code: SPLY

display: supply

definition: Supply orders and deliveries are simple Acts that focus on the delivered product. The product is associated with the Supply Act via Participation.typeCode="product". With general Supply Acts, the precise identification of the Material (manufacturer, serial numbers, etc.) is important.  Most of the detailed information about the Supply should be represented using the Material class.  If delivery needs to be scheduled, tracked, and billed separately, one can associate a Transportation Act with the Supply Act.  Pharmacy dispense services are represented as Supply Acts, associated with a SubstanceAdministration  Act. The SubstanceAdministration class represents the administration of medication, while dispensing is supply.


code: SCOPOL

display: scope of practice policy

definition:
Description:An ethical or clinical obligation, requirement, rule, or expectation imposed or strongly encouraged by organizations that oversee particular clinical domains or provider certification which define the boundaries within which a provider may practice and which may have legal basis or ramifications on:

                              The activity of another party

                              The behavior of another party

                              The manner in which an act is executed

                           Examples:An ethical obligation for a provider to fully inform a patient about all treatment options.  An ethical obligation for a provider not to disclose personal health information that meets certain criteria, e.g., where disclosure might result in harm to the patient or another person.  The set of health care services which a provider is credentialed or privileged to provide.

hierarchy: ACT POLICY

resourceType: Concept


definition:
Lying with the front or ventral surface downward; lying face down.

                              Deprecation Comment:
                           This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation.  The same code has been added to the ObservationValue code system.

code: PRN

display: prone


definition: The spatial relationship of a subject whether human, other animal, or plant, to a frame of reference such as gravity or a collection device.

display: subject physical position

hierarchy: ACT OBS


code: SBEXT

display: Substance Extraction

definition: Description: The act of removing a substance from the subject.

hierarchy: ACT PROC


code: SPCOBS

display: specimen observation

definition: An observation on a specimen in a laboratory environment that may affect processing, analysis or result interpretation


definition:
Lying on the right side.

                              Deprecation Comment:
                           This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation.  The same code has been added to the ObservationValue code system.

code: RLD

display: right lateral decubitus


definition: An observable finding or state that persists over time and tends to require intervention or management, and, therefore, distinguished from an Observation made at a point in time; may exist before an Observation of the Condition is made or after interventions to manage the Condition are undertaken. Examples: equipment repair status, device recall status, a health risk, a financial risk, public health risk, pregnancy, health maintenance, chronic illness

code: COND

display: Condition


code: CLUSTER

display: Cluster

definition:
Description:An ACT that organizes a set of component acts into a semantic grouping that have a shared subject. The subject may be either a subject participation (SBJ), subject act relationship (SUBJ), or child participation/act relationship types.

                           Discussion: The focus in a CLUSTER act is the grouping of the contained acts.  For example "a request to cluster" (RQO), "a type of cluster that is allowed to occur" (DEF), etc.

                           Examples:

                              Radiologic investigations that might include administration of a dye, followed by radiographic observations;

                              "Isolate cluster" which includes all testing and specimen processing performed on a specific isolate;

                              a set of actions to perform at a particular stage in a clinical trial.

hierarchy: ACT _ActClassRecordOrganizer GROUPER


code: CONS

display: consent

definition:
The Consent class represents informed consents and all similar medico-legal transactions between the patient (or his legal guardian) and the provider. Examples are informed consent for surgical procedures, informed consent for clinical trials, advanced beneficiary notice, against medical advice decline from service, release of information agreement, etc.

                        The details of consents vary. Often an institution has a number of different consent forms for various purposes, including reminding the physician about the topics to mention. Such forms also include patient education material. In electronic medical record communication, consents thus are information-generating acts on their own and need to be managed similar to medical activities. Thus, Consent is modeled as a special class of Act.

                        The "signatures" to the consent document are represented electronically through Participation instances to the consent object. Typically an informed consent has Participation.typeCode of "performer", the healthcare provider informing the patient, and "consenter", the patient or legal guardian. Some consent may associate a witness or a notary public (e.g., living wills, advanced directives). In consents where a healthcare provider is not required (e.g. living will), the performer may be the patient himself or a notary public.

                        Some consent has a minimum required delay between the consent and the service, so as to allow the patient to rethink his decisions. This minimum delay can be expressed in the act definition by the ActRelationship.pauseQuantity attribute that delays the service until the pause time has elapsed after the consent has been completed.


code: CLNTRL

display: clinical trial

definition: The set of actions that define an experiment to assess the effectiveness and/or safety of a biopharmaceutical product (food, drug, device, etc.).  In definition mood, this set of actions is often embodied in a clinical trial protocol; in event mood, this designates the aggregate act of applying the actions to one or more subjects.


code: SEQ

display: bio sequence

definition: Description:A sequence of biomolecule like the DNA, RNA, protein and the like.

hierarchy: ACT OBS GEN


code: FCNTRCT

display: financial contract

definition: A contract whose value is measured in monetary terms.

hierarchy: ACT CNTRCT


definition:
Lying on the left side.

                              Deprecation Comment:
                           This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation.  The same code has been added to the ObservationValue code system.

code: LLD

display: left lateral decubitus


code: OBS

display: observation

definition:
Description:An act that is intended to result in new information about a subject. The main difference between Observations and other Acts is that Observations have a value attribute. The code attribute of Observation and the value attribute of Observation must be considered in combination to determine the semantics of the observation.

                           Discussion:

                        Structurally, many observations are name-value-pairs, where the Observation.code (inherited from Act) is the name and the Observation.value is the value of the property. Such a construct is also known as a  variable (a named feature that can assume a value) hence, the Observation class is always used to hold generic name-value-pairs or variables, even though the variable valuation may not be the result of an elaborate observation method. It may be a simple answer to a question or it may be an assertion or setting of a parameter.

                        As with all Act statements, Observation statements describe what was done, and in the case of Observations, this includes a description of what was actually observed (results or answers); and those results or answers are part of the observation and not split off into other objects.

                        The method of action is asserted by the Observation classCode or its subclasses at the least granular level, by the Observation.code attribute value at the medium level of granularity, and by the attribute value of observation.methodCode when a finer level of granularity is required. The method in whole or in part may also appear in the attribute value of Observation.value when using coded data types to express the value of the attribute. Relevant aspects of methodology may also be restated in value when the results themselves imply or state a methodology.

                        An observation may consist of component observations each having their own Observation.code and Observation.value. In this case, the composite observation may not have an Observation.value for itself. For instance, a white blood cell count consists of the sub-observations for the counts of the various granulocytes, lymphocytes and other normal or abnormal blood cells (e.g., blasts). The overall white blood cell count Observation itself may therefore not have a value by itself (even though it could have one, e.g., the sum total of white blood cells). Thus, as long as an Act is essentially an Act of recognizing and noting information about a subject, it is an Observation, regardless of whether it has a simple value by itself or whether it has sub-observations.

                        Even though observations are professional acts (see Act) and as such are intentional actions, this does not require that every possible outcome of an observation be pondered in advance of it being actually made. For instance, differential white blood cell counts (WBC) rarely show blasts, but if they do, this is part of the WBC observation even though blasts might not be predefined in the structure of a normal WBC.

                        Clinical documents commonly have Subjective and Objective findings, both of which are kinds of Observations. In addition, clinical documents commonly contain Assessments, which are also kinds of Observations. Thus, the establishment of a diagnosis is an Observation.

                           Examples:

                              Recording the results of a Family History Assessment

                              Laboratory test and associated result

                              Physical exam test and associated result

                              Device temperature

                              Soil lead level


definition: ActClassContainer

display: ActClassContainer


code: EXTRACT

display: extract

definition:
This context represents the part of a patient record conveyed in a single communication. It is drawn from a providing system for the purposes of communication to a requesting process (which might be another repository, a client application or a middleware service such as an electronic guideline engine), and supporting the faithful inclusion of the communicated data in the receiving system.

                        An extract may be the entirety of the patient record as held by the sender or it may be a part of that record (e.g. changes since a specified date).

                        An extract contains folders or compositions.

                        An extract cannot contain another extract.


code: ACCT

display: account

definition: A financial account established to track the net result of financial acts.


code: ENC

display: encounter

definition: An interaction between a patient and healthcare participant(s) for the purpose of providing patient service(s) or assessing the health status of a patient.  For example, outpatient visit to multiple departments, home health support (including physical therapy), inpatient hospital stay, emergency room visit, field visit (e.g., traffic accident), office visit, occupational therapy, telephone call.

hierarchy: ACT PCPR


code: ALRT

display: detected issue

definition:
An observation identifying a potential adverse outcome as a result of an Act or combination of Acts.

                           Examples: Detection of a drug-drug interaction; Identification of a late-submission for an invoice; Requesting discharge for a patient who does not meet hospital-defined discharge criteria.

                           Discussion: This class is commonly used for identifying 'business rule' or 'process' problems that may result in a refusal to carry out a particular request. In some circumstances it may be possible to 'bypass' a problem by modifying the request to acknowledge the issue and/or by providing some form of mitigation.

                           Constraints: the Act or Acts that may cause the the adverse outcome are the target of a subject ActRelationship. The subbtypes of this concept indicate the type of problem being detected (e.g. drug-drug interaction) while the Observation.value is used to repesent a specific problem code (e.g. specific drug-drug interaction id).


definition: Regions of Interest (ROI) within a subject Act. Primarily used for making secondary observations on a subset of a subject observation. The relationship between a ROI and its referenced Act is specified through an ActRelationship of type "subject" (SUBJ), which must always be present.

display: ActClassROI


code: CACT

display: control act

definition: An act representing a system action such as the change of state of another act or the initiation of a query.  All control acts represent trigger events in the HL7 context.  ControlActs may occur in different moods.


code: INVSTG

display: investigation

definition: An formalized inquiry into the circumstances surrounding a particular unplanned event or potential event for the purposes of identifying possible causes and contributing factors for the event. This investigation could be conducted at a local institutional level or at the level of a local or national government.


code: OBSCOR

display: correlated observation sequences

definition: Container for Observation Sequences (Observations whose values are contained in LIST<>'s) having values correlated with each other.  Each contained Observation Sequence LIST<> must be the same length.  Values in the LIST<>'s are correlated based on index.  E.g. the values in position 2 in all the LIST<>'s are correlated.  This is analogous to a table where each column is an Observation Sequence with a LIST<> of values, and each row in the table is a correlation between the columns.  For example, a 12-lead ECG would contain 13 sequences: one sequence for time, and a sequence for each of the 12 leads.

hierarchy: ACT OBS OBSSER


code: DOCBODY

display: document body

definition: A context that distinguishes the body of a document from the document header. This is seen, for instance, in HTML documents, which have discrete <head> and <body> elements.

hierarchy: ACT _ActClassRecordOrganizer CONTAINER


code: DISPACT

display: disciplinary action

definition:
An action taken with respect to a subject Entity by a regulatory or authoritative body with supervisory capacity over that entity. The action is taken in response to behavior by the subject Entity that body finds to be 							undesirable.

                        Suspension, license restrictions, monetary fine, letter of reprimand, mandated training, mandated supervision, etc.Examples:


definition: An outbreak represents a series of public health cases. The date on which an outbreak starts is the earliest date of onset among the cases assigned to the outbreak, and its ending date is the last date of onset among the cases assigned to the outbreak.

code: OUTB

display: outbreak

hierarchy: ACT OBS COND CASE


code: PCPR

display: care provision

definition:
An Act that of taking on whole or partial responsibility for, or attention to, safety and well-being of a subject of care.

                           Discussion: A care provision event may exist without any other care actions taking place. For example, when a patient is assigned to the care of a particular health professional.

                        In request (RQO) mood care provision communicates a referral, which is a request:

                              from one party (linked as a participant of type author (AUT)),

                              to another party (linked as a participant of type performer (PRF),

                              to take responsibility for a scope specified by the code attribute,

                              for an entity (linked as a participant of type subject (SBJ)).

                        The scope of the care for which responsibility is taken is identified by code attribute.

                        In event (EVN) mood care provision indicates the effective time interval of a specified scope of responsibility by a performer (PRF) or set of performers (PRF) for a subject (SBJ).

                           Examples:

                              Referral from GP to a specialist.

                              Assignment of a patient or group of patients to the case list of a health professional.

                              Assignment of inpatients to the care of particular nurses for a working shift.


code: STDPOL

display: standard of practice policy

definition:
Description:A requirement, rule, or expectation typically documented as guidelines, protocols, or formularies imposed or strongly encouraged by an organization that oversees or has authority over the practices within a domain, and which may have legal basis or ramifications on:

                              The activity of another party

                              The behavior of another party

                              The manner in which an act is executed

                           Examples:A payer may require a prescribing provider to adhere to formulary guidelines.  An institution may adopt clinical guidelines and protocols and implement these within its electronic health record and decision support systems.


code: OUTBR

definition:
An Outbreak is a concern resulting from a series of public health cases.

                           UsageNotes: The date on which an outbreak starts is the earliest date of onset among the cases assigned to the outbreak and its ending date is the last date of onset among the cases assigned to the outbreak. The effectiveTime attribute is used to convey the relevant dates for the case. An outbreak definition (Act.moodCode = "definition" includes the criteria for the number, types and occurrence pattern of cases necessary to declare an outbreak and to judge the severity of an outbreak.

hierarchy: ACT CONC


code: TRFR

display: transfer

definition: Definition: The act of transferring information without the intent of imparting understanding about a topic to the subject that is the recipient or holder of the transferred information where the participation association must be RCV or HLD.


code: TEXPOS

display: transmission exposure

definition:
Description:

                        A transmission exposure act describes the proximity (time and location) over which the participating source entity was capable of transmitting a physical (including energy), chemical or biological substance agent to another entity.  The transmission exposure act is used in conjunction with acquisition exposure acts as part of an analysis technique for contact tracing.  Although an exposure can be decomposed into transmission and acquisition exposures, there is no requirement that all exposures be treated in this fashion.

                           Constraints:  The Transmission Exposure inherits the participation constraints that apply to Exposure with the following exception.  The EXPTRGT (exposure target) participation must never be associated with the Transmission Exposure either directly or via context conduction.

hierarchy: ACT EXPOS


code: CONC

display: concern

definition:
Definition: A worry that tends to persist over time and has as its subject a state or process. The subject of the worry has the potential to require intervention or management.

                           Examples: an observation result, procedure, substance administration, equipment repair status, device recall status, a health risk, a financial risk, public health risk, pregnancy, health maintenance, allergy, and acute or chronic illness.


definition:
To be stationary, upright, vertical, on one's legs.

                              Deprecation Comment:
                           This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation.  The same code has been added to the ObservationValue code system.

code: STN

display: standing


code: DGIMG

display: diagnostic image

definition: Class for holding attributes unique to diagnostic images.


code: ACT

display: act

definition:
A record of something that is being done, has been done, can be done, or is intended or requested to be done.

                           Examples:The kinds of acts that are common in health care are (1) a clinical observation, (2) an assessment of health condition (such as problems and diagnoses), (3) healthcare goals, (4) treatment services (such as medication, surgery, physical and psychological therapy), (5) assisting, monitoring or attending, (6) training and education services to patients and their next of kin, (7) and notary services (such as advanced directives or living will), (8)  editing and maintaining documents, and many others.

                           Discussion and Rationale: Acts are the pivot of the RIM; all domain information and processes are represented primarily in Acts. Any profession or business, including healthcare, is primarily constituted of intentional and occasionally non-intentional actions, performed and recorded by responsible actors. An Act-instance is a record of such an action.

                        Acts connect to Entities in their Roles through Participations and connect to other Acts through ActRelationships. Participations are the authors, performers and other responsible parties as well as subjects and beneficiaries (which includes tools and material used in the performance of the act, which are also subjects). The moodCode distinguishes between Acts that are meant as factual records, vs. records of intended or ordered services, and the other modalities in which act can appear.

                        One of the Participations that all acts have (at least implicitly) is a primary author, who is responsible of the Act and who "owns" the act. Responsibility for the act means responsibility for what is being stated in the Act and as what it is stated. Ownership of the act is assumed in the sense of who may operationally modify the same act. Ownership and responsibility of the Act is not the same as ownership or responsibility of what the Act-object refers to in the real world. The same real world activity can be described by two people, each being the author of their Act, describing the same real world activity. Yet one can be a witness while the other can be a principal performer. The performer has responsibilities for the physical actions; the witness only has responsibility for making a true statement to the best of his or her ability. The two Act-instances may even disagree, but because each is properly attributed to its author, such disagreements can exist side by side and left to arbitration by a recipient of these Act-instances.

                        In this sense, an Act-instance represents a "statement" according to Rector and Nowlan (1991) [Foundations for an electronic medical record. Methods Inf Med. 30.]  Rector and Nowlan have emphasized the importance of understanding the medical record not as a collection of facts, but "a faithful record of what clinicians have heard, seen, thought, and done." Rector and Nowlan go on saying that "the other requirements for a medical record, e.g., that it be attributable and permanent, follow naturally from this view." Indeed the Act class is this attributable statement, and the rules of updating acts (discussed in the state-transition model, see Act.statusCode) versus generating new Act-instances are designed according to this principle of permanent attributable statements.

                        Rector and Nolan focus on the electronic medical record as a collection of statements, while attributed statements, these are still mostly factual statements. However, the Act class goes beyond this limitation to attributed factual statements, representing what is known as "speech-acts" in linguistics and philosophy.  The notion of speech-act includes that there is pragmatic meaning in language utterances, aside from just factual statements; and that these utterances interact with the real world to change the state of affairs, even directly cause physical activities to happen. For example, an order is a speech act that (provided it is issued adequately) will cause the ordered action to be physically performed. The speech act theory has culminated in the seminal work by Austin (1962) [How to do things with words. Oxford University Press].

                        An activity in the real world may progress from defined, through planned and ordered to executed, which is represented as the mood of the Act. Even though one might think of a single activity as progressing from planned to executed, this progression is reflected by multiple Act-instances, each having one and only one mood that will not change along the Act-instance life cycle.  This is because the attribution and content of speech acts along this progression of an activity may be different, and it is often critical that a permanent and faithful record be maintained of this progression. The specification of orders or promises or plans must not be overwritten by the specification of what was actually done, so as to allow comparing actions with their earlier specifications. Act-instances that describe this progression of the same real world activity are linked through the ActRelationships (of the relationship category "sequel").

                        Act as statements or speech-acts are the only representation of real world facts or processes in the HL7 RIM. The truth about the real world is constructed through a combination (and arbitration) of such attributed statements only, and there is no class in the RIM whose objects represent "objective state of affairs" or "real processes" independent from attributed statements. As such, there is no distinction between an activity and its documentation. Every Act includes both to varying degrees. For example, a factual statement made about recent (but past) activities, authored (and signed) by the performer of such activities, is commonly known as a procedure report or original documentation (e.g., surgical procedure report, clinic note etc.). Conversely, a status update on an activity that is presently in progress, authored by the performer (or a close observer) is considered to capture that activity (and is later superceded by a full procedure report). However, both status update and procedure report are acts of the same kind, only distinguished by mood and state (see statusCode) and completeness of the information.


code: SPCTRT

display: specimen treatment

definition: A procedure or treatment performed on a specimen to prepare it for analysis


code: ADJUD

display: financial adjudication

definition:
A transformation process where a requested invoice is transformed into an agreed invoice.  Represents the adjudication processing of an invoice (claim).  Adjudication results can be adjudicated as submitted, with adjustments or refused.

                        Adjudication results comprise 2 components: the adjudication processing results and a restated (or adjudicated) invoice or claim


definition:
Contains codes for defining the observed, physical position of a subject, such as during an observation, assessment, collection of a specimen, etc.  ECG waveforms and vital signs, such as blood pressure, are two examples where a general, observed position typically needs to be noted.

                              Deprecation Comment:
                           This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation.  The same code has been added to the ObservationValue code system.

display: subject body position

hierarchy: ACT OBS _SubjectPhysicalPosition


code: SPECCOLLECT

display: Specimen Collection

definition: A procedure for obtaining a specimen from a source entity.

hierarchy: ACT PROC SBEXT


code: CNTRCT

display: contract

definition: An agreement of obligation between two or more parties that is subject to contractual law and enforcement.


code: DETPOL

display: determinant peptide

definition: Description:A determinant peptide in a polypeptide as described by polypeptide.


code: CTTEVENT

display: clinical trial timepoint event

definition: An identified point during a clinical trial at which one or more actions are scheduled to be performed (definition mood), or are actually performed (event mood).  The actions may or may not involve an encounter between the subject and a healthcare professional.


code: TRNS

display: transportation

definition: Transportation is the moving of a payload (people or material) from a location of origin to a destination location.  Thus, any transport service has the three target instances of type payload, origin, and destination, besides the targets that are generally used for any service (i.e., performer, device, etc.)


code: POLICY

display: policy

definition:
Description:A mandate, regulation, obligation, requirement, rule, or expectation unilaterally imposed by one party on:

                              The activity of another party

                              The behavior of another party

                              The manner in which an act is executed


code: ACCM

display: accommodation

definition: An accommodation is a service provided for a Person or other LivingSubject in which a place is provided for the subject to reside for a period of time.  Commonly used to track the provision of ward, private and semi-private accommodations for a patient.


code: POSCOORD

display: position coordinate

definition: Description:An observation representing one of a set of numerical values used to determine the position of a place.  The name of the coordinate value is determined by the reference coordinate system.

hierarchy: ACT OBS POS


code: HCASE

display: public health case

definition:
A public health case is a Concern about an observation or event that has a specific significance for public health. The creation of a PublicHealthCase initiates the tracking of the object of concern.  The decision to track is related to but somewhat independent of the underlying event or observation.

                           UsageNotes: Typically a Public Health Case involves an instance or instances of a reportable infectious disease or other condition. The public health case can include a health-related event concerning a single individual or it may refer to multiple health-related events that are occurrences of the same disease or condition of interest to public health.

                        A public health case definition (Act.moodCode = "definition") includes the description of the clinical, laboratory, and epidemiologic indicators associated with a disease or condition of interest to public health. There are case definitions for conditions that are reportable, as well as for those that are not. A public health case definition is a construct used by public health for the purpose of counting cases, and should not be used as clinical indications for treatment. Examples include AIDS, toxic-shock syndrome, and salmonellosis and their associated indicators that are used to define a case.


code: GROUPER

display: grouper

definition:
Definition: An ACT that organizes a set of component acts into a semantic grouping that share a particular context such as timeframe, patient, etc.

                           UsageNotes: The focus in a GROUPER act is the grouping of the contained acts.  For example "a request to group" (RQO), "a type of grouping that is allowed to occur" (DEF), etc.

                        Unlike WorkingList, which represents a dynamic, shared, continuously updated collection to provide a "view" of a set of objects, GROUPER collections tend to be static and simply indicate a shared set of semantics.  Note that sharing of semantics can be achieved using ACT as well.  However, with GROUPER, the sole semantic is of grouping.


code: FOLDER

display: folder

definition:
A context representing the high-level organization of an extract e.g. to group parts of the record by episode, care team, clinical specialty, clinical condition, or source application. Internationally, this kind of organizing structure is used variably: in some centers and systems the folder is treated as an informal compartmentalization of the overall health record; in others it might represent a significant legal portion of the EHR relating to the originating enterprise or team.

                        A folder contains compositions.

                        Folders may be nested within folders.


code: VERIF

display: Verification

definition: An act which describes the process whereby a 'verifying party' validates either the existence of the Role attested to by some Credential or the actual Vetting act and its details.


code: REG

display: registration

definition:
Represents the act of maintaining information about the registration of its associated registered subject. The subject can be either an Act or a Role, and includes subjects such as lab exam definitions, drug protocol definitions, prescriptions, persons, patients, practitioners, and equipment.

                        The registration may have a unique identifier - separate from the unique identification of the subject - as well as a core set of related participations and act relationships that characterize the registration event and aid in the disposition of the subject information by a receiving system.


definition: Used to group a set of acts sharing a common context. Organizer structures can nest within other context structures - such as where a document is contained within a folder, or a folder is contained within an EHR extract.

display: record organizer


definition:
Resting the body on the buttocks, typically with upper torso erect or semi erect.

                              Deprecation Comment:
                           This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation.  The same code has been added to the ObservationValue code system.

code: SIT

display: sitting


code: XACT

display: financial transaction

definition:
A sub-class of Act representing any transaction between two accounts whose value is measured in monetary terms.

                        In the "intent" mood, communicates a request for a transaction to be initiated, or communicates a transfer of value between two accounts.

                        In the "event" mood, communicates the posting of a transaction to an account.


code: JURISPOL

display: jurisdictional policy

definition:
Description:A mandate, regulation, obligation, requirement, rule, or expectation unilaterally imposed by a jurisdiction on:

                              The activity of another party

                              The behavior of another party

                              The manner in which an act is executed

                           Examples:A jurisdictional mandate regarding the prescribing and dispensing of a particular medication.  A jurisdictional privacy or security regulation dictating the manner in which personal health information is disclosed.  A jurisdictional requirement that certain services or health conditions are reported to a monitoring program, e.g., immunizations, methadone treatment, or cancer registries.


code: EXP

display: expression level

definition: Description:An expression level of genes/proteins or other expressed genomic entities.


definition:
Deprecation Comment:
                           This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation.  The same code has been added to the ObservationValue code system.

code: SUP

display: supine


definition:
A semi-sitting position in bed with the head of the bed elevated approximately 45 degrees.

                              Deprecation Comment:
                           This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation.  The same code has been added to the ObservationValue code system.

code: SFWL

display: Semi-Fowler's


code: INFO

display: information

definition: Sender sends payload to addressee as information.  Addressee does not have responsibilities beyond serving addressee's own interest (i.e., read and memorize if you see fit).  This is equivalent to an FYI on a memo.

hierarchy: ACT CACT


definition:
Diet services are supply services, with some aspects resembling Medication services: the detail of the diet is given as a description of the Material associated via Participation.typeCode="product". Medically relevant diet types may be communicated in the Diet.code attribute using domain ActDietCode, however, the detail of the food supplied and the various combinations of dishes should be communicated as Material instances.

                           Deprecation Note

                           Class: Use either the Supply class (if dealing with what should be given to the patient) or SubstanceAdministration class (if dealing with what the patient should consume)

                           energyQuantity: This quantity can be conveyed by using a Content relationship with a quantity attribute expressing the calories

                           carbohydrateQuantity:This quantity can be conveyed using a Content relationship to an Entity with a code of  carbohydrate and a quantity attribute on the content relationship.

code: DIET

display: diet

hierarchy: ACT SPLY


code: ORGPOL

display: organizational policy

definition:
Description:A mandate, obligation, requirement, rule, or expectation unilaterally imposed by an organization on:

                              The activity of another party

                              The behavior of another party

                              The manner in which an act is executed

                           Examples:A clinical or research protocols imposed by a payer, a malpractice insurer, or an institution to which a provider must adhere.  A mandate imposed by a denominational institution for a provider to provide or withhold certain information from the patient about treatment options.

hierarchy: ACT POLICY


code: MPROT

display: monitoring program

definition: An officially or unofficially instituted program to track acts of a particular type or categorization.


code: LOC

display: locus

definition: Description:The position of a gene (or other significant sequence) on the genome.


definition:
Lying on the back, on an inclined plane, typically about 30-45 degrees, with  head lowered and feet raised.

                              Deprecation Comment:
                           This concept has been deprecated because it does not describe a type of Act (as it should in the ActClass code system), but rather encodes the result or value of an observation.  The same code has been added to the ObservationValue code system.

code: TRD

display: trendelenburg


code: INC

display: incident

definition: An event that occurred outside of the control of one or more of the parties involved.  Includes the concept of an accident.


code: COMPOSITION

display: composition

definition:
A context representing a grouped commitment of information to the EHR. It is considered the unit of modification of the record, the unit of transmission in record extracts, and the unit of attestation by authorizing clinicians.

                        A composition represents part of a patient record originating from a single interaction between an authenticator and the record.

                        Unless otherwise stated all statements within a composition have the same authenticator, apply to the same patient and were recorded in a single session of use of a single application.

                        A composition contains organizers and entries.


code: ORGANIZER

display: organizer

definition:
Organizer of entries. Navigational. No semantic content. Knowledge of the section code is not required to interpret contained observations. Represents a heading in a heading structure, or "organizer tree".

                        The record entries relating to a single clinical session are usually grouped under headings that represent phases of the encounter, or assist with layout and navigation. Clinical headings usually reflect the clinical workflow during a care session, and might also reflect the main author's reasoning processes. Much research has demonstrated that headings are used differently by different professional groups and specialties, and that headings are not used consistently enough to support safe automatic processing of the E H R.


code: TOPIC

display: topic

definition:
A group of entries within a composition that are related to a common clinical theme - such as a specific disorder or problem, prevention, screening and provision of contraceptive services.

                        A topic may contain categories and entries.


code: PHN

display: phenotype

definition: Description:A genomic phenomenon that is expressed externally in the organism.


code: CONTAINER

display: record container

definition:
Description: Container of clinical statements. Navigational. No semantic content. Knowledge of the section code is not required to interpret contained observations. Represents a heading in a heading structure, or "container tree".

                        The record entries relating to a single clinical session are usually grouped under headings that represent phases of the encounter, or assist with layout and navigation. Clinical headings usually reflect the clinical workflow during a care session, and might also reflect the main author's reasoning processes. Much research has demonstrated that headings are used differently by different professional groups and specialties, and that headings are not used consistently enough to support safe automatic processing of the E H R.


code: CATEGORY

display: category

definition:
A group of entries within a composition or topic that have a common characteristic - for example, Examination, Diagnosis, Management OR Subjective, Objective, Analysis, Plan.

                        The distinction from Topic relates to value sets. For Category there is a bounded list of things like "Examination", "Diagnosis" or SOAP categories. For Topic the list is wide open to any clinical condition or reason for a part of an encounter.

                        A CATEGORY MAY CONTAIN ENTRIES.


code: COV

display: coverage

definition:
When used in the EVN mood, this concept means with respect to a covered party:

                              A health care insurance policy or plan that is contractually binding between two or more parties; or

                              A health care program, usually administered by government entities, that provides coverage to persons determined eligible under the terms of the program.

                              When used in the definition (DEF) mood, COV means potential coverage for a patient who may or may not be a covered party.

                              The concept's meaning is fully specified by the choice of ActCoverageTypeCode (abstract) ActProgramCode or ActInsurancePolicyCode.

hierarchy: ACT CNTRCT FCNTRCT


code: OBSSER

display: observation series

definition: Container for Correlated Observation Sequences sharing a common frame of reference.  All Observations of the same cd must be comparable and relative to the common frame of reference.  For example, a 3-channel ECG device records a 12-lead ECG in 4 steps (3 leads at a time).  Each of the separate 3-channel recordings would be in their own "OBSCOR".  And, all 4 OBSCOR would be contained in one OBSSER because all the times are relative to the same origin (beginning of the recording) and all the ECG signals were from a fixed set of electrodes.

hierarchy: ACT OBS


code: CDALVLONE

display: CDA Level One clinical document

definition: A clinical document that conforms to Level One of the HL7 Clinical Document Architecture (CDA)

hierarchy: ACT _ActClassRecordOrganizer COMPOSITION DOC DOCCLIN


code: SBADM

display: substance administration

definition:
The act of introducing or otherwise applying a substance to the subject.

                           Discussion: The effect of the substance is typically established on a biochemical basis, however, that is not a requirement. For example, radiotherapy can largely be described in the same way, especially if it is a systemic therapy such as radio-iodine.  This class also includes the application of chemical treatments to an area.

                           Examples: Chemotherapy protocol; Drug prescription; Vaccination record

hierarchy: ACT PROC


code: CONTREG

display: container registration

definition: An Act where a container is registered either via an automated sensor, such as a barcode reader,  or by manual receipt


code: DOCCLIN

display: clinical document

definition:
A clinical document is a documentation of clinical observations and services, with the following characteristics:

                              Persistence - A clinical document continues to exist in an unaltered state, for a time period defined by local and regulatory requirements;

                              Stewardship - A clinical document is maintained by a person or organization entrusted with its care;

                              Potential for authentication - A clinical document is an assemblage of information that is intended to be legally authenticated;

                              Wholeness - Authentication of a clinical document applies to the whole and does not apply to portions of the document without the full context of the document;

                              Human readability - A clinical document is human readable.

hierarchy: ACT _ActClassRecordOrganizer COMPOSITION DOC


definition:
An instance of Observation of a Condition at a point in time that includes any Observations or Procedures associated with that Condition as well as links to previous instances of Condition Node for the same Condition

                              Deprecation Comment:
                           This concept has been deprecated because an alternative structure for tracking the evolution of a problem has been presented and adopted by the Care Provision Work Group.

code: CNOD

display: Condition Node


code: vegetarian

display: Vegetarian

definition: Food without meat, poultry or seafood.


code: dairy-free

display: Dairy Free

definition: Excludes dairy products.


code: nut-free

display: Nut Free

definition: Excludes ingredients containing nuts.


code: gluten-free

display: Gluten Free

definition: Excludes ingredients containing gluten.


code: vegan

display: Vegan

definition: Food without meat, poultry, seafood, eggs, dairy products and other animal-derived substances.


code: halal

display: Halal

definition: Foods that conform to Islamic law.


code: kosher

display: Kosher

definition: Foods that conform to Jewish dietary law.


code: AA

display: Application Acknowledgement Accept

definition: Receiving application successfully processed message.


code: AE

display: Application Acknowledgement Error

definition: Receiving application found error in processing message.  Sending error response with additional error detail information.


code: AR

display: Application Acknowledgement Reject

definition: Receiving application failed to process message for reason unrelated to content or format.  Original message sender must decide on whether to automatically send message again.


code: CA

display: Accept Acknowledgement Commit Accept

definition: Receiving message handling service accepts responsibility for passing message onto receiving application.


code: CE

display: Accept Acknowledgement Commit Error

definition: Receiving message handling service cannot accept message for any other reason (e.g. message sequence number, etc.).


code: CR

display: Accept Acknowledgement Commit Reject

definition: Receiving message handling service rejects message if interaction identifier, version or processing mode is incompatible with known receiving application role information.


code: L

display: Local facility/user facility

nl: Lokale afdeling/gebruiker afdeling


code: R

display: Regulatory agency

nl: Toezichthoudend orgaan


definition:
Definition: A jurisdictional mandate in the U.S. relating to privacy.

                           Usage Note: ActPrivacyLaw codes may be associated with an Act or a Role to indicate the legal provision to which the assignment of an Act.confidentialityCode or Role.confidentialtyCode complies.  May be used to further specify rationale for assignment of other ActPrivacyPolicy codes in the US realm, e.g., ETH and 42CFRPart2 can be differentiated from ETH and Title38Part1.

display: ActUSPrivacyLaw


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.

display: 42 CFR Part2


definition:
U.S. Federal regulations governing the protection of human subjects in research (codified at Subpart A of 45 CFR part 46) that has been adopted by 15 U.S. Federal departments and agencies in an effort to promote uniformity, understanding, and compliance with human subject protections. Existing regulations governing the protection of human subjects in Food and Drug Administration (FDA)-regulated research (21 CFR parts 50, 56, 312, and 812) are separate from the Common Rule but include similar requirements.

                           Definition: U.S. federal laws governing research-related privacy policies.

                           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.confidentialtyCode complies.

code: CommonRule

display: Common Rule


definition:
The U.S. Public Law 104-191 Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule (45 CFR Part 164 Subpart E) permits access, use and disclosure of certain personal health information (PHI as defined under the law) for purposes of Treatment, Payment, and Operations, and requires that the provider ask that patients acknowledge the Provider's Notice of Privacy Practices as permitted conduct under the law.

                           Definition: Notification of HIPAA Privacy Practices.

                           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.confidentialtyCode complies.

code: HIPAANOPP

display: HIPAA notice of privacy practices


definition:
The U.S. Public Law 104-191 Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule (45 CFR Part 164 Section 164.508) requires authorization for certain uses and disclosure of psychotherapy notes.

                           Definition: Authorization that must be obtained for disclosure of psychotherapy notes.

                           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: HIPAAPsyNotes

display: HIPAA psychotherapy notes


definition:
Section 13405(a) of the Health Information Technology for Economic and Clinical Health Act (HITECH) stipulates the right of an individual to have disclosures regarding certain health care items or services for which the individual pays out of pocket in full restricted from a health plan.

                           Definition: Non-disclosure of health information to a health plan relating to health care items or services for which an individual pays out of pocket in full.

                           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: HIPAASelfPay

display: HIPAA self-pay


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 fulfill 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 - Â§1.462 Confidentiality restrictions.

(a) General. The patient records to which Â§Â§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.

display: Title 38 Section 7332


code: instance

display: Instance

definition: The CapabilityStatement instance represents the present capabilities of a specific system instance.  This is the kind returned by /metadata for a FHIR server end-point.


code: capability

display: Capability

definition: The CapabilityStatement instance represents the capabilities of a system or piece of software, independent of a particular installation.


code: requirements

display: Requirements

definition: The CapabilityStatement instance represents a set of requirements for other systems to meet; e.g. as part of an implementation guide or 'request for proposal'.


code: any

display: Any

definition: Any payload type can be used with this endpoint, it is either a payload agnostic infrastructure (such as a storage repository), or some other type of endpoint where payload considerations are internally handled, and not available


definition: This endpoint does not require any content to be sent; simply connecting to the endpoint is enough notification. This can be used as a 'ping' to wakeup a service to retrieve content, which could be to ensure security considerations are correctly handled


code: notIn

display: notIn

definition: Compare value not within a known set of values.


code: greaterThan

display: greaterThan

definition: Compare value to be greater than a known value.


code: contains

display: contains

definition: Compare value string contains a known value.


code: notEmpty

display: notEmpty

definition: Compare value is not empty.


code: eval

display: evaluate

definition: Evaluate the FHIRPath expression as a boolean condition.


code: empty

display: empty

definition: Compare value is empty.


code: lessThan

display: lessThan

definition: Compare value to be less than a known value.


code: notEquals

display: notEquals

definition: Not equals comparison.


code: equals

display: equals

definition: Default value. Equals comparison.


code: in

display: in

definition: Compare value within a known set of values.


code: notContains

display: notContains

definition: Compare value string does not contain a known value.


code: A

display: Alphabetic (i.e., Default or some single-byte)

nl: Alfabetisch (d.w.z. standaard of bepaalde 1-byte)


code: I

display: Ideographic (i.e., Kanji)

nl: Ideografisch (d.w.z. Kanjii)


code: P

display: Phonetic (i.e., ASCII, Katakana, Hiragana, etc.)

nl: Fonetisch (d.w.z. ASCII, Katakane, Hirogana, etc.)


code: consequence

display: Consequence

definition: The message represents/requests a change that should not be processed more than once; e.g., making a booking for an appointment.


code: currency

display: Currency

definition: The message represents a response to query for current information. Retrospective processing is wrong and/or wasteful.


code: notification

display: Notification

definition: The content is not necessarily intended to be current, and it can be reprocessed, though there may be version issues created by processing old notifications.


code: Complete

display: A request to add a completed appointment, used to maintain records of completed appointments that did not appear in the schedule (e.g., STAT, walk-in, etc.)

nl: Een verzoek voor toevoegen voltooide afspraak, gebruikt voor bijhouden naslag van voltooide afspraken die niet in de agenda verschenen (bijv. STAT, inloop, etc.)


code: Normal

display: Routine schedule request type – default if not valued

nl: Routine agendaverzoek type - standaardwaarde als geen waarde


code: Tentative

display: A request for a tentative (e.g., “penciled in”) appointment

nl: Een verzoek voor een voorlopige afspraak (bijv. "met potlood toegevoegd")


code: inpatient

display: Inpatient

definition: Includes requests for medications to be administered or consumed in an inpatient or acute care setting


code: outpatient

display: Outpatient

definition: Includes requests for medications to be administered or consumed in an outpatient setting (for example, Emergency Department, Outpatient Clinic, Outpatient Surgery, Doctor's office)


code: community

display: Community

definition: Includes requests for medications to be administered or consumed by the patient in their home (this would include long term care or nursing homes, hospices, etc.)


code: discharge

display: Discharge

definition: Includes requests for medications created when the patient is being released from a facility


code: indel

display: INDEL Comparison

definition: INDEL Comparison.


code: unknown

display: UNKNOWN Comparison

definition: UNKNOWN Comparison.


code: ProbabilityScale

display: Probability Scale


code: organ

display: Organ

definition: A collection of tissues joined in a structural unit to serve a common function.


code: tissue

display: Tissue

definition: An ensemble of similar cells and their extracellular matrix from the same origin that together carry out a specific function.


code: biologicalAgent

display: BiologicalAgent

definition: Biological agent of unspecified type.


code: TMP

display: temporary address

definition: Description: A temporary address, may be good for visit or mailing. Note that an address history can provide more detailed information.


code: PST

display: postal address

definition: Description: Used to send mail.


definition: Description: Address uses that can apply to both postal and telecommunication addresses.


code: PHYS

display: physical visit address

definition: Description: Used primarily to visit an address.


code: H

display: home address

definition: Description: A communication address at a home, attempted contacts for business purposes might intrude privacy and chances are one will contact family or other household members instead of the person one wishes to call. Typically used with urgent cases, or if no other contacts are available.


code: WP

display: work place

definition: Description: An office address. First choice for business related contacts during business hours.


code: BAD

display: bad address

definition: Description: A flag indicating that the address is bad, in fact, useless.


code: PUB

display: public

definition: Description: Indicates a work place address or telecommunication address that is a 'standard' address which may reach a reception service, mail-room, or other intermediary prior to the target entity.


code: DIR

display: direct

definition: Description: Indicates a work place address or telecommunication address that reaches the individual or organization directly without intermediaries. For phones, often referred to as a 'private line'.


code: CONF

display: confidential address

definition: Description: Indicates that the address is considered sensitive and should only be shared or published in accordance with organizational controls governing patient demographic information with increased sensitivity. Uses of Addresses.   Lloyd to supply more complete description.


code: HV

display: vacation home

definition: Description: A vacation home, to reach a person while on vacation.


definition: Description: Address uses that only apply to postal addresses, not telecommunication addresses.


code: AS

display: answering service

definition: Description: An automated answering machine used for less urgent cases and if the main purpose of contact is to leave a message or access an automated announcement.


code: EC

display: emergency contact

definition: Description: A contact specifically designated to be used for emergencies. This is the first choice in emergencies, independent of any other use codes.


definition: Description: Address uses that only apply to telecommunication addresses, not postal addresses.


code: PG

display: pager

definition: Description: A paging device suitable to solicit a callback or to leave a very short message.


code: MC

display: mobile contact)

definition: Description: A telecommunication device that moves and stays with its owner. May have characteristics of all other use codes, suitable for urgent matters, not the first choice for routine business.


code: HP

display: primary home

definition: Description: The primary home, to reach a person after business hours.


code: OLD

display: no longer in use

definition:
This address is no longer in use.

                           Usage Note: Address may also carry valid time ranges. This code is used to cover the situations where it is known that the address is no longer valid, but no particular time range for its use is known.


code: dichotomous

display: Dichotomous

definition: The variable is dichotomous, such as present or absent.


code: continuous

display: Continuous

definition: The variable is a continuous result such as a quantity.


code: descriptive

display: Descriptive

definition: The variable is described narratively rather than quantitatively.


code: admit

display: Admit

definition: The patient has been admitted.


code: discharge

display: Discharge

definition: The patient has been discharged.


code: absent

display: Absent

definition: The patient has temporarily left the institution.


code: return

display: Returned

definition: The patient has returned from a temporary absence.


code: moved

display: Moved

definition: The patient has been moved to a new location.


code: edit

display: Edit

definition: Encounter details have been updated (e.g. to correct a coding error).


code: AN

display: Ascending, case insensitive

nl: Oplopend, niet-hoofdlettergevoelig


code: DN

display: Descending, case insensitive

nl: Aflopend, niet-hoofdlettergevoelig


code: D

display: On discharge

de: Bei Entlassung

nl: Bij ontslag


code: O

display: On receipt of order

de: Bei Auftragseingang

nl: Bij ontvangst van aanvraag


code: R

display: At time service is completed

de: Mit Ende der Leistungserbringung

nl: Bij voltooiing service


code: S

display: At time service is started

de: Am Beginn der Leistungserbringung

nl: Bij aanvang service


code: T

display: At a designated date/time

de: Zum angegebenen Zeitpunkt

nl: Op opgegeven moment


code: active

display: Active

definition: The subject is currently experiencing the symptoms of the condition or there is evidence of the condition.


code: recurrence

display: Recurrence

definition: The subject is experiencing a re-occurence or repeating of a previously resolved condition, e.g. urinary tract infection, pancreatitis, cholangitis, conjunctivitis.


code: relapse

display: Relapse

definition: The subject is experiencing a return of a condition, or signs and symptoms after a period of improvement or remission, e.g. relapse of cancer, multiple sclerosis, rheumatoid arthritis, systemic lupus erythematosus, bipolar disorder, [psychotic relapse of] schizophrenia, etc.


code: inactive

display: Inactive

definition: The subject is no longer experiencing the symptoms of the condition or there is no longer evidence of the condition.


code: remission

display: Remission

definition: The subject is no longer experiencing the symptoms of the condition, but there is a risk of the symptoms returning.


code: resolved

display: Resolved

definition: The subject is no longer experiencing the symptoms of the condition and there is a negligible perceived risk of the symptoms returning.


display: MedicationCap

definition: Cap types for medication containers


code: CHILD

display: ChildProof

definition: A cap designed to be difficult to open for children.  Generally requires multiple simultaneous actions (e.g. squeeze and twist) to open.  Used for products that may be dangerous if ingested or overdosed by children.


code: EASY

display: EasyOpen

definition: A cap designed to be easily removed.  For products intended to be opened by persons with limited strength or dexterity.


code: FILM

display: Film

definition: A non-reactive plastic film covering over the opening of a container.


code: FOIL

display: Foil

definition: A foil covering (type of foil not specified) over the opening of a container


code: PUSH

display: Push Cap

definition: A non-threaded cap that forms a tight-fitting closure on a container by pushing the fitted end into the conatiner opening


code: SCR

display: Screw Cap

definition: A threaded cap that is screwed onto the opening of a container


code: postal

display: Postal

definition: Mailing addresses - PO Boxes and care-of addresses.


code: physical

display: Physical

definition: A physical address that can be visited.


code: both

display: Postal & Physical

definition: An address that is both physical and postal.


code: GRNDCHILD

display: grandchild

definition: The player of the role is a child of the scoping person's son or daughter.


code: STPFTH

display: stepfather

definition: The player of the role is the husband of scoping person's mother and not the scoping person's natural father.

hierarchy: _PersonalRelationshipRoleType FAMMEMB PRN FTH


display: AffiliationRoleType

definition:
Concepts characterizing the type of association formed by player and scoper when there is a recognized Affiliate role by which the two parties are related.

                           Examples: Business Partner, Business Associate, Colleague


code: PAYOR

display: Payor Contact

definition: A contact role used to identify a person within a Payor organization to whom this communication is addressed.


code: PEDNICU

display: Pediatric neonatal intensive care unit

definition: Pediatric neonatal intensive care unit


code: MTHINLAW

display: mother-in-law

definition: The player of the role is the mother of the scoping person's husband or wife.

hierarchy: _PersonalRelationshipRoleType FAMMEMB EXT INLAW PRNINLAW


definition: Description:Describes types of identifiers other than the primary location registry identifier for a service delivery location.  Identifiers may be assigned by a local service delivery organization, a formal body capable of accrediting the location for the capability to provide specific services or the identifier may be assigned at a jurisdictional level.

display: LocationIdentifiedEntityRoleCode


code: TRAVEL

display: Travel and geographic medicine clinic

definition: Travel and geographic medicine clinic


display: ResearchSubjectRoleBasis

definition: Specifies the administrative functionality within a formal experimental design for which the ResearchSubject role was established.  Examples: screening - role is used for pre-enrollment evaluation portion of the design; enrolled - role is used for subjects admitted to the active treatment portion of the design.


code: PROG

display: program eligible

definition: A party that meets the eligibility criteria for coverage under a program.


code: RESPRSN

display: responsible party

definition: The role played by a party who has legal responsibility for another party.


code: INJWKR

display: injured worker

definition:
Description: A person playing the role of program eligible under a workers compensation program based on the filing of work-related injury claim.

                           Discussion:  This CoveredPartyRoleType.code is used when the CoveredPartyRole class code is either "program eligible", a "named insured", and "individual insured",  or "dependent", and the person's status as differently abled or "handicapped" meets jurisdictional, policy, or program criteria.


code: ICU

display: Intensive care unit

definition: Intensive care unit


code: INDIV

display: individual

definition: A party covered under a policy as the policyholder.


code: FI

display: Fiber

definition: Animals raised for their fur, hair or skins


definition: Description: The player of the role is a male child (of any type) of scoping entity (parent)

child: SONADOPT SONFOST SON

code: SONC

display: son


code: RADDX

display: Radiology diagnostics or therapeutics unit

definition: A practice setting where radiology services (diagnostic or therapeutic) are provided            (X12N 261QR0200N)


code: HOSP

display: Hospital

definition: An acute care institution that provides medical, surgical, or psychiatric care and treatment for the sick or the injured.


code: CCO

display: Clinical Companion

definition: Description:Companion animals, such as dogs, cats, and rabbits, which may be provided to patients to improve general mood, decrease depression and loneliness, and distract from stress-inducing concerns to improve quality of life.


code: SCN

display: screening

definition: Definition:The specific role being played by a research subject participating in the pre-enrollment evaluation portion of  a research study.


display: ServiceDeliveryLocationRoleType

definition: A role of a place that further classifies the setting (e.g., accident site, road side, work site, community location) in which services are delivered.


code: CHLDFOST

display: foster child

definition: The player of the role is a child receiving parental care and nurture from the scoping person (parent) but not related to him or her through legal or blood ties.


code: SCHOOL

display: school

definition: Location where healthcare service was delivered, identified as a school or educational facility.


code: MGRMTH

display: maternal grandmother

definition: Description:The player of the role is the biological mother of the scoping person's biological mother.

hierarchy: _PersonalRelationshipRoleType FAMMEMB EXT GRPRN GRMTH


code: GRANTEE

display: grantee

definition: An entity which accepts certain rights or authority from a grantor.


code: BMTC

display: Bone marrow transplant clinic

definition: Bone marrow transplant clinic


code: OMS

display: Oral and maxillofacial surgery clinic

definition: Oral and maxillofacial surgery clinic


code: STPDAU

display: stepdaughter

definition: The player of the role is a daughter of the scoping person's spouse by a previous union.

hierarchy: _PersonalRelationshipRoleType FAMMEMB CHILD DAUC


code: FRND

display: unrelated friend

definition: The player of the role is a person who is known, liked, and trusted by the scoping person.


code: HPOWATT

display: healthcare power of attorney

definition: A relationship between two people in which one person authorizes another to act for him or her in a manner which is a legally binding upon the person giving such authority as if he or she personally were to do the acts that continues (by its terms) to be effective even though the grantor has become mentally incompetent after signing the document.

hierarchy: _AffiliationRoleType RESPRSN POWATT


code: RHAT

display: addiction treatment center

definition: Description: A location that plays the role of delivering services which may include life training and/or social support to people with addictions.


code: NSIS

display: natural sister

definition: The player of the role is a female having the same biological parents as the scoping entity.

hierarchy: _PersonalRelationshipRoleType FAMMEMB SIB NSIB


code: MGGRMTH

display: maternal great-grandmother

definition: Description:The player of the role is the biological mother of the scoping person's biological mother's parent.

hierarchy: _PersonalRelationshipRoleType FAMMEMB EXT GGRPRN GGRMTH


code: MU

display: Multiplier

definition: Poultry flocks used for chick/poult production


code: SIGOTHR

display: significant other

definition: A person who is important to one's well being; especially a spouse or one in a similar relationship.  (The player is the one who is important)


code: SEE

display: Seeing

definition: Description:Dogs trained to assist persons who are seeing impaired or blind.


code: CONSWIT

display: consent witness

definition: An entity which has witnessed and attests to observing another entity being counseled about an agreement such as a consent for services, advanced directive, or a privacy consent directive.


code: SPS

display: spouse

definition: The player of the role is a marriage partner of the scoping person.


code: GDF

display: generic drug form

definition: Relates a manufactured drug product to the non-proprietary (generic) representation of its ingredients and dose form, independent of strength of the ingredients. The scoping entity identifies a unique combination of medicine ingredients in a specific dose form.


code: ENDO

display: Endocrinology clinic

definition: Endocrinology clinic


code: AMB

display: Ambulance

definition: Location (mobile) where healthcare service was delivered, identified specifically as an ambulance.


code: ONCL

display: Medical oncology clinic

definition: Medical oncology clinic


code: FSTUD

display: full-time student

definition: Covered party to an insurance policy has coverage through full-time attendance at a recognized educational institution as defined by a particular insurance policy.


code: Q

display: Quality Control

definition: A specimen specifically used to verify the sensitivity, specificity, accuracy or other perfomance parameter of a diagnostic test.


code: STPSIS

display: stepsister

definition: The player of the role is a daughter of the scoping person's stepparent.

hierarchy: _PersonalRelationshipRoleType FAMMEMB SIB SIS


code: PSY

display: Psychiatry clinic

definition: Psychiatry clinic


code: SONFOST

display: foster son

definition: The player of the role is a male child receiving parental care and nurture from the scoping person (parent) but not related to him or her through legal or blood ties.

hierarchy: _PersonalRelationshipRoleType FAMMEMB CHILD CHLDFOST


code: DRIVCLASSIFIER

display: derivative classifier

definition: An individual who is only authorized to classify reproduced, extracted, or summarized classified information, or compile classified and unclassified information by applying classification markings derived from source material or as directed by a classification guide.


code: PEDGI

display: Pediatric gastroenterology clinic

definition: Pediatric gastroenterology clinic


code: VL

display: Veal

definition: Cattle raised for veal meat production.  Implicit is the husbandry method.


code: RHPIMS

display: physical impairment - motor skills center

definition: Description: A location that plays the role of delivering services for people with motor skill impairments.


code: INTPRTER

display: interpreter

definition: An entity which converts spoken or written language into the language of key participants in an event such as when a provider is obtaining a patient's consent to treatment or permission to disclose information.


code: DX

display: Diagnostics or therapeutics unit

definition: A practice setting where diagnostic procedures or therapeutic interventions are performed


definition:
Description:PayorRoleType for a particular type of policy or program benefit package or plan where more detail about the coverage administration role of the Payor is required.  The functions performed by a Payor qualified by a PayorRoleType may be specified by the PayorParticpationFunction value set.

                           Examples:A Payor that is a TPA may administer a managed care plan without underwriting the risk.

display: PayorRoleType


code: RHPIH

display: physical impairment - hearing center

definition: Description: A location that plays the role of delivering services for people with hearing impairments.


code: NIENEPH

display: niece/nephew

definition: The player of the role is a child of scoping person's brother or sister or of the brother or sister of the 	scoping person's spouse.


code: GCHILD

display: grandchild

definition: A child of one's son or daughter.


code: STUD

display: student

definition: Covered party to an insurance policy has coverage through full-time or part-time attendance at a recognized educational institution as defined by a particular insurance policy.


code: BILL

display: Billing Contact

definition: A contact role used to identify a person within a Provider organization that can be contacted for billing purposes (e.g. about the content of the Invoice).


definition: Description: The player of the role is a female child (of any type) of scoping entity (parent)

child: DAUADOPT DAUFOST

code: DAUC

display: daughter


code: RHPI

display: physical impairment center

definition: Description: A location that plays the role of delivering services which may include adaptation, rehabilitation and social integration services for people with physical impairments.


code: HBRO

display: half-brother

definition: The player of the role is a male related to the scoping entity by sharing only one biological parent.

hierarchy: _PersonalRelationshipRoleType FAMMEMB SIB BRO


code: DEBR

display: Debridement

definition:
Description:Maggots raised for biodebridement.

                           Discussion: Maggot Debridement Therapy is the medical use of live maggots for cleaning non-healing wounds.

                           Examples:Removal of burnt skin.


code: pathologist

display: Pathologist

definition: Pathologist


definition: A contact role used for business and/or administrative purposes.

display: AdministrativeContactRoleType


code: L

display: Pool

definition: Aliquots of individual specimens combined to form a single specimen representing all of the included individuals.


code: CHR

display: Chronic Care Facility

definition: (1) A hospital including a physical plant and personnel that provides multidisciplinary diagnosis and treatment for diseases that have one or more of the following characteristics: is permanent; leaves residual disability; is caused by nonreversible pathological alteration; requires special training of the patient for rehabilitation; and/or may be expected to require a long period of supervision or care. In addition, patients require the safety, security, and shelter of these specialized inpatient or partial hospitalization settings. (2) A hospital that provides medical and skilled nursing services to patients with long-term illnesses who are not in an acute phase but who require an intensity of services not available in nursing homes


display: PolicyOrProgramCoverageRoleType

definition:
Description: A role recognized through the eligibility of an identified party for benefits covered under an insurance policy or a program based on meeting eligibility criteria.

                        Eligibility as a covered party may be conditioned on the party meeting criteria to qualify for coverage under a policy or program, which may be mandated by law.  These criteria may be:

                              The sole basis for coverage, e.g., being differently abled may qualify a person for disability coverage

                              May more fully qualify a covered party role e.g, being differently abled may qualify an adult child as a dependent

                              May impact the level of coverage for a covered party under a policy or program, e.g., being differently abled may qualify a program eligible for additional benefits.

                           Discussion:  The Abstract Value Set "CoverageRoleType", which was developed for use in the Canadian realm "pre-coordinate" coverage roles with other roles that a covered party must play in order to be eligible for coverage, e.g., "handicapped dependent".   These role.codes may only be used with COVPTY to avoid overlapping concepts that would result from using them to specify the specializations of COVPTY, e.g., the role.class DEPEN should not be used with the role.code family dependent because that relationship has overlapping concepts due to the role.code precoodination and is conveyed in FICO with the personal relationship role that has a PART role link to the covered party role.  For the same reasons, the role.class DEPEN should not be used with the role.code HANDIC (handicapped dependent); the role.code DIFFABLE (differently abled) should be used instead.

                        In summary, the coded concepts in the Abstract Value Set "CoveredPartyRoleType" can be "post-coordinated" with the "RoleClassCoveredParty" Abstract Value Set.  Decoupling these concepts is intended to support an expansive range of covered party concepts and their semantic comparability.


code: SIBINLAW

display: sibling in-law

definition: The player of the role is: (1) a sibling of the scoping person's spouse, or (2) the spouse of the scoping person's sibling, or (3) the spouse of a sibling of the scoping person's spouse.

hierarchy: _PersonalRelationshipRoleType FAMMEMB EXT INLAW


code: CONSENTER

display: consenter

definition: An entity or an entity's delegatee who is the grantee in an agreement such as a consent for services, advanced directive, or a privacy consent directive in accordance with jurisdictional, organizational, or patient policy.


code: NBOR

display: neighbor

definition: The player of the role lives near or next to the 	scoping person.


code: PRN

display: parent

definition: The player of the role is one who begets, gives birth to, or nurtures and raises the scoping entity (child).


code: NAMED

display: named insured

definition: A party to an insurance policy to whom the insurer agrees to indemnify for losses, provides benefits for, or renders services.


code: NIECE

display: niece

definition: The player of the role is a daughter of the scoping person's brother or sister or of the brother or sister of the 	scoping person's spouse.

hierarchy: _PersonalRelationshipRoleType FAMMEMB EXT NIENEPH


definition: The player of the role is a male who begets or raises or nurtures the scoping entity (child).

child: ADOPTF

code: FTH

display: father


definition: The player of the role is a child of the scoping person's spouse by a previous union.

child: STPDAU STPSON

code: STPCHLD

display: step child


code: NBRO

display: natural brother

definition: The player of the role is a male having the same biological parents as the scoping entity.


code: GACH

display: Hospitals; General Acute Care Hospital


code: CRS

display: Colon and rectal surgery clinic

definition: Colon and rectal surgery clinic


code: PGRFTH

display: paternal grandfather

definition: Description:The player of the role is the biological father of the scoping person's biological father.

hierarchy: _PersonalRelationshipRoleType FAMMEMB EXT GRPRN GRFTH


code: GRPRN

display: grandparent

definition: The player of the role is a parent of the scoping person's mother or father.


code: INLAB

display: inpatient laboratory

definition: Description: A location that plays the role of delivering services which may include tests are done on clinical specimens to get health information about a patient pertaining to the diagnosis, treatment, and prevention of disease for a hospital visit longer than one day.


code: SON

display: natural son

definition: The player of the role is a male offspring of the scoping entity (parent).

hierarchy: _PersonalRelationshipRoleType FAMMEMB CHILD NCHILD


code: STEP

definition: A child receiving parental care and nurture from a person who is related to them through marriage to their parent.


code: ADOPTP

display: adoptive parent

definition: The player of the role (parent) has taken the scoper (child) into their family through legal means and raises them as his or her own child.


code: ORG

display: organizational contact

definition:
A contact for an organization for administrative purposes. Contact role specifies a person acting as a liason for the organization.

                        Example: HR Department representative.


code: JURID

display: jurisdiction location identifier

definition: Description:Identifier assigned to a location by a jurisdiction.


code: RHMAD

display: parents with adjustment difficulties center

definition: Description: A location that plays the role of delivering services which may social support services for adolescents who are pregnant or have child and are experiencing adaptation issues/difficulties in their current or eventual parenting role.


code: PROS

display: Prosthodontics clinic

definition: Prosthodontics clinic


display: PersonalRelationshipRoleType

definition: PersonalRelationshipRoleType


code: G

display: Group

definition: A set of patient samples in which the individuals of the group may or may not be identified.


code: GYN

display: Gynecology clinic

definition: Gynecology clinic


code: MGGRFTH

display: maternal great-grandfather

definition: Description:The player of the role is the biological father of the scoping person's biological mother's parent.

hierarchy: _PersonalRelationshipRoleType FAMMEMB EXT GGRPRN GGRFTH


definition: The player of the role is related to the scoping entity by sharing only one biological parent.

child: HBRO

code: HSIB

display: half-sibling


code: MHSP

display: Military Hospital

definition: A health care facility operated by the Department of Defense or other military operation.


definition: A role of a place that further classifies a setting that is intended to house the provision of services.


code: FAMDEP

display: family dependent

definition: The player of the role is dependent of the scoping entity.


code: CSC

display: community service center

definition: Description: A location that plays the role of delivering services which may include providing front-line services to the population of a defined geographic area such as: healthcare services and social services, preventive or curative, rehabilitation or reintegration.


code: COCBEN

display: continuity of coverage beneficiary

definition:
Description: A person playing the role of an individual insured with continuity of coverage under a policy which is being terminated based on loss of original status that was the basis for coverage.  Criteria for qualifying for continuity of coverage may be set by law.

                           Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible" or "subscriber" and the person's status as a continuity of coverage beneficiary meets jurisdictional or policy criteria.


code: PEDHEM

display: Pediatric hematology clinic

definition: Pediatric hematology clinic


code: CRP

display: non-country member with residence permit

definition: A foreigner who is a resident of the country but does not have citizenship.


code: COPART

display: co-participant

definition: An entity which participates in the generation of and attest to veracity of content, but is not an author or coauthor. For example a surgeon who is required by institutional, regulatory, or legal rules to sign an operative report, but who was not involved in the authorship of that report.


code: EXT

display: extended family member

definition: Description: A family member not having an immediate genetic or legal relationship e.g. Aunt, cousin, great grandparent, grandchild, grandparent, niece, nephew or uncle.


code: DOMPART

display: domestic partner

definition: The player of the role cohabits with the scoping person but is not the scoping person's spouse.


code: MGDSF

display: manufactured drug strength form

definition: Relates a manufactured drug product to the non-proprietary (generic) representation of its ingredients with their strength in a specific dose form. The scoping entity identifies a unique combination of medicine ingredients with their strength in a single dose form.


code: HANDIC

display: handicapped dependent

definition: Covered party is a dependent of the policy holder with a physical or mental disability causing a disadvantage that makes independent achievement unusually difficult.


code: PAUNT

display: paternal aunt

definition: Description:The player of the role is a biological sister of the scoping person's biological father.

hierarchy: _PersonalRelationshipRoleType FAMMEMB EXT AUNT


code: DERM

display: Dermatology clinic

definition: Dermatology clinic


definition: The player of the role is a female sharing one or both parents in common with the scoping entity.

child: HSIS NSIS

code: SIS

display: sister


definition: The player of the role is an offspring of the scoping entity as determined by birth.

child: DAU

code: NCHILD

display: natural child


display: MedicationGeneralizationRoleType

definition:
Identifies the specific hierarchical relationship between the playing and scoping medications.

                           Examples: Generic, Generic Formulation, Therapeutic Class, etc.


code: PT

display: Patient

definition: The recipient for the service(s) and/or product(s) when they are not the covered party.


code: FTHINLAW

display: father-in-law

definition: The player of the role is the father of the scoping person's husband or wife.


definition: The player of the role is the spouse of the scoping person's parent and not the scoping person's natural parent.

child: STPFTH STPMTH

code: STPPRN

display: step parent


code: COAG

display: Coagulation clinic

definition: Coagulation clinic


code: SNIFF

display: Sniffing

definition: Description:Dogs trained or having the ability to detect imminent seizures or cancers in humans, probably as a result of volatile chemical (odors) given off by the malignancy of the host.


definition: Description:The player of the role is a biological parent of the scoping person's biological mother's parent.

child: MGGRFTH MGGRMTH

code: MGGRPRN

display: maternal great-grandparent

hierarchy: _PersonalRelationshipRoleType FAMMEMB EXT GGRPRN


code: INV

display: Infertility clinic

definition: Infertility clinic


code: WORK

display: work site

definition: Location where healthcare service was delivered, identified as a work place.


definition: A role of a place that further classifies the clinical setting (e.g., cardiology clinic, primary care clinic, rehabilitation hospital, skilled nursing facility) in which care is delivered during an encounter.

display: DedicatedClinicalLocationRoleType


code: MOBL

display: Mobile Unit

definition: Location (mobile) where healthcare service was delivered.


code: DIFFABL

display: differently abled

definition:
Description: A person playing the role of program eligible under a program based on meeting criteria for health or functional limitation set by law or by the program.

                           Discussion: This CoveredPartyRoleType.code is typically used when the CoveredPartyRole class code is either "program eligible", "named insured", "individual insured", or "dependent", and the person's status as differently abled meets jurisdictional, policy, or program criteria.


code: communityLaboratory

display: Community Laboratory

definition: Community Laboratory


code: HTN

display: Hypertension clinic

definition: Hypertension clinic


code: GIM

display: General internal medicine clinic

definition: General internal medicine clinic


code: FULLINS

display: Fully insured coverage sponsor

definition: Description:An employer or organization that contracts with an underwriter to assumes the financial risk and administrative responsibility for coverage of health services for covered parties.


code: SUBSCR

display: subscriber

definition: A party covered under a policy based on association with a sponsor who is the policy holder, and whose association may provide for the eligibility of dependents for coverage


definition:
A role recognized through the eligibility of an identified living subject for benefits covered under an insurance policy or a program.  Eligibility as a covered party may be conditioned on a relationship with (1) the policy holder such as the policy holder who is covered as an individual under a poliy or as a party sponsored for coverage by the policy holder.

                           Example:An employee as a subscriber; or (2) on being scoped another covered party such as the subscriber, as in the case of a dependent.

                           Discussion:  The Abstract Value Set "CoverageRoleType", which was developed for use in the Canadian realm "pre-coordinate" coverage roles with other roles that a covered party must play in order to be eligible for coverage, e.g., "handicapped dependent".  Other codes in the Abstract Value Set CoveredPartyRoleType domain can be "post-coordinated" with the EligiblePartyRoleType codes to denote comparable concepts.  Decoupling the concepts is intended to support a wider range of concepts and semantic comparability of coded concepts.

display: covered party role type


code: PUNCLE

display: paternal uncle

definition: Description:The player of the role is a biological brother of the scoping person's biological father.

hierarchy: _PersonalRelationshipRoleType FAMMEMB EXT UNCLE


code: FTWINSIS

display: fraternal twin sister

definition: The scoper was carried in the same womb as the female player and shares common biological parents but is the product of a distinct egg/sperm pair.

hierarchy: _PersonalRelationshipRoleType FAMMEMB SIB NSIB NSIS TWINSIS


code: GRNDDAU

display: granddaughter

definition: The player of the role is a daughter of the scoping person's son or daughter.

hierarchy: _PersonalRelationshipRoleType FAMMEMB EXT GRNDCHILD


code: NCCF

display: Nursing or custodial care facility

definition: Nursing or custodial care facility


code: STPMTH

display: stepmother

definition: The player of the role is the wife of scoping person's father and not the scoping person's natural mother.

hierarchy: _PersonalRelationshipRoleType FAMMEMB PRN MTH


code: COMM

display: Community Location

definition: Community location where healthcare is delivered.


code: RHPIVS

display: physical impairment - visual skills center

definition: Description: A location that plays the role of delivering services for people with visual skill impairments.


code: WL

display: Wool

definition: Sheep, goats and other mammals raised for their fiber


code: MTHFOST

display: foster mother

definition:
The player of the role (parent) who is a female state-certified caregiver responsible for the scoper (child) who has been placed in the parent's care. The placement of the child is usually arranged through the government or a social-service agency, and temporary.

                        The state, via a jurisdiction recognized child protection agency, stands as in loco parentis to the child, making all legal decisions while the foster parent is responsible for the day-to-day care of the specified child.


code: REVIEWER

display: reviewer

definition: An entity authorized to filter information according to approved criteria.


code: CAS

display: asylum seeker

definition: A person who has fled his or her home country to find a safe place elsewhere.


code: HEM

display: Hematology clinic

definition: Hematology clinic


code: GGRFTH

display: great grandfather

definition: The player of the role is the father of the scoping person's grandparent.


code: UMO

display: Utilization management organization

definition: Description:A payor that is responsible for review and case management of health services covered under a policy or program.