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TX: CodeSystem v3-ActReason

Properties

Language en
Defining URL http://terminology.hl7.org/CodeSystem/v3-ActReason
Version 4.0.0
Name ActReason
Title ActReason
Status active
Definition

A set of codes specifying the motivation, cause, or rationale of an Act, when such rationale is not reasonably represented as an ActRelationship of type "has reason" linking to another Act.

Examples: Example reasons that might qualify for being coded in this field might be: "routine requirement", "infectious disease reporting requirement", "on patient request", "required by law".

Publisher Health Level Seven International
Copyright This material derives from the HL7 Terminology THO. THO is copyright ©1989+ Health Level Seven International and is made available under the CC0 designation. For more licensing information see: https://terminology.hl7.org/license.html

Properties

This code system defines the following properties for its concepts

Code URI Type Description
status http://hl7.org/fhir/concept-properties#status code Designation of a concept's state. Normally is not populated unless the state is retired..
notSelectable http://hl7.org/fhir/concept-properties#notSelectable boolean Indicates that the code is abstract - only intended to be used as a selector for other concepts
HL7usageNotes http://terminology.hl7.org/CodeSystem/utg-concept-properties#HL7usageNotes string HL7 Concept Usage Notes
subsumedBy http://hl7.org/fhir/concept-properties#parent code The concept code of a parent concept

Concepts

This case-sensitive code system http://terminology.hl7.org/CodeSystem/v3-ActReason defines the following codes in a is-a hierarchy:

Code Display Definition HL7 Concept Usage Notes The concept code of a parent concept
_ActAccommodationReason ActAccommodationReason Identifies the reason the patient is assigned to this accommodation type
_ActCoverageReason ActCoverageReason **Description:**Codes used to specify reasons or criteria relating to coverage provided under a policy or program. May be used to convey reasons pertaining to coverage contractual provisions, including criteria for eligibility, coverage limitations, coverage maximums, or financial participation required of covered parties.
_ActInformationManagementReason ActInformationManagementReason **Description:**The rationale or purpose for an act relating to information management, such as archiving information for the purpose of complying with an enterprise data retention policy.
_ActInvalidReason ActInvalidReason **Description:** Types of reasons why a substance is invalid for use.
_ActInvoiceCancelReason ActInvoiceCancelReason Domain specifies the codes used to describe reasons why a Provider is cancelling an Invoice or Invoice Grouping.
_ActNoImmunizationReason ActNoImmunizationReason A coded description of the reason for why a patient did not receive a scheduled immunization. (important for public health strategy
_ActSupplyFulfillmentRefusalReason ActSupplyFulfillmentRefusalReason Indicates why a fulfiller refused to fulfill a supply order, and considered it important to notify other providers of their decision. E.g. "Suspect fraud", "Possible abuse", "Contraindicated". (used when capturing 'refusal to fill' annotations)
_ClinicalResearchEventReason ClinicalResearchEventReason **Definition:**Specifies the reason that an event occurred in a clinical research study.
_ClinicalResearchObservationReason ClinicalResearchObservationReason **Definition:**SSpecifies the reason that a test was performed or observation collected in a clinical research study. **Note:**This set of codes are not strictly reasons, but are used in the currently Normative standard. Future revisions of the specification will model these as ActRelationships and thes codes may subsequently be retired. Thus, these codes should not be used for new specifications.
_CombinedPharmacyOrderSuspendReasonCode CombinedPharmacyOrderSuspendReasonCode **Description:**Indicates why the prescription should be suspended.
_ControlActNullificationReasonCode ControlActNullificationReasonCode **Description:**Identifies reasons for nullifying (retracting) a particular control act.
_ControlActNullificationRefusalReasonType ControlActNullificationRefusalReasonType **Description:** Reasons to refuse a transaction to be undone.
_ControlActReason ControlActReason Identifies why a specific query, request, or other trigger event occurred.
_GenericUpdateReasonCode GenericUpdateReasonCode **Description:**Identifies why a change is being made to a record.
_PatientProfileQueryReasonCode patient profile query reason **Definition:**A collection of concepts identifying why the patient's profile is being queried.
_PharmacySupplyRequestFulfillerRevisionRefusalReasonCode PharmacySupplyRequestFulfillerRevisionRefusalReasonCode **Definition:**Indicates why the request to transfer a prescription from one dispensing facility to another has been refused.
_RefusalReasonCode RefusalReasonCode **Description:** Identifies why a request to add (or activate) a record is being refused. Examples include the receiving system not able to match the identifier and find that record in the receiving system, having no permission, or a detected issue exists which precludes the requested action.
_SchedulingActReason SchedulingActReason Reasons for cancelling or rescheduling an Appointment
_StatusRevisionRefusalReasonCode StatusRevisionRefusalReasonCode Indicates why the act revision (status update) is being refused.
_SubstanceAdministrationPermissionRefusalReasonCode SubstanceAdministrationPermissionRefusalReasonCode **Definition:**Indicates why the requested authorization to prescribe or dispense a medication has been refused.
_SubstanceAdminSubstitutionNotAllowedReason SubstanceAdminSubstitutionNotAllowedReason Reasons why substitution of a substance administration request is not permitted.
_SubstanceAdminSubstitutionReason SubstanceAdminSubstitutionReason
_TransferActReason TransferActReason The explanation for why a patient is moved from one location to another within the organization
_ActAdjudicationReason ActAdjudicationReason Explanatory codes that describe reasons why an Adjudicator has financially adjusted an invoice (claim). A companion domain (ActAdjudicationInformationCode) includes information reasons which do not have a financial impact on an invoice (claim). Example adjudication reason code is AA-CLAIM-0011 - Only Basic Procedure/Test Eligible. Codes from this domain further rationalizes ActAdjudicationCodes (e.g. AA - Adjudicated with Adjustment), which are used to describe the process of adjudicating an invoice. For AS - Adjudicated as Submitted, there should be no specification of ActAdjudicationReason codes, as there are no financial adjustments against the invoice.
_ActBillableServiceReason ActBillableServiceReason **Definition:** This domain is used to document reasons for providing a billable service; the billable services may include both clinical services and social services.
_ActCoverageLevelRasonCode ActCoverageLevelRasonCode **Description:**Represents the reason for the level of coverage provided under the policy or program in terms of the types of entities that may play covered parties based on their personal relationships or employment status.
_ActImmunizationReason ActImmunizationReason **Description:**A coded description of the reason for why a patient was administered an immunization. **Examples:**Post Exposure - Reason, Universal Immunization Program, Outbreak Control, Universal School Program
_ConrolActNullificationReasonCode ConrolActNullificationReasonCode **Description:**Identifies reasons for nullifying (retracting) a particular control act. **Examples:**"Entered in error", "altered decision", etc.
_NonPerformanceReasonCode NonPerformanceReasonCode The reason the action wasn't performed, e.g. why the medication was not taken. If an action wasn"t performed, it is often clinically important to know why the action wasn"t taken. *Examples:*Patient refused, clinically inappropriate, absolute contraindication etc.
_ReasonForNotEvaluatingDevice ReasonForNotEvaluatingDevice Code assigned to indicate the rationale for not performing an evaluation investigation on a device for which a defect has been reported. Examples include: device received in a condition that made analysis impossible, device evaluation anticipated but not yet begun, device not made by company.
_ReferralReasonCode ReferralReasonCode The reason a referral was made. *Examples:*Specialized Medical Assistance, Other Care Requirements.
BONUS
CHD Children only **Description:**The level of coverage under the policy or program is available only to children
DEP Dependents only **Description:**The level of coverage under the policy or program is available only to a subscriber's dependents.
ECH Employee and children **Description:**The level of coverage under the policy or program is available to an employee and his or her children.
EDU
EMP Employee only **Description:**The level of coverage under the policy or program is available only to an employee.
ESP Employee and spouse **Description:**The level of coverage under the policy or program is available to an employee and his or her spouse.
FAM Family **Description:**The level of coverage under the policy or program is available to a subscriber's family.
IND Individual **Description:**The level of coverage under the policy or program is available to an individual.
INVOICE
PROA
RECOV
RETRO
SPC Spouse and children **Description:**The level of coverage under the policy or program is available to a subscriber's spouse and children
SPO Spouse only **Description:**The level of coverage under the policy or program is available only to a subscribers spouse
TRAN
ACCREQNA Accommodation Requested Not Available Accommodation requested is not available. _ActAccommodationReason
FLRCNV Floor Convenience Accommodation is assigned for floor convenience. _ActAccommodationReason
MEDNEC Medical Necessity Required for medical reasons(s). _ActAccommodationReason
PAT Patient request The Patient requested the action _ActAccommodationReason, _SchedulingActReason, _SubstanceAdminSubstitutionNotAllowedReason
_MedicallyNecessaryDuplicateProcedureReason MedicallyNecessaryDuplicateProcedureReason **Definition:** This domain is used to document why the procedure is a duplicate of one ordered/charged previously for the same patient within the same date of service and has been determined to be medically necessary. **Example:** A doctor needs a different view in a chest X-Ray. _ActBillableClinicalServiceReason
_ActBillableClinicalServiceReason ActBillableClinicalServiceReason Reason for Clinical Service being performed. This domain excludes reasons specified by diagnosed conditions. Examples of values from this domain include duplicate therapy and fraudulent prescription. _ActBillableServiceReason
OVRER emergency treatment override To perform one or more operations on information to which the patient has not consented by authorized entities for treating a condition which poses an immediate threat to the patient's health and which requires immediate medical intervention. *Usage Notes:* The patient is unable to provide consent, but the provider determines they have an urgent healthcare related reason to access the record. The patient is unable to provide consent, but the provider determines they have an urgent healthcare related reason to access the record. _ActConsentInformationAccessOverrideReason
OVRINCOMP incompetency override To perform one or more operations on information to which the patient has not consented because deemed incompetent to provide consent. *Usage Note:* Maps to v2 CON-16 Subject Competence Indicator (ID) 01791 Definition: Identifies whether the subject was deemed competent to provide consent. Refer to table HL7 Table 0136 - Yes/No Indicator and CON-23 Non-Subject Consenter Reason User-defined Table 0502 - Non-Subject Consenter Reason code NC "Subject is not competent to consent". _ActConsentInformationAccessOverrideReason
OVRPJ professional judgment override To perform one or more operations on information to which the patient declined to consent for providing health care. *Usage Notes:* The patient, while able to give consent, has not. However the provider believes it is in the patient's interest to access the record without patient consent. The patient, while able to give consent, has not. However the provider believes it is in the patient's interest to access the record without patient consent. _ActConsentInformationAccessOverrideReason
OVRPS public safety override To perform one or more operations on information to which the patient has not consented for public safety reasons. *Usage Notes:* The patient, while able to give consent, has not. However, the provider believes that access to masked patient information is justified because of concerns related to public safety. The patient, while able to give consent, has not. However, the provider believes that access to masked patient information is justified because of concerns related to public safety. _ActConsentInformationAccessOverrideReason
OVRTPS third party safety override To perform one or more operations on information to which the patient has not consented for third party safety. *Usage Notes:* The patient, while able to give consent, has not. However, the provider believes that access to masked patient information is justified because of concerns related to the health and safety of one or more third parties. The patient, while able to give consent, has not. However, the provider believes that access to masked patient information is justified because of concerns related to the health and safety of one or more third parties. _ActConsentInformationAccessOverrideReason
_EligibilityActReasonCode EligibilityActReasonCode Identifies the reason or rational for why a person is eligibile for benefits under an insurance policy or progam. *Examples:* A person is a claimant under an automobile insurance policy are client deceased & adopted client has been given a new policy identifier. A new employee is eligible for health insurance as an employment benefit. A person meets a government program eligibility criteria for financial, age or health status. _ActCoverageReason
_ActCoverageProviderReason ActCoverageProviderReason **Description:**Identifies the reason or rationale for coverage of a service or product based on characteristics of the provider, e.g., contractual relationship to payor, such as in or out-of-network; relationship of the covered party to the provider. **Example:**In closed managed care plan, a covered party is assigned a primary care provider who provides primary care services and authorizes referrals and ancillary and non-primary care services. _ActCoverageReason
_ActCoverageServiceReason ActCoverageServiceReason **Description:**Identifies the reason or rationale for coverage of a service or product based on clinical efficacy criteria or practices prescribed by the payor. _ActCoverageReason
_CoverageExclusionReason CoverageExclusionReason **Definition:** Identifies the reason or rationale for coverage of a service or product based on coverage exclusions related to the risk of adverse selection by covered parties. _ActCoverageReason
_CoverageFinancialParticipationReason CoverageFinancialParticipationReason **Description:**Identifies the reason or rationale for coverage of a service or product based on financial participation responsibilities of the covered party. _ActCoverageReason
_CoverageLimitationReason CoverageLimitationReason **Description:**Identifies the reason or rationale for limitations on the coverage of a service or product based on coverage contract provisions. **Example:**The maximum cost per unit; or the maximum number of units per period, which is typically the policy or program effective time. _ActCoverageReason
gold-card Gold card Ordering Practitioner has been granted 'gold card' status with this payer/coverage type. This status indicates that, because of their prior track record, fewer services require prior authorization and/or documentation requirements associated with prior authorization requests are reduced. While the phrase 'gold-card' is specific to U.S. national and state regulation, the concept can be used in other jurisdictions where the semantics are appropriate. _ActCoverageReason
_ActConsentInformationAccessOverrideReason ActConsentInformationAccessOverrideReason To perform one or more operations on information to which the patient has not consented as deemed necessary by authorized entities for providing care in the best interest of the patient; providing immediately needed health care for an emergent condition; or for protecting public or third party safety. *Usage Notes:* Used to convey the reason that a provider or other entity may or has accessed personal healthcare information. Typically, this involves overriding the subject's consent directives. Used to convey the reason that a provider or other entity may or has accessed personal healthcare information. Typically, this involves overriding the subject's consent directives. _ActHealthInformationManagementReason
PurposeOfUse purpose of use Reason for performing one or more operations on information, which may be permitted by source system's security policy in accordance with one or more privacy policies and consent directives. *Usage Notes:* The rationale or purpose for an act relating to the management of personal health information, such as collecting personal health information for research or public health purposes. The rationale or purpose for an act relating to the management of personal health information, such as collecting personal health information for research or public health purposes. _ActHealthInformationManagementReason
_ActHealthInformationPrivacyReason ActHealthInformationPrivacyReason **Description:**The rationale or purpose for an act relating to the management of personal health information, such as collecting personal health information for research or public health purposes. _ActHealthInformationManagementReason
COVSUS coverage suspended When a client has no contact with the health system for an extended period, coverage is suspended. Client will be reinstated to original start date upon proof of identification, residency etc. Example: Coverage may be suspended during a strike situation, when employer benefits for employees are not covered (i.e. not in effect). _ActIneligibilityReason
DECSD deceased Client deceased. _ActIneligibilityReason
REGERR registered in error Client was registered in error. _ActIneligibilityReason
_ActHealthInformationManagementReason ActHealthInformationManagementReason **Description:**The rationale or purpose for an act relating to health information management, such as archiving information for the purpose of complying with an organization policy or jurisdictional law relating to data retention. _ActInformationManagementReason
_ActInformationPrivacyReason ActInformationPrivacyReason **Description:**The rationale or purpose for an act relating to the management of personal information, such as disclosing personal tax information for the purpose of complying with a court order. _ActInformationManagementReason
MARKT marketing **Description:** _ActInformationPrivacyReason
OPERAT operations **Description:**Administrative and contractual processes required to support an activity, product, or service _ActInformationPrivacyReason
PAYMT payment **Description:**Administrative, financial, and contractual processes related to payment for an activity, product, or service _ActInformationPrivacyReason
RESCH research **Description:**Investigative activities conducted for the purposes of obtaining knowledge _ActInformationPrivacyReason
SRVC service **Description:**Provision of a service, product, or capability to an individual or organization _ActInformationPrivacyReason
ADVSTORAGE adverse storage condition **Description:** Storage conditions caused the substance to be ineffective. _ActInvalidReason
EXPLOT expired lot **Description:** The lot from which the substance was drawn was expired. _ActInvalidReason
OUTSIDESCHED administered outside recommended schedule or practice The substance was administered outside of the recommended schedule or practice. _ActInvalidReason
PRODRECALL product recall **Description:** The substance was recalled by the manufacturer. _ActInvalidReason
INCCOVPTY incorrect covered party as patient The covered party (patient) specified with the Invoice is not correct. _ActInvoiceCancelReason
INCINVOICE incorrect billing The billing information, specified in the Invoice Elements, is not correct. This could include incorrect costing for items included in the Invoice. _ActInvoiceCancelReason
INCPOLICY incorrect policy The policy specified with the Invoice is not correct. For example, it may belong to another Adjudicator or Covered Party. _ActInvoiceCancelReason
INCPROV incorrect provider The provider specified with the Invoice is not correct. _ActInvoiceCancelReason
IMMUNE immunity **Definition:**Testing has shown that the patient already has immunity to the agent targeted by the immunization. _ActNoImmunizationReason
MEDPREC medical precaution **Definition:**The patient currently has a medical condition for which the vaccine is contraindicated or for which precaution is warranted. _ActNoImmunizationReason
OSTOCK product out of stock **Definition:**There was no supply of the product on hand to perform the service. _ActNoImmunizationReason
PATOBJ patient objection **Definition:**The patient or their guardian objects to receiving the vaccine. _ActNoImmunizationReason
PHILISOP philosophical objection **Definition:**The patient or their guardian objects to receiving the vaccine because of philosophical beliefs. _ActNoImmunizationReason
RELIG religious objection **Definition:**The patient or their guardian objects to receiving the vaccine on religious grounds. _ActNoImmunizationReason
VACEFF vaccine efficacy concerns **Definition:**The intended vaccine has expired or is otherwise believed to no longer be effective. **Example:**Due to temperature exposure. _ActNoImmunizationReason
VACSAF vaccine safety concerns **Definition:**The patient or their guardian objects to receiving the vaccine because of concerns over its safety. _ActNoImmunizationReason
FRR01 order stopped **Definition:**The order has been stopped by the prescriber but this fact has not necessarily captured electronically. **Example:**A verbal stop, a fax, etc. _ActSupplyFulfillmentRefusalReason
FRR02 stale-dated order **Definition:**Order has not been fulfilled within a reasonable amount of time, and may not be current. _ActSupplyFulfillmentRefusalReason
FRR03 incomplete data **Definition:**Data needed to safely act on the order which was expected to become available independent of the order is not yet available **Example:**Lab results, diagnostic imaging, etc. _ActSupplyFulfillmentRefusalReason
FRR04 product unavailable **Definition:**Product not available or manufactured. Cannot supply. _ActSupplyFulfillmentRefusalReason
FRR05 ethical/religious **Definition:**The dispenser has ethical, religious or moral objections to fulfilling the order/dispensing the product. _ActSupplyFulfillmentRefusalReason
FRR06 unable to provide care **Definition:**Fulfiller not able to provide appropriate care associated with fulfilling the order. **Example:**Therapy requires ongoing monitoring by fulfiller and fulfiller will be ending practice, leaving town, unable to schedule necessary time, etc. _ActSupplyFulfillmentRefusalReason
RET retest **Definition:**The event occurred so that a test or observation performed at a prior event could be performed again due to conditions set forth in the protocol. _ClinicalResearchEventReason
SCH scheduled **Definition:**The event occurred due to it being scheduled in the research protocol. _ClinicalResearchEventReason
TRM termination **Definition:**The event occurred in order to terminate the subject's participation in the study. _ClinicalResearchEventReason
UNS unscheduled **Definition:**The event that occurred was initiated by a study participant (e.g. the subject or the investigator), and did not occur for protocol reasons. _ClinicalResearchEventReason
NPT non-protocol **Definition:**The observation or test was neither defined or scheduled in the study protocol. _ClinicalResearchObservationReason
PPT per protocol **Definition:**The observation or test occurred due to it being defined in the research protocol, and during an activity or event that was scheduled in the protocol. _ClinicalResearchObservationReason
UPT per definition **:**The observation or test occurred as defined in the research protocol, but at a point in time not specified in the study protocol. _ClinicalResearchObservationReason
ALTCHOICE try another treatment first **Description:**This therapy has been ordered as a backup to a preferred therapy. This order will be released when and if the preferred therapy is unsuccessful. _CombinedPharmacyOrderSuspendReasonCode
CLARIF prescription requires clarification **Description:**Clarification is required before the order can be acted upon. _CombinedPharmacyOrderSuspendReasonCode
DRUGHIGH drug level too high **Description:**The current level of the medication in the patient's system is too high. The medication is suspended to allow the level to subside to a safer level. _CombinedPharmacyOrderSuspendReasonCode
HOSPADM admission to hospital **Description:**The patient has been admitted to a care facility and their community medications are suspended until hospital discharge. _CombinedPharmacyOrderSuspendReasonCode
LABINT lab interference issues **Description:**The therapy would interfere with a planned lab test and the therapy is being withdrawn until the test is completed. _CombinedPharmacyOrderSuspendReasonCode
NON-AVAIL patient not-available **Description:**Patient not available for a period of time due to a scheduled therapy, leave of absence or other reason. _CombinedPharmacyOrderSuspendReasonCode
PREG parent is pregnant/breast feeding **Description:**The patient is pregnant or breast feeding. The therapy will be resumed when the pregnancy is complete and the patient is no longer breastfeeding. _CombinedPharmacyOrderSuspendReasonCode
SALG allergy **Description:**The patient is believed to be allergic to a substance that is part of the therapy and the therapy is being temporarily withdrawn to confirm. _CombinedPharmacyOrderSuspendReasonCode
SDDI drug interacts with another drug **Description:**The drug interacts with a short-term treatment that is more urgently required. This order will be resumed when the short-term treatment is complete. _CombinedPharmacyOrderSuspendReasonCode
SDUPTHER duplicate therapy **Description:**Another short-term co-occurring therapy fulfills the same purpose as this therapy. This therapy will be resumed when the co-occuring therapy is complete. _CombinedPharmacyOrderSuspendReasonCode
SINTOL suspected intolerance **Description:**The patient is believed to have an intolerance to a substance that is part of the therapy and the therapy is being temporarily withdrawn to confirm. _CombinedPharmacyOrderSuspendReasonCode
SURG patient scheduled for surgery **Description:**The drug is contraindicated for patients receiving surgery and the patient is scheduled to be admitted for surgery in the near future. The drug will be resumed when the patient has sufficiently recovered from the surgery. _CombinedPharmacyOrderSuspendReasonCode
WASHOUT waiting for old drug to wash out **Description:**The patient was previously receiving a medication contraindicated with the current medication. The current medication will remain on hold until the prior medication has been cleansed from their system. _CombinedPharmacyOrderSuspendReasonCode
ALTD altered decision **Description:**The decision on which the recorded information was based was changed before the decision had an effect. **Example:**Aborted prescription before patient left office, released prescription before suspend took effect. _ControlActNullificationReasonCode
EIE entered in error **Description:**The information was recorded incorrectly or was recorded in the wrong record. _ControlActNullificationReasonCode
NORECMTCH no record match **Description:** There is no match for the record in the database. _ControlActNullificationReasonCode, _StatusRevisionRefusalReasonCode, NOMATCH
INRQSTATE in requested state The record is already in the requested state. _ControlActNullificationRefusalReasonType, _StatusRevisionRefusalReasonCode
NOMATCH no match **Description:** There is no match. _ControlActNullificationRefusalReasonType, _RefusalReasonCode
NOPERM no permission **Description:** There is no permission. _ControlActNullificationRefusalReasonType, _RefusalReasonCode
WRNGVER wrong version **Description:** The record and version requested to update is not the current version. _ControlActNullificationRefusalReasonType
_MedicationOrderAbortReasonCode medication order abort reason **Description:**Indicates the reason the medication order should be aborted. _ControlActReason
_MedicationOrderReleaseReasonCode medication order release reason **Definition:**A collection of concepts that indicate why the prescription should be released from suspended state. _ControlActReason
_ModifyPrescriptionReasonType ModifyPrescriptionReasonType Types of reason why a prescription is being changed. _ControlActReason
_PharmacySupplyEventAbortReason PharmacySupplyEventAbortReason **Definition:**Identifies why the dispense event was not completed. _ControlActReason
_PharmacySupplyEventStockReasonCode pharmacy supply event stock reason **Definition:**A collection of concepts that indicates the reason for a "bulk supply" of medication. _ControlActReason
_PharmacySupplyRequestRenewalRefusalReasonCode pharmacy supply request renewal refusal reason **Definition:**A collection of concepts that identifies why a renewal prescription has been refused. _ControlActReason
_SupplyOrderAbortReasonCode supply order abort reason **Definition:**A collection of concepts that indicates why the prescription should no longer be allowed to be dispensed (but can still administer what is already being dispensed). _ControlActReason
_ControlActReasonConditionNullify ControlActReasonConditionNullify Indicates why the ConditionaTMs status was changed to Nullified. *Examples* administrative error, diagnostic error. _ControlActReason
AGE age eligibility A person becomes eligible for a program based on age. *Example:* In the U.S., a person who is 65 years of age or older is eligible for Medicare. _CoverageEligibilityReason
CRIME crime victim A person becomes eligible for insurance or a program because of crime related health condition or injury. *Example:* A person is a claimant under the U.S. Crime Victims Compensation program. _CoverageEligibilityReason
DIS disability A person becomes a claimant under a disability income insurance policy or a disability rehabilitation program because of a health condition or injury which limits the person's ability to earn an income or function without institutionalization. _CoverageEligibilityReason
EMPLOY employment benefit A person becomes eligible for insurance provided as an employment benefit based on employment status. _CoverageEligibilityReason
FINAN financial eligibility A person becomes eligible for a program based on financial criteria. *Example:* A person whose family income is below a financial threshold for eligibility for Medicaid or SCHIP. _CoverageEligibilityReason
HEALTH health status A person becomes eligible for a program because of a qualifying health condition or injury. *Examples:* A person is determined to have a qualifying health conditions include pregnancy, HIV/AIDs, tuberculosis, end stage renal disease, breast or cervical cancer, or other condition requiring specialized health services, hospice, institutional or community based care provided under a program _CoverageEligibilityReason
MULTI multiple criteria eligibility A person becomes eligible for a program based on more than one criterion. *Examples:* In the U.S., a child whose familiy income meets Medicaid financial thresholds and whose age is less than 18 is eligible for the Early and Periodic Screening, Diagnostic, and Treatment program (EPSDT). A person whose family income meets Medicaid financial thresholds and whose age is 65 years or older is eligible for Medicaid and Medicare, and are referred to as dual eligibles. _CoverageEligibilityReason
PNC property and casualty condition A person becomes a claimant under a property and casualty insurance policy because of a related health condition or injury resulting from a circumstance covered under the terms of the policy. *Example:* A person is a claimant under a homeowners insurance policy because of an injury sustained on the policyholderaTMs premises. _CoverageEligibilityReason
STATUTORY statutory eligibility A person becomes eligible for a program based on statutory criteria. *Examples:* A person is a member of an indigenous group, a veteran of military service, or in the U.S., a recipient of adoption assistance and foster care under Title IV-E of the Social Security. _CoverageEligibilityReason
VEHIC motor vehicle accident victim A person becomes a claimant under a motor vehicle accident insurance because of a motor vehicle accident related health condition or injury. _CoverageEligibilityReason
WORK work related A person becomes eligible for insurance or a program because of a work related health condition or injury. *Example:* A person is a claimant under the U.S. Black Lung Program. _CoverageEligibilityReason
_ActIneligibilityReason ActIneligibilityReason Identifies the reason or rational for why a person is not eligibile for benefits under an insurance policy. Examples are client deceased & adopted client has been given a new policy identifier. _EligibilityActReasonCode
_CoverageEligibilityReason CoverageEligibilityReason Definition: Identifies the reason or rational for why a person is eligibile for benefits under an insurance policy or progam. *Examples:* A person is a claimant under an automobile insurance policy are client deceased & adopted client has been given a new policy identifier. A new employee is eligible for health insurance as an employment benefit. A person meets a government program eligibility criteria for financial, age or health status. _EligibilityActReasonCode
CHGDATA information change **Description:**Information has changed since the record was created. _GenericUpdateReasonCode
FIXDATA error correction **Description:**Previously recorded information was erroneous and is being corrected. _GenericUpdateReasonCode
MDATA merge data Information is combined into the record. _GenericUpdateReasonCode
NEWDATA new information **Description:**New information has become available to supplement the record. _GenericUpdateReasonCode
UMDATA unmerge data Information is separated from the record. _GenericUpdateReasonCode
DISCONT product discontinued **Description:**The medication is no longer being manufactured or is otherwise no longer available. _MedicationOrderAbortReasonCode, _PharmacySupplyRequestRenewalRefusalReasonCode
INEFFECT ineffective **Description:**The therapy has been found to not have the desired therapeutic benefit on the patient. _MedicationOrderAbortReasonCode
MONIT response to monitoring **Description:**Monitoring the patient while taking the medication, the decision has been made that the therapy is no longer appropriate. _MedicationOrderAbortReasonCode
NOREQ no longer required for treatment **Description:**The underlying condition has been resolved or has evolved such that a different treatment is no longer needed. _MedicationOrderAbortReasonCode
NOTCOVER not covered **Description:**The product does not have (or no longer has) coverage under the patientaTMs insurance policy. _MedicationOrderAbortReasonCode
PREFUS patient refuse **Description:**The patient refused to take the product. _MedicationOrderAbortReasonCode
RECALL product recalled **Description:**The manufacturer or other agency has requested that stocks of a medication be removed from circulation. _MedicationOrderAbortReasonCode
REPLACE change in order **Description:**Item in current order is no longer in use as requested and a new one has/will be created to replace it. _MedicationOrderAbortReasonCode
REPLACEFIX error in order **Description:**Current order was issued with incorrect data and a new order has/will be created to replace it. _MedicationOrderAbortReasonCode
UNABLE unable to use **Description:**<The patient is not (or is no longer) able to use the medication in a manner prescribed. **Example:**CanaTMt swallow. _MedicationOrderAbortReasonCode
HOLDDONE suspend reason no longer applies **Definition:**The original reason for suspending the medication has ended. _MedicationOrderReleaseReasonCode
HOLDINAP suspend reason inappropriate **Definition:** _MedicationOrderReleaseReasonCode
ADMINERROR administrative error in order Order was created with incorrect data and is changed to reflect the intended accuracy of the order. _ModifyPrescriptionReasonType
CLINMOD clinical modification Order is changed based on a clinical reason. _ModifyPrescriptionReasonType
ADMREV administrative review **Definition:** To evaluate for service authorization, payment, reporting, or performance/outcome measures. _PatientProfileQueryReasonCode
LEGAL subpoena **Definition:**To provide information as a result of a subpoena. _PatientProfileQueryReasonCode, OPERAT
PATCAR patient care **Definition:**To obtain records as part of patient care. _PatientProfileQueryReasonCode
PATREQ patient request query **Definition:**Patient requests information from their profile. _PatientProfileQueryReasonCode
PRCREV practice review **Definition:**To evaluate the provider's current practice for professional-improvement reasons. _PatientProfileQueryReasonCode
REGUL regulatory review **Description:**Review for the purpose of regulatory compliance. _PatientProfileQueryReasonCode
RSRCH research **Definition:**To provide research data, as authorized by the patient. _PatientProfileQueryReasonCode
VALIDATION validation review **Description:**To validate the patient's record. **Example:**Merging or unmerging records. _PatientProfileQueryReasonCode
CONTRA contraindication **Definition:**Contraindication identified _PharmacySupplyEventAbortReason
FOABORT order aborted **Definition:**Order to be fulfilled was aborted _PharmacySupplyEventAbortReason
FOSUSP order suspended **Definition:**Order to be fulfilled was suspended _PharmacySupplyEventAbortReason
NOPICK not picked up **Definition:**Patient did not come to get medication _PharmacySupplyEventAbortReason
PATDEC patient changed mind **Definition:**Patient changed their mind regarding obtaining medication _PharmacySupplyEventAbortReason
QUANTCHG change supply quantity **Definition:**Patient requested a revised quantity of medication _PharmacySupplyEventAbortReason
FLRSTCK floor stock **Definition:**The bulk supply is issued to replenish a ward for local dispensing. (Includes both mobile and fixed-location ward stocks.) _PharmacySupplyEventStockReasonCode
LTC long term care use **Definition:**The bulk supply will be administered within a long term care facility. _PharmacySupplyEventStockReasonCode
OFFICE office use **Definition:**The bulk supply is intended for general clinician office use. _PharmacySupplyEventStockReasonCode
PHARM pharmacy transfer **Definition:**The bulk supply is being transferred to another dispensing facility to. **Example:**Alleviate a temporary shortage. _PharmacySupplyEventStockReasonCode
PROG program use **Definition:**The bulk supply is intended for dispensing according to a specific program. **Example:**Mass immunization. _PharmacySupplyEventStockReasonCode
LOCKED locked **Definition:**The prescription may not be reassigned from the original pharmacy. _PharmacySupplyRequestFulfillerRevisionRefusalReasonCode
NOUSERPERM no user permission **Definition:**The user does not have permission _PharmacySupplyRequestFulfillerRevisionRefusalReasonCode, _StatusRevisionRefusalReasonCode, _SubstanceAdministrationPermissionRefusalReasonCode, NOPERM
UNKWNTARGET unknown target **Definition:**The target facility does not recognize the dispensing facility. _PharmacySupplyRequestFulfillerRevisionRefusalReasonCode
ALREADYRX new prescription exists **Definition:**Patient has already been given a new (renewal) prescription. _PharmacySupplyRequestRenewalRefusalReasonCode
FAMPHYS family physician must authorize further fills **Definition:**Request for further authorization must be done through patient's family physician. _PharmacySupplyRequestRenewalRefusalReasonCode
MODIFY modified prescription exists **Definition:**Therapy has been changed and new prescription issued _PharmacySupplyRequestRenewalRefusalReasonCode
NEEDAPMT patient must make appointment **Definition:**Patient must see prescriber prior to further fills. _PharmacySupplyRequestRenewalRefusalReasonCode
NOTAVAIL prescriber not available **Definition:**Original prescriber is no longer available to prescribe and no other prescriber has taken responsibility for the patient. _PharmacySupplyRequestRenewalRefusalReasonCode
NOTPAT patient no longer in this practice **Definition:**Patient no longer or has never been under this prescribers care. _PharmacySupplyRequestRenewalRefusalReasonCode
ONHOLD medication on hold **Definition:**This medication is on hold. _PharmacySupplyRequestRenewalRefusalReasonCode
PRNA product not available **Description:**This product is not available or manufactured. _PharmacySupplyRequestRenewalRefusalReasonCode
STOPMED prescriber stopped medication for patient Renewing or original prescriber informed patient to stop using the medication. _PharmacySupplyRequestRenewalRefusalReasonCode
TOOEARLY too early **Definition:**The patient should have medication remaining. _PharmacySupplyRequestRenewalRefusalReasonCode
BLK Unexpected Block (of Schedule) The time slots previously allocated are now blocked and no longer available for booking Appointments _SchedulingActReason
DEC Patient Deceased The Patient is deceased _SchedulingActReason
FIN No Financial Backing Patient unable to pay and not covered by insurance _SchedulingActReason
MED Medical Status Altered The medical condition of the Patient has changed _SchedulingActReason
MTG In an outside meeting The Physician is in a meeting. For example, he/she may request administrative time to talk to family after appointment _SchedulingActReason
PHY Physician request The Physician requested the action _SchedulingActReason
FILLED fully filled Ordered quantity has already been completely fulfilled. _StatusRevisionRefusalReasonCode
PATINELIG patient not eligible **Definition:**Patient not eligible for drug _SubstanceAdministrationPermissionRefusalReasonCode
PROTUNMET protocol not met **Definition:**Patient does not meet required protocol _SubstanceAdministrationPermissionRefusalReasonCode
PROVUNAUTH provider not authorized **Definition:**Provider is not authorized to prescribe or dispense _SubstanceAdministrationPermissionRefusalReasonCode
ALGINT allergy intolerance **Definition:** Patient has had a prior allergic intolerance response to alternate product or one of its components. _SubstanceAdminSubstitutionNotAllowedReason
COMPCON compliance concern **Definition:** Patient has compliance issues with medication such as differing appearance, flavor, size, shape or consistency. _SubstanceAdminSubstitutionNotAllowedReason
THERCHAR therapeutic characteristics The prescribed product has specific clinical release or other therapeutic characteristics not shared by other substitutable medications. _SubstanceAdminSubstitutionNotAllowedReason
TRIAL clinical trial drug **Definition:** The specific manufactured drug is part of a clinical trial. _SubstanceAdminSubstitutionNotAllowedReason
CT continuing therapy Indicates that the decision to substitute or to not substitute was driven by a desire to maintain consistency with a pre-existing therapy. I.e. The performer provided the same item/service as had been previously provided rather than providing exactly what was ordered, or rather than substituting with a lower-cost equivalent. _SubstanceAdminSubstitutionReason
FP formulary policy Indicates that the decision to substitute or to not substitute was driven by a policy expressed within the formulary. _SubstanceAdminSubstitutionReason
OS out of stock In the case of 'substitution', indicates that the substitution occurred because the ordered item was not in stock. In the case of 'no substitution', indicates that a cheaper equivalent was not substituted because it was not in stock. _SubstanceAdminSubstitutionReason
RR regulatory requirement Indicates that the decision to substitute or to not substitute was driven by a jurisdictional regulatory requirement mandating or prohibiting substitution. _SubstanceAdminSubstitutionReason
IMPROV condition improved **Definition:**The patient's medical condition has nearly abated. _SupplyOrderAbortReasonCode
INTOL intolerance **Description:**The patient has an intolerance to the medication. _SupplyOrderAbortReasonCode
NEWSTR new strength **Definition:**The current medication will be replaced by a new strength of the same medication. _SupplyOrderAbortReasonCode
NEWTHER new therapy **Definition:**A new therapy will be commenced when current supply exhausted. _SupplyOrderAbortReasonCode
ER Error Moved to an error in placing the patient in the original location. _TransferActReason
RQ Request Moved at the request of the patient. _TransferActReason
COLDCHNBRK cold chain break **Description:** Cold chain was not maintained for the substance. ADVSTORAGE
CLINTRCHNPC clinical trial research without patient care To perform one or more operations on information for conducting scientific investigations in accordance with clinical trial protocols to obtain health care knowledge without provision of patient care. May be post-coordinated or used with other purposes of use such as disease, discipline, specialty, population origins or ancestry, translational healthcare research. For example, a clinical trial conducted on laboratory specimens collected from a specified patient population. CLINTRCH
CLINTRCHPC clinical trial research with patient care To perform one or more operations on information for conducting scientific investigations with patient care in accordance with clinical trial protocols to obtain health care knowledge. May be post-coordinated or used with other purposes of use such as disease, discipline, specialty, population origins or ancestry, translational healthcare research. For example, an "off-label" drug used for cancer therapy administer to a specified patient population. CLINTRCH
PRECLINTRCH preclinical trial research To perform one or more operations on information in preparation for conducting scientific investigation to obtain health care knowledge, such as research on animals or review of patient health records, to determine the feasibility of a clinical trial study; assist with protocol design; or in preparation for institutional review board or ethics committee approval process. May be post-coordinated or used with other purposes of use such as disease, discipline, specialty, population origins or ancestry, translational healthcare research. CLINTRCH
ELIGDTRM eligibility determination To perform one or more operations on information used for conducting eligibility determination for coverage in a program or policy. May entail review of financial status or disability assessment. COVERAGE
ELIGVER eligibility verification To perform one or more operations on information used for conducting eligibility verification of coverage in a program or policy. May entail provider contacting coverage source (e.g., government health program such as workers compensation or health plan) for confirmation of enrollment, eligibility for specific services, and any applicable copays. COVERAGE
ENROLLM enrollment To perform one or more operations on information used for enrolling a covered party in a program or policy. May entail recording of covered party's and any dependent's demographic information and benefit choices. COVERAGE
MILDCRG military discharge To perform one or more operations on information for the process of releasing military personnel from their service obligations, which may include determining service merit, discharge benefits, and disability assessment. COVERAGE
BTG break the glass To perform policy override operations on information for provision of immediately needed health care for an emergent condition affecting potential harm, death or patient safety by end users who are not provisioned for this purpose of use. Includes override of organizational provisioning policies and may include override of subject of care consent directive restricting access. *Map:* Partially Maps to ISO 14265 Classification Term "Emergency care provision to an individual subject of care" described as "To inform persons needing to provide health care services to the subject of care urgently, possibly needing to over-ride the policies and consents pertaining to Purpose 1 above." Purpose 1 is equivalent to HL7 treatment purpose of use: "Clinical care provision to an individual subject of care" described as "To inform persons or processes responsible for providing health care services to the subject of care." The ISO description conflates both of the proposed specializations of HL7 ETREAT: break the glass and the typically broader access to health information normally available to providers who are provisioned for emergency workflows on a regular basis, e.g., Emergency Room providers. Examples of greater access than is normally accessible by providers based on the need to know are access to sensitive information for which access typically requires a patient's consent. This is not an override of a patient's dissent to disclose sensitive information in cases where the applicable policy waives the need for that consent to access this information. In US, Title 38 Section 7332 and 42 CFR Part 2 both permit emergency access without the need to override a patient's consent directive; rather, this access is a limitation to the patient's right to dissent from disclosure. ETREAT
ERTREAT emergency room treatment To perform one or more operations on information for provision of immediately needed health care for an emergent condition in an emergency room or similar emergent care context by end users provisioned for this purpose, which does not constitute as policy override such as in a "Break the Glass" purpose of use. Map:Partially Maps to ISO 14265 Classification Term "Emergency care provision to an individual subject of care" described as "To inform persons needing to provide health care services to the subject of care urgently, possibly needing to over-ride the policies and consents pertaining to Purpose 1 above." Purpose 1 is equivalent to HL7 treatment purpose of use: "Clinical care provision to an individual subject of care" described as "To inform persons or processes responsible for providing health care services to the subject of care." The ISO description conflates both of the proposed specializations of HL7 ETREAT: break the glass and the typically broader access to health information normally available to providers who are provisioned for emergency workflows on a regular basis, e.g., Emergency Room providers. Examples of greater access than is normally accessible by providers based on the need to know are access to sensitive information for which access typically requires a patient's consent. This is not an override of a patient's dissent to disclose sensitive information in cases where the applicable policy waives the need for that consent to access this information. In US, Title 38 Section 7332 and 42 CFR Part 2 both permit emergency access without the need to override a patient's consent directive; rather, this access is a limitation to the patient's right to dissent from disclosure. There is a semantic gap in concepts. This classification term is described as activities "to inform persons" rather than the rationale for performing actions/operations on information related to the activity. ETREAT
CAREMGT care management To perform analytics, evaluation and other secondary uses of treatment and healthcare related information to manage the quality, efficacy, patient safety, population health, and cost effectiveness of healthcare delivery. Explicitly excludes the use of information to organize the delivery of health care for care coordination and case management, or to provide healthcare treatment. *Usage Note:* The concept of care management is narrower than the list of activities related to more general organizational objectives such as provider profiling, education of healthcare and non-healthcare professionals; insurance underwriting, premium rating, reinsurance; organizational legal, medical review, auditing, compliance and fraud and abuse detection; business planning, development, and restructuring; fund-raising; and customer service. *Map:* Maps to ISO 14265 Classification Term "Health service management and quality assurance" described as "To inform persons or processes responsible for determining the availability, quality, safety, equity and cost-effectiveness of health care services." There is a semantic gap in concepts. This classification term is described as activities, i.e., "to inform persons" or "to inform processes" rather than the rationale for performing actions/operations on information related to the activity. HOPERAT
DONAT donation To perform one or more operations on information used for cadaveric organ, eye or tissue donation. HOPERAT
FRAUD fraud To perform one or more operations on information used for fraud detection and prevention processes. HOPERAT
GOV government To perform one or more operations on information used within government processes. HOPERAT
HACCRED health accreditation To perform one or more operations on information for conducting activities related to meeting accreditation criteria. HOPERAT
HCOMPL health compliance To perform one or more operations on information used for conducting activities required to meet a mandate. HOPERAT
HDECD decedent To perform one or more operations on information used for handling deceased patient matters. HOPERAT
HDIRECT directory To perform one or more operation operations on information used to manage a patient directory. **Examples:** * facility * enterprise * payer * health information exchange patient directory HOPERAT
HDM healthcare delivery management To perform one or more actions on information used for conducting administrative and contractual activities by or on behalf of organizational entities responsible for delivery of an individual's benefits in a healthcare program, health plan or insurance. Explicitly excludes the use of information to organize the delivery of health care for care coordination and case management, or to provide healthcare treatment. *Usage Note:* Examples of activities conducted under this purpose of use: provider profiling, risk adjustment, underwriting, fraud and abuse, quality improvement population health and care management. Aligns with HIPAA Operation POU minus coordination of care or other treatment related activities. Similar to the description in SAMHSA Confidentiality of Substance Use Disorder Patient Records Supplemental notice of proposed rulemaking. *Map:* Maps to ISO 14265 Classification Term "Administration of care for an individual subject of care" described as "To inform persons or processes responsible for enabling the availability of resources or funding or permissions for providing health care services to the subject of care." However, this classification term is described as activities, i.e., "to inform persons" or "to inform processes" rather than the rationale for performing actions/operations on information related to the activity. HOPERAT
HLEGAL legal To perform one or more operations on information for conducting activities required by legal proceeding. HOPERAT
HOUTCOMS health outcome measure To perform one or more operations on information used for assessing results and comparative effectiveness achieved by health care practices and interventions. HOPERAT
HPRGRP health program reporting To perform one or more operations on information used for conducting activities to meet program accounting requirements. HOPERAT
HQUALIMP health quality improvement To perform one or more operations on information used for conducting administrative activities to improve health care quality. HOPERAT
HSYSADMIN health system administration To perform one or more operations on information to administer the electronic systems used for the delivery of health care. HOPERAT
MEMADMIN member administration To perform one or more operations on information to administer health care coverage to an enrollee under a policy or program. HOPERAT
MILCDM military command To perform one or more operations on information for conducting activities required by military processes, procedures, policies, or law. HOPERAT
PATADMIN patient administration To perform one or more operations on information used for operational activities conducted to administer the delivery of health care to a patient. HOPERAT
PATSFTY patient safety To perform one or more operations on information in processes related to ensuring the safety of health care. HOPERAT
PERFMSR performance measure To perform one or more operations on information used for monitoring performance of recommended health care practices and interventions. HOPERAT
RECORDMGT records management To perform one or more operations on information used within the health records management process. HOPERAT
SYSDEV system development To perform one or more operations on information to design, develop, implement, test, or deploy a healthcare system or application. HOPERAT
TRAIN training To perform one or more operations on information used in training and education. HOPERAT
MLTRAINING machine learning training To perform one or more operations on information used in training a machine learning (AI) model. HOPERAT
CLMATTCH claim attachment To perform one or more operations on information for provision of additional clinical evidence in support of a request for coverage or payment for health services. HPAYMT
COVAUTH coverage authorization To perform one or more operations on information for conducting prior authorization or predetermination of coverage for services. HPAYMT
COVERAGE coverage under policy or program To perform one or more operations on information for conducting activities related to coverage under a program or policy. HPAYMT
REMITADV remittance advice To perform one or more operations on information about the amount remitted for a health care claim. HPAYMT
PMTDS decision support assisted payment decision To apply algorithms (e.g. AI, CDS) to perform one or more operations on information to arrive at decision used in payment for provision of health care. HPAYMT
BIORCH biomedical research To perform one or more operations on information for conducting scientific investigations to obtain health care knowledge. Use of the data must be related to specified biomedical basic or applied research. For example, research on rare plants to determine whether biologic properties may be useful for pharmaceutical development. May be used in combination with clinical trial and other healthcare research purposes of use. HRESCH
CLINTRCH clinical trial research To perform one or more operations on information for conducting scientific investigations in accordance with clinical trial protocols to obtain health care knowledge. HRESCH
DSRCH disease specific healthcare research To perform one or more operations on information for conducting scientific investigations to obtain health care knowledge. Use of the data must be related to specified conditions, diagnosis, or disease healthcare research. For example, conducting cancer research by testing reaction of tumor cells to certain biologics. May be used in combination with clinical trial and other healthcare research purposes of use. HRESCH
POARCH population origins or ancestry healthcare research To perform one or more operations on information, including genealogical pedigrees, historical records, surveys, family health data, health records, and genetic information, for conducting scientific investigations to obtain health care knowledge. Use of the data must be related to population origins and/or ancestry healthcare research. For example, gathering genetic specimens from a specific population in order to determine the ancestry and population origins of that group. May be used in combination with clinical trial and other healthcare research purposes of use. HRESCH
TRANSRCH translational healthcare research To perform one or more operations on information for conducting scientific investigations to obtain health care knowledge related to evidence based medicine during the course of providing healthcare treatment. Sometimes referred to as "bench to bedside", which is the iterative feedback loop between healthcare research and clinical trials with input from information collected in the course of routine provision of healthcare. For example, by extending a patient encounter to conduct a survey related to a research topic such as attitudes about use of a wellness device that a patient agreed to use. May be used in combination with clinical trial and other healthcare research purposes of use. HRESCH
LABELING labeling To perform one or more operations on information to assign, persist, and manage labels to healthcare data to characterize various aspects, such as its security classification, sensitivity, compartment, integrity, and provenance; applicable privacy, consent, security, provenance, and trust policies; and handling caveats such as purpose of use, obligations, and refrain policies. Label management includes classification of target data by constructing and binding of a label set per applicable policies, security policy information file semantics, and classification guides. Label management also includes process and procedures for subsequent revision of a label for, e.g., reclassification, downgrading classification, and declassification. Label revisions may be triggered by, e.g., expiry of classification period; changes in applicable policy, e.g., revocation of a consent directive; or changes in the governing policy domain in which the data is relocated or a copy of the data is sent. If a label is revised, an audit log should be kept and the provenance of the label changes should be tracked. HSYSADMIN
METAMGT metadata management To perform one or more operations on information to assign, persist, and manage metadata to healthcare data to characterize various aspects used for its indexing, discovery, retrieval, and processing by systems, applications, and end users. For example, master index identifier, media type, and location. HSYSADMIN
NOPRODMTCH no product match **Description:** There is no match for the product in the master file repository. NOMATCH
NOSERMTCH no service match **Description:** There is no match for the service in the master file repository. NOMATCH
NOVERMTCH no version match **Description:** There is no match for the record and version. NOMATCH
NOAGNTPERM no agent permission **Description:** The agent does not have permission. NOPERM
NOUSRPERM no user permission **Description:** The user does not have permission. NOPERM
ACCRED accreditation **Description:**Operational activities conducted for the purposes of meeting of criteria defined by an accrediting entity for an activity, product, or service OPERAT
COMPL compliance **Description:**Operational activities required to meet a mandate related to an activity, product, or service OPERAT
ENADMIN entity administration **Description:**Operational activities conducted to administer information relating to entities involves with an activity, product, or service OPERAT
OUTCOMS outcome measure **Description:**Operational activities conducted for the purposes of assessing the results of an activity, product, or service OPERAT
PRGRPT program reporting **Description:**Operational activities conducted to meet program accounting requirements related to an activity, product, or service OPERAT
QUALIMP quality improvement **Description:**Operational activities conducted for the purposes of improving the quality of an activity, product, or service OPERAT
SYSADMN system administration **Description:**Operational activities conducted to administer the electronic systems used for an activity, product, or service OPERAT
FAMRQT family requested To perform one or more operations on information in response to a request by a family member authorized by the patient. PATRQT
PWATRNY power of attorney To perform one or more operations on information in response to a request by a person appointed as the patient's legal representative. PATRQT
SUPNWK support network To perform one or more operations on information in response to a request by a person authorized by the patient. PATRQT
DISASTER disaster To perform one or more operations on information used for provision of immediately needed health care to a population of living subjects located in a disaster zone. PUBHLTH
THREAT threat To perform one or more operations on information used to prevent injury or disease to living subjects who may be the target of violence. PUBHLTH
HMARKT healthcare marketing To perform one or more operations on information for marketing services and products related to health care. PurposeOfUse
HOPERAT healthcare operations To perform one or more operations on information used for conducting administrative and contractual activities related to the provision of health care. PurposeOfUse
HPAYMT healthcare payment To perform one or more operations on information for conducting financial or contractual activities related to payment for provision of health care. PurposeOfUse
HRESCH healthcare research To perform one or more operations on information for conducting scientific investigations to obtain health care knowledge. Use of the data iincludes basic and applied research such as biomedical, population origin or ancestry, translational research, and disease, discipline, specialty specific healthcare research and clinical trial research. PurposeOfUse
PATRQT patient requested To perform one or more operations on information in response to a patient's request. PurposeOfUse
PUBHLTH public health To perform one or more operations on information for conducting public health activities, such as the reporting of notifiable conditions. PurposeOfUse
TREAT treatment To perform one or more operations on information for provision of health care. PurposeOfUse
DOSECHG change in medication/dose **Description:**The medication is being re-prescribed at a different dosage. REPLACE
HTEST test health data To perform one or more operations on information that is simulated or synthetic health data used for testing system capabilities outside of a production or operational system environment. *Usage Note:* Data marked with a HTEST security label enables an access control system to permit interfacing systems or end users provisioned with a clearance, which includes a HTEST purpose of use attribute, to test, verify, or validate that a system or application will operate in production as intended based on design specifications. SYSDEV
CLINTRL clinical trial To perform health care as part of the clinical trial protocol. TREAT
COC coordination of care To perform one or more actions on information in order to organize the provision and case management of an individual's healthcare, including: Monitoring a person's goals, needs, and preferences; acting as the communication link between two or more participants concerned with a person's health and wellness; organizing and facilitating care activities and promoting self-management by advocating for, empowering, and educating a person; and ensuring safe, appropriate, non-duplicative, and effective integrated care. *Usage Note:* Use when describing these functions: 1. Monitoring a person's goals, needs, and preferences. 2. Acting as the communication link between two or more participants concerned with a person's health and wellness. 3. Organizing and facilitating care activities and promoting self-management by advocating for, empowering, and educating a person. 4. Ensuring safe, appropriate, non-duplicative, and effective integrated care. The goal is to clearly differentiate this type of coordination of care from HIPAA Operations by specifying that these actions on information are undertaken in the provision of healthcare treatment. For similar uses of this concept, see SAMHSA Confidentiality of Substance Use Disorder Patient Records Supplemental notice of proposed rulemaking, which differentiates concepts of care coordination and case management for the provision of treatment as specifically distinct from activities related to health care delivery management and the operations of organizational entities involved in the delivery of healthcare. *Map:* Maps to ISO 14265 Classification Terms: "Support of care activities within the provider organisation for an individual subject of care" described as "To inform persons or processes enabling others to provide health care services to the subject of care." "Subject of Care Uses" described as "To inform the subject of care in support of his or her own interests." TREAT
ETREAT Emergency Treatment To perform one or more operations on information for provision of immediately needed health care for an emergent condition. TREAT
POPHLTH population health To perform one or more operations on information for provision of health care to a population of living subjects, e.g., needle exchange program. TREAT
TREATDS decision support assisted treatment decision To apply algorithms (e.g. AI, CDS) to perform one or more operations on information to arrive at decision used in health care treatment. TREAT