| Package | hl7.terminology |
| Resource Type | CodeSystem |
| Id | medical-management-type |
| FHIR Version | R5 |
| Source | http://terminology.hl7.org/https://build.fhir.org/ig/HL7/UTG/CodeSystem-medical-management-type.html |
| URL | http://terminology.hl7.org/CodeSystem/medical-management-type |
| Version | 1.0.0 |
| Status | active |
| Date | 2025-08-07T21:08:36+00:00 |
| Name | MedicalManagementType |
| Title | Medical Management Type |
| Realm | uv |
| Authority | hl7 |
| Description | Types of medical management requirements or processes used by health insurers (payers) that may impact whether a service or item is covered or reimbursement rates. |
| 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 |
| Content | complete |
| ValueSet | |
| medical-management-type | Medical Management Type |
No resources found
Note: links and images are rebased to the (stated) source
Generated Narrative: CodeSystem medical-management-type
Last updated: 2025-05-26 00:00:00+0000
Profile: Shareable CodeSystem
This case-sensitive code system http://terminology.hl7.org/CodeSystem/medical-management-type defines the following codes:
{
"resourceType": "CodeSystem",
"id": "medical-management-type",
"meta": {
"lastUpdated": "2025-05-26T00:00:00+00:00",
"profile": [
"http://hl7.org/fhir/StructureDefinition/shareablecodesystem"
]
},
"text": {
"status": "generated",
"div": "<!-- snip (see above) -->"
},
"extension": [
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-wg",
"valueCode": "fm"
},
{
"url": "http://hl7.org/fhir/StructureDefinition/structuredefinition-fmm",
"valueInteger": 1
}
],
"url": "http://terminology.hl7.org/CodeSystem/medical-management-type",
"identifier": [
{
"system": "urn:ietf:rfc:3986",
"value": "urn:oid:2.16.840.1.113883.5.175"
}
],
"version": "1.0.0",
"name": "MedicalManagementType",
"title": "Medical Management Type",
"status": "active",
"experimental": false,
"date": "2025-08-07T21:08:36+00:00",
"publisher": "Health Level Seven International",
"contact": [
{
"telecom": [
{
"system": "url",
"value": "http://hl7.org"
},
{
"system": "email",
"value": "hq@HL7.org"
}
]
}
],
"description": "Types of medical management requirements or processes used by health insurers (payers) that may impact whether a service or item is covered or reimbursement rates.",
"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",
"caseSensitive": true,
"valueSet": "http://terminology.hl7.org/ValueSet/medical-management-type",
"content": "complete",
"concept": [
{
"code": "concurrent-review",
"display": "Concurrent Review",
"definition": "Review of medical necessity while the patient is actively receiving treatment."
},
{
"code": "prior-auth",
"display": "Prior Authorization",
"definition": "Review of medical necessity prior to receiving treatment."
},
{
"code": "step-therapy",
"display": "Step Therapy (Fail First)",
"definition": "Requirement that lower cost or preferred treatments be tried, or perhaps contra-indicated, before alternatives are utilized. This policy is sometimes referred to as 'fail first'."
}
]
}