FHIR IG analytics| Package | hl7.fhir.uv.xver-r5.r4.r4 |
| Resource Type | ValueSet |
| Id | ValueSet-R5-v3-ActInvoiceOverrideCode-for-R4.json |
| FHIR Version | R4 |
| Source | http://hl7.org/fhir/uv/xver-r5.r4/0.0.1-snapshot-2/ValueSet-R5-v3-ActInvoiceOverrideCode-for-R4.html |
| URL | http://hl7.org/fhir/5.0/ValueSet/R5-v3-ActInvoiceOverrideCode-for-R4 |
| Version | 0.0.1-snapshot-2 |
| Status | active |
| Date | 2025-09-01T22:37:04.907511+10:00 |
| Name | R5_v3_ActInvoiceOverrideCode_for_R4 |
| Title | Cross-version VS for R5.ActInvoiceOverrideCode for use in FHIR R4 |
| Realm | uv |
| Authority | hl7 |
| Description | This cross-version ValueSet represents concepts from http://terminology.hl7.org/ValueSet/v3-ActInvoiceOverrideCode|2.0.0 for use in FHIR R4. Concepts not present here have direct `equivalent` mappings crossing all versions from R5 to R4. |
No resources found
| CodeSystem | |
| v3-ActCode | ActCode |
Note: links and images are rebased to the (stated) source
Generated Narrative: ValueSet R5-v3-ActInvoiceOverrideCode-for-R4
This value set expansion contains 15 concepts.
| Code | System | Display | Definition |
| COVGE | http://terminology.hl7.org/CodeSystem/v3-ActCode | coverage problem | Insurance coverage problems have been encountered. Additional explanation information to be supplied. |
| EFORM | http://terminology.hl7.org/CodeSystem/v3-ActCode | electronic form to follow | Electronic form with supporting or additional information to follow. |
| FAX | http://terminology.hl7.org/CodeSystem/v3-ActCode | fax to follow | Fax with supporting or additional information to follow. |
| GFTH | http://terminology.hl7.org/CodeSystem/v3-ActCode | good faith indicator | The medical service was provided to a patient in good faith that they had medical coverage, although no evidence of coverage was available before service was rendered. |
| LATE | http://terminology.hl7.org/CodeSystem/v3-ActCode | late invoice | Knowingly over the payor's published time limit for this invoice possibly due to a previous payor's delays in processing. Additional reason information will be supplied. |
| MANUAL | http://terminology.hl7.org/CodeSystem/v3-ActCode | manual review | Manual review of the invoice is requested. Additional information to be supplied. This may be used in the case of an appeal. |
| OOJ | http://terminology.hl7.org/CodeSystem/v3-ActCode | out of jurisdiction | The medical service and/or product was provided to a patient that has coverage in another jurisdiction. |
| ORTHO | http://terminology.hl7.org/CodeSystem/v3-ActCode | orthodontic service | The service provided is required for orthodontic purposes. If the covered party has orthodontic coverage, then the service may be paid. |
| PAPER | http://terminology.hl7.org/CodeSystem/v3-ActCode | paper documentation to follow | Paper documentation (or other physical format) with supporting or additional information to follow. |
| PIE | http://terminology.hl7.org/CodeSystem/v3-ActCode | public insurance exhausted | Public Insurance has been exhausted. Invoice has not been sent to Public Insuror and therefore no Explanation Of Benefits (EOB) is provided with this Invoice submission. |
| PYRDELAY | http://terminology.hl7.org/CodeSystem/v3-ActCode | delayed by a previous payor | Allows provider to explain lateness of invoice to a subsequent payor. |
| REFNR | http://terminology.hl7.org/CodeSystem/v3-ActCode | referral not required | Rules of practice do not require a physician's referral for the provider to perform a billable service. |
| REPSERV | http://terminology.hl7.org/CodeSystem/v3-ActCode | repeated service | The same service was delivered within a time period that would usually indicate a duplicate billing. However, the repeated service is a medical necessity and therefore not a duplicate. |
| UNRELAT | http://terminology.hl7.org/CodeSystem/v3-ActCode | unrelated service | The service provided is not related to another billed service. For example, 2 unrelated services provided on the same day to the same patient which may normally result in a refused payment for one of the items. |
| VERBAUTH | http://terminology.hl7.org/CodeSystem/v3-ActCode | verbal authorization | The provider has received a verbal permission from an authoritative source to perform the service or supply the item being invoiced. |
FHIR
FHIRsmith{
"resourceType": "ValueSet",
"id": "R5-v3-ActInvoiceOverrideCode-for-R4",
"text": {
"status": "generated",
"div": "<!-- snip (see above) -->"
},
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode": "fhir"
},
{
"extension": [
{
"url": "packageId",
"valueId": "hl7.fhir.uv.xver-r5.r4"
},
{
"url": "version",
"valueString": "0.0.1-snapshot-2"
}
],
"url": "http://hl7.org/fhir/StructureDefinition/package-source"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger": 0,
"_valueInteger": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
"valueCanonical": "http://hl7.org/fhir/5.0/ImplementationGuide/hl7.fhir.uv.xver-r5.r4"
}
]
}
},
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-standards-status",
"valueCode": "trial-use",
"_valueCode": {
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-conformance-derivedFrom",
"valueCanonical": "http://hl7.org/fhir/5.0/ImplementationGuide/hl7.fhir.uv.xver-r5.r4"
}
]
}
}
],
"url": "http://hl7.org/fhir/5.0/ValueSet/R5-v3-ActInvoiceOverrideCode-for-R4",
"version": "0.0.1-snapshot-2",
"name": "R5_v3_ActInvoiceOverrideCode_for_R4",
"title": "Cross-version VS for R5.ActInvoiceOverrideCode for use in FHIR R4",
"status": "active",
"experimental": false,
"date": "2025-09-01T22:37:04.907511+10:00",
"publisher": "FHIR Infrastructure",
"contact": [
{
"name": "FHIR Infrastructure",
"telecom": [
{
"system": "url",
"value": "http://www.hl7.org/Special/committees/fiwg"
}
]
}
],
"description": "This cross-version ValueSet represents concepts from http://terminology.hl7.org/ValueSet/v3-ActInvoiceOverrideCode|2.0.0 for use in FHIR R4. Concepts not present here have direct `equivalent` mappings crossing all versions from R5 to R4.",
"jurisdiction": [
{
"coding": [
{
"system": "http://unstats.un.org/unsd/methods/m49/m49.htm",
"code": "001",
"display": "World"
}
]
}
],
"compose": {
"include": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version": "8.0.0",
"concept": [
{
"code": "COVGE",
"display": "coverage problem"
},
{
"code": "EFORM",
"display": "electronic form to follow"
},
{
"code": "FAX",
"display": "fax to follow"
},
{
"code": "GFTH",
"display": "good faith indicator"
},
{
"code": "LATE",
"display": "late invoice"
},
{
"code": "MANUAL",
"display": "manual review"
},
{
"code": "OOJ",
"display": "out of jurisdiction"
},
{
"code": "ORTHO",
"display": "orthodontic service"
},
{
"code": "PAPER",
"display": "paper documentation to follow"
},
{
"code": "PIE",
"display": "public insurance exhausted"
},
{
"code": "PYRDELAY",
"display": "delayed by a previous payor"
},
{
"code": "REFNR",
"display": "referral not required"
},
{
"code": "REPSERV",
"display": "repeated service"
},
{
"code": "UNRELAT",
"display": "unrelated service"
},
{
"code": "VERBAUTH",
"display": "verbal authorization"
}
]
}
]
},
"expansion": {
"timestamp": "2025-09-01T22:37:04.907507+10:00",
"contains": [
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version": "8.0.0",
"code": "COVGE",
"display": "coverage problem"
},
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version": "8.0.0",
"code": "EFORM",
"display": "electronic form to follow"
},
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version": "8.0.0",
"code": "FAX",
"display": "fax to follow"
},
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version": "8.0.0",
"code": "GFTH",
"display": "good faith indicator"
},
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version": "8.0.0",
"code": "LATE",
"display": "late invoice"
},
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version": "8.0.0",
"code": "MANUAL",
"display": "manual review"
},
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version": "8.0.0",
"code": "OOJ",
"display": "out of jurisdiction"
},
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version": "8.0.0",
"code": "ORTHO",
"display": "orthodontic service"
},
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version": "8.0.0",
"code": "PAPER",
"display": "paper documentation to follow"
},
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version": "8.0.0",
"code": "PIE",
"display": "public insurance exhausted"
},
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version": "8.0.0",
"code": "PYRDELAY",
"display": "delayed by a previous payor"
},
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version": "8.0.0",
"code": "REFNR",
"display": "referral not required"
},
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version": "8.0.0",
"code": "REPSERV",
"display": "repeated service"
},
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version": "8.0.0",
"code": "UNRELAT",
"display": "unrelated service"
},
{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActCode",
"version": "8.0.0",
"code": "VERBAUTH",
"display": "verbal authorization"
}
]
}
}