FHIR IG analytics| Package | hl7.fhir.uv.xver-r5.r4b |
| Resource Type | ValueSet |
| Id | ValueSet-R5-v3-ActCoverageReason-for-R4B.json |
| FHIR Version | R4B |
| Source | http://hl7.org/fhir/uv/xver-r5.r4b/0.0.1-snapshot-2/ValueSet-R5-v3-ActCoverageReason-for-R4B.html |
| URL | http://hl7.org/fhir/5.0/ValueSet/R5-v3-ActCoverageReason-for-R4B |
| Version | 0.0.1-snapshot-2 |
| Status | active |
| Date | 2025-09-01T22:37:04.880519+10:00 |
| Name | R5_v3_ActCoverageReason_for_R4B |
| Title | Cross-version VS for R5.ActCoverageReason for use in FHIR R4B |
| Realm | uv |
| Authority | hl7 |
| Description | This cross-version ValueSet represents concepts from http://terminology.hl7.org/ValueSet/v3-ActCoverageReason|2.0.0 for use in FHIR R4B. Concepts not present here have direct `equivalent` mappings crossing all versions from R5 to R4B. |
No resources found
| CodeSystem | |
| v3-ActReason | ActReason |
Note: links and images are rebased to the (stated) source
Generated Narrative: ValueSet R5-v3-ActCoverageReason-for-R4B
This value set expansion contains 14 concepts.
| Code | System | Display | Definition |
| COVSUS | http://terminology.hl7.org/CodeSystem/v3-ActReason | 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). |
| DECSD | http://terminology.hl7.org/CodeSystem/v3-ActReason | deceased | Client deceased. |
| REGERR | http://terminology.hl7.org/CodeSystem/v3-ActReason | registered in error | Client was registered in error. |
| AGE | http://terminology.hl7.org/CodeSystem/v3-ActReason | 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. |
| CRIME | http://terminology.hl7.org/CodeSystem/v3-ActReason | 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. |
| DIS | http://terminology.hl7.org/CodeSystem/v3-ActReason | 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. |
| EMPLOY | http://terminology.hl7.org/CodeSystem/v3-ActReason | employment benefit | A person becomes eligible for insurance provided as an employment benefit based on employment status. |
| FINAN | http://terminology.hl7.org/CodeSystem/v3-ActReason | 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. |
| HEALTH | http://terminology.hl7.org/CodeSystem/v3-ActReason | 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 |
| MULTI | http://terminology.hl7.org/CodeSystem/v3-ActReason | 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. |
| PNC | http://terminology.hl7.org/CodeSystem/v3-ActReason | 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. |
| STATUTORY | http://terminology.hl7.org/CodeSystem/v3-ActReason | 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. |
| VEHIC | http://terminology.hl7.org/CodeSystem/v3-ActReason | 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. |
| WORK | http://terminology.hl7.org/CodeSystem/v3-ActReason | 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. |
FHIR
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"name": "R5_v3_ActCoverageReason_for_R4B",
"title": "Cross-version VS for R5.ActCoverageReason for use in FHIR R4B",
"status": "active",
"experimental": false,
"date": "2025-09-01T22:37:04.880519+10:00",
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"description": "This cross-version ValueSet represents concepts from http://terminology.hl7.org/ValueSet/v3-ActCoverageReason|2.0.0 for use in FHIR R4B. Concepts not present here have direct `equivalent` mappings crossing all versions from R5 to R4B.",
"jurisdiction": [
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"concept": [
{
"code": "COVSUS",
"display": "coverage suspended"
},
{
"code": "DECSD",
"display": "deceased"
},
{
"code": "REGERR",
"display": "registered in error"
},
{
"code": "AGE",
"display": "age eligibility"
},
{
"code": "CRIME",
"display": "crime victim"
},
{
"code": "DIS",
"display": "disability"
},
{
"code": "EMPLOY",
"display": "employment benefit"
},
{
"code": "FINAN",
"display": "financial eligibility"
},
{
"code": "HEALTH",
"display": "health status"
},
{
"code": "MULTI",
"display": "multiple criteria eligibility"
},
{
"code": "PNC",
"display": "property and casualty condition"
},
{
"code": "STATUTORY",
"display": "statutory eligibility"
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{
"code": "VEHIC",
"display": "motor vehicle accident victim"
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{
"code": "WORK",
"display": "work related"
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"expansion": {
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{
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"code": "DECSD",
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{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
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"code": "REGERR",
"display": "registered in error"
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{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
"version": "2.1.0",
"code": "AGE",
"display": "age eligibility"
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{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
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"code": "CRIME",
"display": "crime victim"
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"version": "2.1.0",
"code": "DIS",
"display": "disability"
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{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
"version": "2.1.0",
"code": "EMPLOY",
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{
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"version": "2.1.0",
"code": "FINAN",
"display": "financial eligibility"
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{
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"version": "2.1.0",
"code": "HEALTH",
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"version": "2.1.0",
"code": "MULTI",
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{
"system": "http://terminology.hl7.org/CodeSystem/v3-ActReason",
"version": "2.1.0",
"code": "PNC",
"display": "property and casualty condition"
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{
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{
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"version": "2.1.0",
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"display": "motor vehicle accident victim"
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{
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"version": "2.1.0",
"code": "WORK",
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}