liability.
                           Research Informed Consent for participation in clinical trials and disclosure of health information after being informed of risks and benefits, thereby reducing the grantee's liability.
                           Substitute decision maker delegation in which the grantee assumes responsibility to act on behalf of the grantor.
                           Contracts in which the agreement requires assent/dissent by the grantor of terms offered by a grantee, a consumer opts out of an "award" system for use of a retailer's marketing or credit card vendor's point collection cards in exchange for allowing purchase tracking and profiling.
                           A mobile device or App privacy policy and terms of service to which a user must agree in whole or in part in order to utilize the service.
                           Agreements between a client and an authorization server or between an authorization server and a resource operator and/or resource owner permitting or restricting e.g., collection, access, use, and disclosure of information, and any associated handling caveats.

display: ActConsentDirective


code: EHCPOL

display: extended healthcare

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


code: FLEXP

display: flexible benefit plan policy

definition:
Definition:  An insurance policy that covers qualified benefits under a Flexible Benefit plan such as group medical insurance, long and short term disability income insurance, group term life insurance for employees only up to $50,000 face amount, specified disease coverage such as a cancer policy, dental and/or vision insurance, hospital indemnity insurance, accidental death and dismemberment insurance, a medical expense reimbursement plan and a dependent care reimbursement plan.

                            Discussion: See UnderwriterRoleTypeCode flexible benefit plan which is defined as a benefit plan that allows employees to choose from several life, health, disability, dental, and other insurance plans according to their individual needs. Also known as cafeteria plans.  Authorized under Section 125 of the Revenue Act of 1978.


code: HOUSEHLD

display: Household Interaction

definition: Description: Exposure interaction occurred in context of domestic interaction, i.e. both participants reside in the same household.


display: ActSpecimenTransportCode

definition: Transportation of a specimen.


definition: Code for the mechanism by which disease was acquired by the living subject involved in the public health case. Includes sexually transmitted, airborne, bloodborne, vectorborne, foodborne, zoonotic, nosocomial, mechanical, dermal, congenital, environmental exposure, indeterminate.

display: case transmission mode


code: TRSTFWK

display: trust framework

definition: Type of security metadata about a complete set of contracts, regulations, or commitments that enable participating actors to rely on certain assertions by other actors to fulfill their information security requirements. [Kantara Initiative]


code: SECCATOBS

display: security category observation

definition:
Type of security metadata observation made about the category of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions. Security category metadata is defined by ISO/IEC 2382-8:1998(E/F)/ T-REC-X.812-1995 as: "A nonhierarchical grouping of sensitive information used to control access to data more finely than with hierarchical security classification alone."

                           Rationale: A security category observation supports requirement to specify the type of IT resource to facilitate application of appropriate levels of information security according to a range of levels of impact or consequences that might result from the unauthorized disclosure, modification, or use of the information or information system.  A resource is assigned to a specific category of information (e.g., privacy, medical, proprietary, financial, investigative, contractor sensitive, security management) defined by an organization or in some instances, by a specific law, Executive Order, directive, policy, or regulation. [FIPS 199]

                           Examples: Types of security categories include:

                           Compartment:  A division of data into isolated blocks with separate security controls for the purpose of reducing risk. (ISO 2382-8).  A security label tag that "segments" an IT resource by indicating that access and use is restricted to members of a defined community or project. (HL7 Healthcare Classification System)
                           Sensitivity:  The characteristic of an IT resource which implies its value or importance and may include its vulnerability. (ISO 7492-2)  Privacy metadata for information perceived as undesirable to share.  (HL7 Healthcare Classification System)


code: TB

display: Trial Balance

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


display: ActAdjudicationCode

definition: 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.


code: PHYRHB

display: Physical Rehab

definition: Provision of treatment for physical injury.


display: imaging study requiring contrast

definition: Description:Contrast agent required for imaging study.


code: FDAIMPRINTCD

display: imprint code

definition: FDA label imprint code


code: MICROSENSRREV

display: microbiology sensitivity test results review task

definition: A person reviews the sensitivity test of microbiology results of a given patient.

hierarchy: _ActTaskCode PATINFO MICRORREV


code: MARWLREV

display: medication administration record work list review task

definition: A clinician reviews a work list of medications to be administered to a given patient.

hierarchy: _ActTaskCode PATINFO MLREV


code: PRDMX

display: period maximum

definition: Definition: Maximum amount paid by payer or covered party; or maximum number of services/products covered under the policy or program by time period specified by the effective time on the act.


code: RISKASSESS

display: risk assessment instrument task

definition: A person reviews a Risk Assessment Instrument report of a given patient.


code: CTMO

display: case transmission mode observation

definition:
An observation that states the mechanism by which disease was acquired by the living subject involved in the public health case.

                           OpenIssue: This code could be moved to LOINC if it can be done before there are significant implemenations using it.


display: ActIncidentCode

definition: Set of codes indicating the type of incident or accident.


code: UPC

display: Universal Product Code

definition: Description:Universal Product Code is one of a wide variety of bar code languages widely used in the United States and Canada for items in stores.


code: ADPPSPMNCT

display: adjud. payee payable same-period manual count

definition: 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.


code: NOPAT

display: no disclosure to patient, family or caregivers without attending provider's authorization

definition:
Prohibition on disclosing information to patient, family or caregivers without attending provider's authorization.

                           Usage Note: The information may be labeled with the ActInformationSensitivity TBOO code, triggering application of this RefrainPolicy code as a handling caveat controlling access.

                        Maps to FHIR NOPAT: Typically, this is used on an Alert resource, when the alert records information on patient abuse or non-compliance.

                        FHIR print name is "keep information from patient". Maps to the French realm - code: INVISIBLE_PATIENT.

                           displayName: Document non visible par le patient
                           codingScheme: 1.2.250.1.213.1.1.4.13

                        French use case:  A label for documents that the author  chose to hide from the patient until the content can be disclose to the patient in a face to face meeting between a healthcare professional and the patient (in French law some results like cancer diagnosis or AIDS diagnosis must be announced to the patient by a healthcare professional and should not be find out by the patient alone).


code: PLYDOC

display: Poly-orderer Alert

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


code: DOSEL

display: Low Dose Alert

definition: Proposed dosage is below suggested therapeutic levels


code: ACALLG

display: allergy access

definition: Description: Provide consent to collect, use, disclose, or access allergy information for a patient.


code: DRIVLABEL

display: derive security label

definition: Custodian security system must assign and bind security labels derived from compilations of information by aggregation or disaggregation in order to classify information compiled in the information systems under its control for collection, access, use and disclosure in accordance with applicable jurisdictional privacy policies associated with the target information. The system must retain an immutable record of the previous assignment and binding.


code: DERMTRNS

display: transdermal transmission

definition: Communication of an agent from a living subject or environmental source to a living subject via agent migration through intact skin.


code: LIVARG

display: living arrangement information sensitivity

definition:
Policy for handling information related to an information subject's living arrangement, which will be afforded heightened confidentiality.  Policies may govern sensitivity of information related to an information subject's living arrangement, the disclosure of which could impact the privacy, well-being, or safety of that subject.

                           Usage Note: If there is a jurisdictional mandate, then use the applicable ActPrivacyLaw code system, and specify the law rather than or in addition to this more generic code.


display: Work Interaction

definition: Description: Exposure interaction occurred in a work setting, i.e. participants are co-workers.


code: SECOBS

display: SecurityObservationType

definition:
An observation identifying security metadata about an IT resource (data, information object, service, or system capability), which may be used to make access control decisions.  Security metadata are used to name security labels.

                           Rationale: According to ISO/TS 22600-3:2009(E) A.9.1.7 SECURITY LABEL MATCHING, Security label matching compares the initiator's clearance to the target's security label.  All of the following must be true for authorization to be granted:

                           The security policy identifiers shall be identical
                           The classification level of the initiator shall be greater than or equal to that of the target (that is, there shall be at least one value in the classification list of the clearance greater than or equal to the classification of the target), and
                           For each security category in the target label, there shall be a security category of the same type in the initiator's clearance and the initiator's classification level shall dominate that of the target.

                           Examples: SecurityObservationType  security label fields include:

                           Confidentiality classification
                           Compartment category
                           Sensitivity category
                           Security mechanisms used to ensure data integrity or to perform authorized data transformation
                           Indicators of an IT resource completeness, veracity, reliability, trustworthiness, or provenance.

                           Usage Note: SecurityObservationType codes designate security label field types, which are valued with an applicable SecurityObservationValue code as the "security label tag".


code: ADNPPPELCT

display: adjud. non-payee payable prior-period electronic count

definition: 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.


code: ENCRYPT

display: encrypt

definition:
Custodian system must render information unreadable by algorithmically transforming plaintext into ciphertext.

                           Usage Notes: A mathematical transposition of a file or data stream so that it cannot be deciphered at the receiving end without the proper key. Encryption is a security feature that assures that only the parties who are supposed to be participating in a videoconference or data transfer are able to do so. It can include a password, public and private keys, or a complex combination of all.  (Per Infoway.)


definition:
Definition: Set of codes indicating the type of insurance policy.  Insurance, in law and economics, is a form of risk management primarily used to hedge against the risk of potential financial loss. Insurance is defined as the equitable transfer of the risk of a potential loss, from one entity to another, in exchange for a premium and duty of care. A policy holder is an individual or an organization enters into a contract with an underwriter which stipulates that, in exchange for payment of a sum of money (a premium), one or more covered parties (insureds) is guaranteed compensation for losses resulting from certain perils under specified conditions.  The underwriter analyzes the risk of loss, makes a decision as to whether the risk is insurable, and prices the premium accordingly.  A policy provides benefits that indemnify or cover the cost of a loss incurred by a covered party, and may include coverage for services required to remediate a loss.  An insurance policy contains pertinent facts about the policy holder, the insurance coverage, the covered parties, and the insurer.  A policy may include exemptions and provisions specifying the extent to which the indemnification clause cannot be enforced for intentional tortious conduct of a covered party, e.g., whether the covered parties are jointly or severably insured.

                           Discussion: In contrast to programs, an insurance policy has one or more policy holders, who own the policy.  The policy holder may be the covered party, a relative of the covered party, a partnership, or a corporation, e.g., an employer.  A subscriber of a self-insured health insurance policy is a policy holder.  A subscriber of an employer sponsored health insurance policy is holds a certificate of coverage, but is not a policy holder; the policy holder is the employer.  See CoveredRoleType.

child: AUTOPOL

display: ActInsuranceTypeCode


definition: An identifying data string for medical facility accommodations.


code: DOSEHINDW

display: High Dose for Weight Alert

definition: Proposed dosage exceeds standard practice for the patient's weight


display: Consulted Prescriber

definition: Consulted prescriber, therapy confirmed


code: REFLEX

display: reflex permission

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


code: PTNTCARE

display: Health Care Interaction - Patient Care

definition: Description: Exposure participants' interaction occurred during the course of  health care delivery by a provider (e.g. a physician treating a patient in her office).


code: PNC

display: property and casualty insurance policy

definition: Definition: A type of insurance that covers damage to or loss of the policyholderaTMs property by providing payments for damages to property damage or the injury or death of living subjects.  The terms "casualty" and "liability" insurance are often used interchangeably. Both cover the policyholder's legal liability for damages caused to other persons and/or their property.


code: XRAY

display: x-ray

definition: Description: Digital X-Ray Attachment


code: DISPLAY

display: Display

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


code: VRXINV

display: vision dispense invoice

definition: Vision dispense invoice for up to 2 lens (left and right), frame and optional discount.  Eye exams are invoiced as a clinical service invoice.


code: R

display: Process Completed

definition: 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.


code: CPND

display: certified pneumonia disease care

definition: Description:Scope of responsibility taken on by an organization for care of a patient as defined by the disease management certification agency.


code: SECINTOBS

display: security integrity observation

definition:
Type of security metadata observation made about the integrity of an IT resource (data, information object, service, or system capability), which may be used to make access control decisions.

                           Rationale: A security integrity observation supports the requirement to guard against improper information modification or destruction, and includes ensuring information non-repudiation and authenticity. (44 U.S.C., SEC. 3542)

                           Examples: Types of security integrity metadata include:

                           Integrity status, which indicates the completeness or workflow status of an IT resource (data, information object, service, or system capability)
                           Integrity confidence, which indicates the reliability and trustworthiness of an IT resource
                           Integrity control, which indicates pertinent handling caveats, obligations, refrain policies, and purpose of use for  the resource
                           Data integrity, which indicate the security mechanisms used to ensure that the accuracy and consistency are preserved regardless of changes made (ISO/IEC DIS 2382-8)
                           Alteration integrity, which indicate the security mechanisms used for authorized transformations of the resource
                           Integrity provenance, which indicates the entity responsible for a report or assertion relayed "second-hand" about an IT resource