Kenya eClaims FHIR Implementation Guide
0.1.0 - ci-build KE

Kenya eClaims FHIR Implementation Guide - Local Development build (v0.1.0) built by the FHIR (HL7® FHIR® Standard) Build Tools. See the Directory of published versions

ValueSet: Coverage Exclusion Reason ValueSet

Official URL: https://fhir.dha.go.ke/eclaims/ValueSet/ExclusionVS Version: 0.1.0
Active as of 2026-05-19 Computable Name: ExclusionVS

ValueSet for reasons a service is excluded from coverage in Kenya health insurance (MOH-Kenya OCL: COVERAGE-EXCLUSION-REASON)

References

Logical Definition (CLD)

 

Expansion

Expansion performed internally based on codesystem Exclusion Code System v0.1.0 (CodeSystem)

This value set contains 7 concepts

SystemCodeDisplay (en)JSONXML
https://fhir.dha.go.ke/eclaims/CodeSystem/ExclusionCS  COSMETICCosmetic
https://fhir.dha.go.ke/eclaims/CodeSystem/ExclusionCS  EXPERIMENTALExperimental
https://fhir.dha.go.ke/eclaims/CodeSystem/ExclusionCS  ELECTIVEElective
https://fhir.dha.go.ke/eclaims/CodeSystem/ExclusionCS  OUT-OF-NETWORKOut of Network
https://fhir.dha.go.ke/eclaims/CodeSystem/ExclusionCS  NON-FORMULARY-DRUGNon Formulary Drug
https://fhir.dha.go.ke/eclaims/CodeSystem/ExclusionCS  INFERTILITYInfertility
https://fhir.dha.go.ke/eclaims/CodeSystem/ExclusionCS  PRE-EXISTING-CONDITIONPre Existing Condition

Explanation of the columns that may appear on this page:

Level A few code lists that FHIR defines are hierarchical - each code is assigned a level. In this scheme, some codes are under other codes, and imply that the code they are under also applies
System The source of the definition of the code (when the value set draws in codes defined elsewhere)
Code The code (used as the code in the resource instance)
Display The display (used in the display element of a Coding). If there is no display, implementers should not simply display the code, but map the concept into their application
Definition An explanation of the meaning of the concept
Comments Additional notes about how to use the code