HL7 - Version 2.3.1

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2.3.1

2.3.1 DE

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Data Structs

Table 0043: Condition code

Interpretation:	-
OID Table:	2.16.840.1.113883.12.43
Codesystem OID:	2.16.840.1.113883.18.19 Version 1
Value Set OID:	2.16.840.1.113883.21.22
Binding:
Expansion:	all codes from codesystem
Vocabulary Domain:	tbd
Table Type:	User
Case insensitive:	Falsch
Section	6

Value	Description	German Interpretation
01	Military service related
02	Condition is employment related
03	Patient covered by insurance not reflected here
04	HMO enrollee
05	Lien has been filed
06	ESRD patient in first 18 months of entitlement covered by employer group health insurance
07	Treatment of non-terminal condition for hospice patient
08	Beneficiary would not provide information concerning other insurance coverage
09	Neither patient nor spouse is employed
10	Patient and/or spouse is employed but no EGHP exists
11	Disabled beneficiary but no LGHP
13	Payer codes.
16	Payer codes.
14	Payer codes.
12	Payer codes.
12 ... 16	Payer codes.
15	Payer codes.
18	Maiden name retained
19	Child retains mother’s name
20	Beneficiary requested billing
21	Billing for Denial Notice
26	VA eligible patient chooses to receive services in a medicare certified facility
27	Patient referred to a sole community hospital for a diagnostic laboratory test
28	Patient and/or spouse’s EGHP is secondary to Medicare
29	Disabled beneficiary and/or family member’s LGHP is secondary to Medicare
31	Patient is student (full time-day)
32	Patient is student (cooperative/work study program)
33	Patient is student (full time-night)
34	Patient is student (Part time)
36	General care patient in a special unit
37	Ward accommodation as patient request
38	Semi-private room not available
39	Private room medically necessary
40	Same day transfer
41	Partial hospitalization
46	Non-availability statement on file
48	Psychiatric residential treatment centers for children and adolescents
55	SNF bed not available
56	Medical appropriateness
57	SNF readmission
60	Day outlier
61	Cost outlier
62	Payer code
66	Provider does not wish cost outlier payment
67	Beneficiary elects not to use life time reserve (LTR) days
68	Beneficiary elects to use life time reserve (LTR) days
70	Self-administered EPO
71	Full care in unit
72	Self-care in unit
73	Self-care training
74	Home
75	Home - 100% reimbursement
76	Back-up in facility dialysis
77	Provider accepts or is obligated/required due to a contractual arrangement or law to accept payment by a primary payer as payment in full
78	New coverage not implemented by HMO
79	Corf services provided off-site
80	Pregnant	schwanger

Comments made by the German HL7 User Group:

Used Within the following Data Elements

00536 Condition Code (35-39) / nicht verwendet (6.4.10.7)

00555 Condition Code (24-30) / nicht verwendet (6.4.11.3)

Links to Other/Further HL7 Information

generated: Aug 07, 2023 (FO)

Health Level Seven, Int. (HQ)

HL7 Germany
HL7 Europe

Frank Oemig's HL7 Site
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HL7-Experts Network