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4.4.2.88 HL7 v3 Value Set ParticipationFunction

Vocabulary Work Group Maturity Level: N/AExternal Use Context: Any

This value set (http://terminology.hl7.org/ValueSet/v3-ParticipationFunction) is defined as part of HL7 v3.

Summary

Defining URL:http://terminology.hl7.org/ValueSet/v3-ParticipationFunction
Version:2018-08-12
Name:v3.ParticipationFunction
Title:v3 Code System ParticipationFunction
Definition:

This code is used to specify the exact function an actor had in a service in all necessary detail. This domain may include local extensions (CWE).

OID:2.16.840.1.113883.1.11.10267 (for OID based terminology systems)
Source ResourceXML / JSON

This value set is used in the following places:


This value set includes codes from the following code systems:

 

This expansion generated 17 May 2019


This value set contains 41 concepts

Expansion based on http://terminology.hl7.org/CodeSystem/v3-ParticipationFunction version 2018-08-12

All codes from system http://terminology.hl7.org/CodeSystem/v3-ParticipationFunction

LvlCodeDisplayDefinition
0_AuthorizedParticipationFunctionAuthorizedParticipationFunctionThis code is used to specify the exact function an actor is authorized to have in a service in all necessary detail.
1  _AuthorizedReceiverParticipationFunctionAuthorizedReceiverParticipationFunctionThis code is used to specify the exact function an actor is authorized to have as a receiver of information that is the subject of a consent directive or consent override.
2    AUCGcaregiver information receiverDescription:Caregiver authorized to receive patient health information.
2    AULRlegitimate relationship information receiverDescription:Provider with legitimate relationship authorized to receive patient health information.
2    AUTMcare team information receiverDescription:Member of care team authorized to receive patient health information.
2    AUWAwork area information receiverDescription:Entities within specified work area authorized to receive patient health information.
1  _ConsenterParticipationFunctionConsenterParticipationFunctionThis code is used to specify the exact function an actor is authorized to have in authoring a consent directive.
2    GRDCONlegal guardian consent authorDescription:Legal guardian of the subject of consent authorized to author a consent directive for the subject of consent.
2    POACONhealthcare power of attorney consent authorDescription:Person authorized with healthcare power of attorney to author a consent directive for the subject of consent.
2    PRCONpersonal representative consent authorDescription:Personal representative of the subject of consent authorized to author a consent directive for the subject of consent.
2    PROMSKauthorized provider masking authorDefinition:Provider authorized to mask information to protect the patient, a third party, or to ensure that the provider has consulted with the patient prior to release of this information.
2    SUBCONsubject of consent authorDescription:Subject of consent authorized to author a consent directive.
1  _OverriderParticipationFunctionOverriderParticipationFunctionThis code is used to specify the exact function an actor is authorized to have in authoring a consent override.
2    AUCOVconsent overriderDescription:Entity authorized to override a consent directive.
2    AUEMROVemergency overriderDescription:Entity authorized to override a consent directive or privacy policy in an emergency.
0_CoverageParticipationFunctionCoverageParticipationFunctionDefinition: Set of codes indicating the manner in which sponsors, underwriters, and payers participate in a policy or program.
1  _PayorParticipationFunctionPayorParticipationFunctionDefinition: Set of codes indicating the manner in which payors participate in a policy or program.</
2    CLMADJclaims adjudicationDefinition: Manages all operations required to adjudicate fee for service claims or managed care encounter reports.
2    ENROLLenrollment brokerDefinition: Managing the enrollment of covered parties.
2    FFSMGTffs managementDefinition: Managing all operations required to administer a fee for service or indemnity health plan including enrolling covered parties and providing customer service, provider contracting, claims payment, care management and utilization review.
2    MCMGTmanaged care managementDefinition: Managing all operations required to administer a managed care plan including enrolling covered parties and providing customer service,, provider contracting, claims payment, care management and utilization review.
2    PROVMGTprovider managementDefinition: Managing provider contracting, provider services, credentialing, profiling, performance measures, and ensuring network adequacy.
2    UMGTutilization managementDefinition: Managing utilization of services by ensuring that providers adhere to, e.g., payeraTMs clinical protocols for medical appropriateness and standards of medical necessity. May include management of authorizations for services and referrals.
1  _SponsorParticipationFunctionSponsorParticipationFunctionDefinition: Set of codes indicating the manner in which sponsors participate in a policy or program. NOTE: use only when the Sponsor is not further specified with a SponsorRoleType as being either a fully insured sponsor or a self insured sponsor.
2    FULINRDfully insuredDefinition: Responsibility taken by a sponsor to contract with one or more underwriters for the assumption of full responsibility for the risk and administration of a policy or program.
2    SELFINRDself insuredDefinition: Responsibility taken by a sponsor to organize the underwriting of risk and administration of a policy or program.
1  _UnderwriterParticipationFunctionUnderwriterParticipationFunctionDefinition: Set of codes indicating the manner in which underwriters participate in a policy or program.
2    PAYORCNTRpayor contractingDefinition: Contracting for the provision and administration of health services to payors while retaining the risk for coverage. Contracting may be for all provision and administration; or for provision of certain types of services; for provision of services by region; and by types of administration, e.g., claims adjudication, enrollment, provider management, and utilization management. Typically done by underwriters for sponsors who need coverage provided to covered parties in multiple regions. The underwriter may act as the payor in some, but not all of the regions in which coverage is provided.
2    REINSreinsuresDefinition: Underwriting reinsurance for another underwriter for the policy or program.
2    RETROCESretrocessionairesDefinition: Underwriting reinsurance for another reinsurer.
2    SUBCTRTsubcontracting riskDefinition: Delegating risk for a policy or program to one or more subcontracting underwriters, e.g., a major health insurer may delegate risk for provision of coverage under a national health plan to other underwriters by region .
2    UNDERWRTNGunderwritingDefinition: Provision of underwriting analysis for another underwriter without assumption of risk.
0ADMPHYSadmitting physicianA physician who admitted a patient to a hospital or other care unit that is the context of this service.
0ANESTanesthesistIn a typical anesthesia setting an anesthesiologist or anesthesia resident in charge of the anesthesia and life support, but only a witness to the surgical procedure itself. To clarify responsibilities anesthesia should always be represented as a separate service related to the surgery.
0ANRSanesthesia nurseIn a typical anesthesia setting the nurse principally assisting the anesthesiologist during the critical periods.
0ASSEMBLERassembly softwareA device that operates independently of an author on custodian's algorithms for data extraction of existing information for purpose of generating a new artifact. UsageConstraint: ASSEMBLER ParticipationFunction should be used with DEV (device) ParticipationType.
0ATTPHYSattending physicianA physician who is primarily responsible for a patient during the hospitalization, which is the context of the service.
0COMPOSERcomposer softwareA device used by an author to record new information, which may also be used by the author to select existing information for aggregation with newly recorded information for the purpose of generating a new artifact. UsageConstraint: COMPOSER ParticipationFunction should be used with DEV (device) ParticipationType. Usage Note: This code will enable implementers to more specifically represent the manner in which a Device participated in and facilitated the generation of a CDA Clinical Document or a CDA Entry by the responsible Author, which is comprised of the Author's newly entered content, and may include the pre-existing content selected by the Author, for the purpose of establishing the provenance and accountability for these acts.
0DISPHYSdischarging physicianA physician who discharged a patient from a hospital or other care unit that is the context of this service.
0FASSTfirst assistant surgeonIn a typical surgery setting the assistant facing the primary surgeon. The first assistant performs parts of the operation and assists in others (e.g., incision, approach, electrocoutering, ligatures, sutures).
0MDWFmidwifeA person (usually female) helping a woman deliver a baby. Responsibilities vary locally, ranging from a mere optional assistant to a full required participant, responsible for (normal) births and pre- and post-natal care for both mother and baby.
0NASSTnurse assistantIn a typical surgery setting the non-sterile nurse handles material supply from the stock, forwards specimen to pathology, and helps with other non-sterile tasks (e.g., phone calls, etc.).
0PCPprimary care physicianThe healthcare provider that holds primary responsibility for the overall care of a patient.
0PRISURGprimary surgeonIn a typical surgery setting the primary performing surgeon.
0REVIEWERreviewerA verifier who is accountable for reviewing and asserting that the verification of an Act complies with jurisdictional or organizational policy. UsageConstraint: UsageConstraint: Specifies the exact function that an actor is authorized to have as a verifier of an Act. Connotes that a specialized verifier asserts compliance for veracity of the review per jurisdictional or organizational policy. E.g., The Provider who takes responsibility for authenticity of a record submitted to a payer. REVIEW ParticipationFunction should be used with VFR (verifier)
0RNDPHYSrounding physicianA physician who made rounds on a patient in a hospital or other care center.
0SASSTsecond assistant surgeonIn a typical surgery setting the assistant who primarily holds the hooks.
0SNRSscrub nurseIn a typical surgery setting the nurse in charge of the instrumentation.
0TASSTthird assistantIn a typical surgery setting there is rarely a third assistant (e.g., in some Hip operations the third assistant postures the affected leg).